You’ve probably heard that exercise can lessen depression and anxiety, but how good is it compared to medication and talk therapy? Also what is happening in the brain that promotes depression and anxiety and can exercise change that? Finally, what type of exercise is the best for depression and exercise ?
Let’s start with how good is exercise compared to medication and talk therapy? Turns out pretty damn good. “meta-analytic evidence suggests that exercise is a promising treatment for depression in adults, showing effects that are comparable to other first-line treatments for depression.” and “There is no evidence for a difference in the effectiveness of exercise relative to psychotherapy and pharmacotherapy in treating depression.” In addition “. . .exercise has a small long-term effect on depressive symptoms post-treatment.”  So it seems that not only can exercise help in the short term with reducing the feelings around depression, it can help over the long term as well.
Yet as pro-exercise as a person as I am, I wouldn’t suggest you throw out your medication and cancel your next therapy session in place of exercise. But by adding in physical activity into your routine looks to be a great addition to other types of therapies.
So what is happening in the brain that promotes depression?
This is actually a complex question to answer and way above my pay grade, so I’m going to keep this simple and focus on two potential contributing factors: the volume of the hippocampus and the amount of the neurotransmitter glutamate has an effect on mood disorders including depression.
There is a significant volume of research that shows a strong correlation between the volume size of the hippocampus and depression. With a smaller volume frequently showing up in people with depression. Secondly there is a large body of research that shows that less of the amount of neurotransmitter glutamate can contribute to depression. So how can exercise improve these issues?
It looks like with consistent long term exercise you can have a better glutamate response and a fatter hippocampus (and who doesn’t want that!)
“[A] cross-sectional study in older adults found that high levels of exercise engagement may mitigate the cumulative adverse effects of lifetime stress on hippocampal volume in late life.”
“In one study, self-reported physical activity (PA), measured by how many blocks an individual walks on average per week, were predictive of greater hippocampal volume nine years later.” 
While an animal study the researchers found “[that their] results point to a modulation of glutamatergic synapses by exercise with likely implications in the exercise-induced mental health.” 
Now the question is what is the best form of exercise to reduce the symptoms of depression?
This answer isn’t too clear cut, with some studies showing cardiovascular exercise to be superior to resistance training  and other studies showing no difference between different forms of exercise.  These results are actually freeing. You don’t consider optimal forms of exercise when you are depressed, if you can just get up and move it’s a win. And if you enjoy doing cardio like walking or cycling or lifting weights doesn’t matter, both will help you feel better. Yet if you want to get the most from whatever exercise you choose there is evidence that working at a higher intensity shows greater improvements over lower intensity exercise. So if you are going for a walk, walk fast and if you are going to lift weights, lift heavy. 
While there are very effective pharmacological and psychological solutions to reducing or reversing depression, don’t overlook exercise. It’s an inexpensive and accessible form of antidepressant.
Geof has been working with bariatric surgery clients for over a decade. His goal with Coaching For Bariatric Success is to give you the tools to make your weight loss successful for the long term.