How exercise can help in recovery from depression – How Much, What Kind, and the Science Behind It

The Cycle of Depression

Understanding depression involves recognising a cycle where we experience a loss of incentive - things do not feel good like they used to - and as life becomes less rewarding, we disengage, do less - why would I do that if it doesn't feel good - resulting in symptoms like sadness, low self-esteem, and biochemical changes. This, in turn, causes more withdrawal behaviours, which reinforce the cycle of depression - as we do less, as wel experience less reward, we feel more depressed. One of the key strategies to break this cycle is increasing activity, including exercise.

A common misconception is that you should wait until you feel better to start being more active. In reality, increasing your activity level can help you feel better sooner. Engaging in exercise—even when you don't feel like it—can initiate a positive feedback loop that breaks the cycle of depression.

Starting small and gradually increasing your activity level is crucial. Incorporating a range of activities, including social, enjoyable, productive, and achievement-based tasks, can enhance the benefits; and all of this needs to be BALANCED:

B - Behavioural Activation

• Getting into action with purpose and intention. Making intentional choices to engage in various activities throughout the day can lift mood and energy.

A - Achievement

• Set small, achievable goals. It can be anything from completing a chore to tackling a personal project—anything that gives a sense of accomplishment.

L - Learning

• Engage in activities that challenge your mind and promote growth, like reading, exploring a new hobby, or practicing a skill.

A - Activity (Areobic Exercise)

• Physical activity, even in small amounts, releases endorphins and boosts mood. From gentle walks to more vigorous exercise - movement helps.

N - Nature

• Spend time outside, whether it’s a walk in a park, gardening, or just sitting in the sunlight; looking at a picture oof natural surroundings; getting a candel that smells of a forest of the sea. Nature has a grounding and calming effect.

C - Connection

• Nurture social interactions and relationships. Talking to friends, family, or even engaging in social hobbies helps reduce loneliness. Joining a group exercise class or walking with a friend.

E - Enjoyment

• Make time for activities you love, whether they’re simple pleasures or hobbies that bring joy and laughter. Choosing activities you love,dancing, swimming, hiking - choose something you love and used to enjoy, don't pick something you think you should like - if you never liked hitting the gym, it is unlikely to be the activity that helps fight your depression.

D - Development

• Focus on things that foster a sense of progress and purpose. Personal growth can come from setting new goals or trying new things that build self-confidence.

How much activity do I need to do?

When it comes to improving mental health, exercise is often recommended as a powerful tool to boost mood, reduce anxiety, and counter symptoms of depression. But how much exercise do we really need? And which activities work best? New research suggests that achieving mental health benefits may require higher levels of exercise than previously thought, with specific types and amounts needed for optimal results.

Exercise is proven to help people recover from depression and other mental health issues. But with so many types of exercise and recommendations out there, it’s easy to wonder how much we really need. The latest research sheds new light on this by identifying a higher minimum "dose" of exercise for people with major depressive disorder (MDD), than the baseline recommended by WHO and the NHS.

A 2024 meta-analysis looked at the effects of four main types of exercise—aerobic, resistance, mind-body, and mixed (combined aerobic and resistance)—on depressive symptoms. The findings showed that all types of exercise offered significant mental health benefits, but aerobic and mind-body exercises (like yoga, weight lifting and Pilates) provided the best results.. The study also introduced higher-than-expected minimum and optimal exercise recommendations, noting a U-shaped relationship between the amount of exercise and the improvement in symptoms.

For instance:

• Minimum Effective Dose: Approximately 320 MET-minutes (METs-min) per week was needed to see improvements.

• Optimal Dose: For maximum benefit, around 860 METs-min per week was recommended.

So what exactly is a MET, and how does it translate into real-world exercise time? Let's break it down:

When it comes to choosing an exercise plan, the best activity is one you actually enjoy. The study emphasised that engaging in activities you like can boost adherence and make it easier to meet these exercise recommendations. Here’s a handy guide to how much time you might need for different types of activities, based on the research findings.

MET (Metabolic Equivalent of Task) Explained

A MET measures the amount of energy expended during an activity relative to resting. For example:

- 1 MET is the amount of energy you’d expend sitting quietly.

- 3 METs would be light activities like slow walking.

- 10 METs or more is very intense exercise, like skipping rope at a moderate pace.

To reach the minimum dose for mental health benefits (320 METs-min per week), or the optimal dose (860 METs-min per week), you can choose from different exercises based on MET values and duration. Here’s a practical breakdown:

Common Activities and Their Minimum/Optimal Times Per Week

Activity	MET Value	Minimum Time (320 METs-min)	Optimal Time (860 METs-min)
Walking	3.5	90 minutes	245 minutes
Moderate Aerobic	6.0	53 minutes	143 minutes
Running	10.0	32 minutes	86 minutes
Skipping	11.0	29 minutes	78 minutes
Hiking	6.0	53 minutes	143 minutes
Gardening	4.0	80 minutes	215 minutes
Bodyweight Exercise	8.0	40 minutes	108 minutes
Yoga	4.0	80 minutes	215 minutes
Pilates	3.5	90 minutes	245 minutes
Heavy Weights	6.0	53 minutes	143 minutes
HIIT	10.0	32 minutes	86 minutes
Cycling	8.0	40 minutes	108 minutes
Swimming	7.0	46 minutes	123 minutes
Rowing	7.0	46 minutes	123 minutes
Badminton	5.5	58 minutes	157 minutes
Tennis	7.0	46 minutes	123 minutes
Football	8.0	40 minutes	108 minutes
Squash	10.0	32 minutes	86 minutes

So, if you love skipping, you could reach the optimal 860 METs-min in around 11 minutes per day. Prefer walking? You’ll need 35 minutes per day to hit the same mark.

Tips for Getting Started

1. Start Small: If these times seem overwhelming, start with the minimum effective dose and build up gradually. Even if it does not meet the minimum dose, the first step is to build the habit - just do the first 5 minutes, and if you want to continue, great, if not, no proble, you met that goal.

2. Mix and Match: Combine different types of activities to keep things interesting and work different muscle groups.

3. Include Enjoyable Activities: Gardening, walking with a friend, or even dancing can help increase overall activity levels in a way that feels less like “exercise.”

4. Remember Social Activities: Engaging in group activities, like tennis or football, can bring social interaction into the mix, which has additional mental health benefits.

The Nerdy Bit: How To Calculate Your Personal Recommendations

Curious about the science behind these calculations? Let’s get into the specifics of MET values and how individual factors can tweak your recommended dose.

What is a MET?

A MET (Metabolic Equivalent of Task) is a measure of how much energy an activity consumes compared to resting:

- 1 MET is equivalent to the energy used while at rest.

- Higher MET values represent activities that burn more energy. For instance, running at 10 METs means you're burning 10 times more energy than when resting.

Adjusting METs for Body Weight

Standard MET values are based on a body weight of around 70 kg (154 lbs). If you weigh more or less than this, you can adjust your exercise requirements accordingly using the formula:

For example, If you weigh 80 kg and are doing an activity with a MET of 10 (like running), your adjusted MET value would be:

Then, using this adjusted MET, you can calculate how long you need to do the activity to meet the recommended METs-min goals:

1. Body Composition: Individuals with higher muscle mass may have a slightly higher metabolic rate, though MET values don’t typically adjust for this directly.

2. Age and Gender: Age can impact metabolism, and men and women may have different metabolic efficiencies due to body composition differences.

3. Fitness Level: Fitter individuals may find intense exercises less taxing, potentially reducing their METs for specific activities.

The best exercise for mental health is the one you enjoy and can stick to. This research provides new guidelines for minimum and optimal exercise doses, giving you specific goals based on your favorite activities. Whether it’s walking, skipping, or gardening, a few hours of movement each week can make a meaningful difference in mood, energy, and motivation. And if you’re a numbers person, adapting MET values based on body weight can fine-tune your approach for even more accurate results.

Happy moving – and here’s to better mental health through the power of exercise!

Reference:

Tian S, Liang Z, Qui F, Yu Y, Wang C, Zhang M, Wang X. Optimal exercise modality and dose to improve depressive symptoms in adults with major depressive disorder: A systematic review and Bayesian model-based network meta-analysis of RCTs. J Psychiatr Res. 2024 Aug;176:384-392. doi: 10.1016/j.jpsychires.2024.06.031. Epub 2024 Jun 25. PMID: 38944017.

Link: https://pubmed.ncbi.nlm.nih.gov/38944017/