Sunday, April 12, 2015

Two weeks in...

And I feel better. In the last two weeks I have gone to the gym 12 days. Worked out for at least an hour. Done some cardio, some weight lifting. And I feel better. Not just physically, but mentally. I've been told for years that exercise will help with depression and anxiety. That's all well and good, in theory. But if you live with depression, you know just how hard it is to get up and do something, anything. When you don't want to get out of bed, you certainly don't want to go to the gym and be around other people, and sweat, and lift things for fun. You want to pull the blanket back over your head, give the world the finger and wait to die. It goes much deeper than a simple lack of motivation, or being "lazy", as so many like to say. Many of our brains simply don't work the same way as others. Getting out of bed may as well be climbing Mt. Everest. But we do it. I do it. Every single day. Exercise is pretty much the same. Every day, I have to force myself to go, but once I do I'm glad I did.

I will say that the first few days were HARD. I did not want to do it. I wanted to stay in my house, in my chair, doing what I always do. My god, people might see me and laugh, or, horrors of horrors, say something to me. But mostly, I just didn't want to do anything. Because that's what depression does to me. It robs me of my motivation, my ambition, my will to do. I had to force myself to go in the doors. It was a struggle to leave the locker room. Stepping on the treadmill was like walking to Mars. And I did it. And I'm glad I did it. Because I feel better. The second day was a little easier, as was the third, and fourth. At the end of two weeks I look forward to going. I go for me. I don't care if people look. I don't care if they comment. But to be honest, they really don't. I get mostly looks of encouragement and kind words. I suppose that has some to do with the gym that I joined. I was very aware of the clientele, the demographic. I think that is probably the most important factor when choosing a gym.

If you feel uncomfortable, you won't go. If you feel like people are pointing and laughing, you won't go. And yes, that does happen in some gyms. I personally had a person ask me; "why's a fattass like you bothering?", I didn't ever go back to that gym. I suppose I could have approached it differently, but I wasn't ready at that point in my life. I simply left, asking myself why I was bothering, what was the point? Went home, wallowed in self pity and crappy food and gained some more weight. So finding a gym that is welcoming, that doesn't allow that type of douchebaggery, that you will keep going back to, is very important. And I seem to have found that.

There are countless articles, books, research papers and opinions detailing the benefits of exercise for depression and anxiety. The Mayo Clinic has this to say:

Regular exercise probably helps ease depression in a number of ways, which may include:
  • Releasing feel-good brain chemicals that may ease depression (neurotransmitters, endorphins and endocannabinoids)
  • Reducing immune system chemicals that can worsen depression
  • Increasing body temperature, which may have calming effects 
It doesn't take a great deal of time to experience the benefits. You don't need to become a gym rat, or start running marathons. Doing 30 minutes or more of exercise a day for three to five days a week may significantly improve depression symptoms. But smaller amounts of physical activity — as little as 10 to 15 minutes at a time — may make a difference. It may take less time exercising to improve your mood when you do more-vigorous activities, such as running or bicycling.

The mental health benefits of exercise and physical activity may last only if you stick with it over the long term — another good reason to focus on finding activities that you enjoy. WebMD has another decent article on the benefits of exercise for depression. Here's some of their pointers:

  • Choose an activity you enjoy. Exercising should be fun.
    • I think this is probably the single most important point and one that can't be stressed enough. As in choosing your gym, what exercise you choose to do has to be fun. Or at the least, not something you hate doing. If you don't enjoy it you won't do it. If you enjoy it, you'll have fun doing it and thus do it more often. I think this is especially true for those of us living with depression. It's hard enough to get motivated, it's almost impossible if you don't like what it is you're trying to get motivated to do
  • Put your exercise routine into your schedule. If you need reminding, put it on your calendar.
  • Variety is the spice of life. Make sure you vary your exercises so that you don't get bored. Check your local gymnasium or community center for an assortment of exercise programs.
    • Most larger gyms offer one or two free sessions with a personal trainer when you join. Use them. Talk to them, be honest about what you need and what you think you're capable of doing. Most importantly, be honest with yourself. 
  • Don't let exercise programs break the bank. Unless you are going to be using them regularly, avoid buying health club memberships or expensive equipment.
  • Stick with it. If you exercise regularly, it will soon become part of your lifestyle and will help reduce your depression.

The Special Health Report from Harvard Medical School, “Understanding Depression”, has some very interesting points taken from various studies on depression and various treatment levels. 

Another study, published in the Archives of Internal Medicine in 1999, divided 156 men and women with depression into three groups. One group took part in an aerobic exercise program, another took the SSRI sertraline (Zoloft), and a third did both. At the 16-week mark, depression had eased in all three groups. About 60%–70% of the people in all three groups could no longer be classed as having major depression. In fact, group scores on two rating scales of depression were essentially the same. This suggests that for those who need or wish to avoid drugs, exercise might be an acceptable substitute for antidepressants. Keep in mind, though, that the swiftest response occurred in the group taking antidepressants, and that it can be difficult to stay motivated to exercise when you’re depressed.

A follow-up to that study found that exercise’s effects lasted longer than those of antidepressants. Researchers checked in with 133 of the original patients six months after the first study ended. They found that the people who exercised regularly after completing the study, regardless of which treatment they were on originally, were less likely to relapse into depression.

I can say from personal experience that I feel much better after a trip to the gym than I ever did while taking medication. While I know that the medication I took has a great deal to do with the fact that I'm alive today, it was not a long term solution. I eventually reached a point where the medication no longer had much of an effect on me. It did its job, no doubt about that, but it's only capable of doing so much. I wish I had started exercising regularly while still taking them. But again, finding and keeping motivation when depressed is very difficult.

When it comes to workouts that fight depression, aerobic and cardio exercises have the edge. “To date, the strongest evidence seems to support aerobic exercise,” says Dr. Muzina. While the correct "dose" of depression-fighting exercise is up for debate, some experts recommend 20 to 30 minutes most days of the week. A recent review of numerous scientific studies found no association between the intensity level of the exercise and its emotional benefit — so simply moving more is a great start. The more you move the better you feel, the better you feel the more you want to move. 


Sources:
Mayo Clinic: Depression and anxiety: Exercise eases symptoms 
WebMD:       Exercise and Depression
Harvard Health Publications: Exercise and Depression

No comments: