How to Exercise While Experiencing a Major Depressive Episode

This perspective article aims to provide and promote different body movement methods during a major depressive episode.

It is well-researched and proven that regular exercise has numerous positive outcomes for the body and mind. For the body, such includes strengthening the muscles, bones, heart, and lungs and helping to prevent certain diseases. 

Optimisation of physical exercise increases mental competencies, such as perseverance and retrieval of top performance, as well as dealing with nervousness, the pressure of expectation and fear of failure. Many studies have examined the efficacy of exercise in reducing symptoms of depression, and most of these studies have described a positive benefit associated with an activity. One of the interventions clinicians prescribe to have better health, emotional well-being and lower rates of mental illness is physical exercise. 

However, this may not be the case for everyone, especially those with sub-threshold, mild and moderate depressive symptoms. But what about those going through a major depressive episode? How realistic is this advice going to be? For example, how does one exercise when in a depressive episode? Is there specific guidance on the optimum style, intensity and duration of physical activity required to produce a therapeutic effect?

An effective coach shares their experiences and lessons for others to know they are not alone in their struggles. I have been through depressive episodes. I had wanted to look and feel good by exercising; sometimes, I couldn't motivate myself to wake up and go to the gym. Instead, exercise or thoughts of any physical activity caused me great anxiety, guilt and, subsequently – stress—quite the opposite feelings from what general doctors claim. 

What is a major depressive episode?

A major depressive episode is diagnosed when an individual has a persistently low or depressed mood, anhedonia or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts. Major depression is more than a passing blue mood, a "bad day", or temporary sadness. The symptoms of major depression are defined as lasting at least two weeks, but usually, they go on much longer — months or even years. 

I am not disputing that people shouldn't exercise when experiencing depression; far from it. But, remember, this is a very precarious time for the individual. We aren't considering increasing happy hormones or endorphins because we are dealing with an existential threat. Rather, we are filled with feelings of failure and unworthiness. It's a period of despair, and we must create feelings of safety.

I point out that such a recommendation will likely overwhelm someone currently sedentary and depressed. Therefore, it would be constructive if there were a host of guidance and advice on what the exercise would look like during this period. For example, in what ways can a person in the various stages of depression exercise? What does that look like? What should the duration, intensity, length and frequency be before recognising a significant reduction in the depressive mood?

I attempt to get people to define it for themselves rather than calling it exercise or physical exercise, which sounds quite overwhelming. So I called mine – "How I can move my body during "pit season."

These are some effective remedies that work for me during pit season. Most are anaerobic exercises such as strength training, relaxation, coordination, and flexibility. I discount length, intensity and fitness gains as my priority during this period is to continue creating energy, gently reminding my brain and body that I am alive.

Move your body. Realise energy that is bound up and locked in your body. Continue creating energy.

1. Small movements. Get up and move. The point is to leave the bed or couch to add movement to the day to release bound energy and continue creating energy in the body. For example, leave the bed, go to the bathroom, try brushing your teeth, and take a shower. Later, you can try shrugging your shoulders or massaging your feet. Perhaps attempt household chores.

2. Stretching. I accidentally stumbled across this, and it has become one of my favourite daily activities. Stretching has numerous benefits, and I have come to enjoy this. I usually start with the area in my body where I feel the most tension. Then, I slowly stretch out that area, focusing energy on the tension. Next, I inhale and exhale, creating breath patterns while focusing on that area as if trying to breathe into the tension. It's a beautiful feeling when done correctly. Here is a video to help teach you how to breathe. It's also great when experiencing panic attacks.

3. Music and dance. Music is a fantastic way to move your body to create energy if you love music and can still stomach any sound during this period. Once, I made it my mission to dance to Rudimental's "Feel the Love" from start to finish. After that, I danced to it several times and felt like I had accomplished something.

4. Walking. I naturally love walking, and this helps me immensely when I am in a depressive episode. During this period, I walk for the sake of walking. I don't time myself or wear a pedometer. The walks are sometimes brief, and low intensity and fitness gains are not necessary. I walk in nature as much as possible and use a treadmill during inclement weather.

5. Yin yoga. Another favourite, but it may only work for some. Yin is a style of yoga that targets the deep connective tissues, bones, joints, fascia, and ligaments in the body. It also focuses on stretching and stimulating different acupressure points from traditional Chinese medicine. There are numerous studios, both in real life and on the internet. My favourite internet instructors are Travis Eliot and Jessica Richburg. Check out their YouTube channel for full videos.

6. Swimming. Admittedly, I don't get to do this enough, but the times I do, I find this extremely therapeutic – perhaps it's the feel of the water on my body or because I get to move my body simultaneously. Like walking, I focus on moving my body, not fitness gains.

Takeaway

• First, work on the frequency comfortably for a manageable time (e.g., 10 minutes). Once you become confident that the exercise/body movement frequency is under your control, the duration of the exercise/body movement can gradually be increased.

• Exercise during this depressive cycle need not be lengthy or intense to enhance mood. For people with a low fitness level, which characterises most people in the depressive cycle, moderate-intensity exercise (60%–80% maximum heart rate) generally produces greater enjoyment than more intense activity.

• Results are equivocal as to whether the time of day of exercise plays a role in this relationship. As such, exercise at a time that is most convenient for you. For some people, depressive symptoms worsen later in the day, and exercise may be easier to schedule and manage if conducted in the morning or afternoon. 

  "It's all about how you feel, not how you look." - Sean Covey.

Major depressive episodes are often recurring, albeit some people may only ever experience one episode in their entire lives. Therefore, it is equally important to understand what it feels like to go through one of these episodes and practise self-care and health habits. Furthermore, given the challenging cognitive and affective features of depression, perhaps recommendations such as exercise for individuals with depression should be delivered by professionals with specific experience in mental health care.

In other words, a well-integrated, tailored and collaborative approach is essential for the individual without further exacerbating the stress hormones.

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Faith Kayiwa Nababi is a Leadership Consultant, Intercultural Coach and Mental Wellness Advocate at Tailormade Consultancy, a global service agency that empowers executives to make the best strategic decisions, create value and purpose for the people they lead, and catalyse conscious change.