How Exercise Helps Ease Depression, and How Much You Actually Need

When you're struggling, hearing “you should exercise more” can feel like being brushed off. I get that. But the research shows that moving your body really does change how your brain works, and you don't need to train for a marathon to feel it.

Why I Wanted to Write About This

Depression is one of the most common things I see in my practice. Worldwide, it affects more than 264 million people, and the World Health Organization ranks it as a leading cause of disability. Therapy and medication help a lot of my patients. But therapy can be hard to find, and antidepressants can take weeks to kick in, come with side effects, and don't work for everyone.

Living overseas can make all of this harder. Finding an English-speaking therapist in Japan isn't always easy, and a move, a deployment, or a long gray winter can weigh on anyone. That's why I want every one of you to know about exercise as a tool. It's free or close to it, you can do it almost anywhere, and the science behind it is solid.

What the Research Looked At

A team of researchers in South Korea recently published a review in the Journal of Exercise Rehabilitation that pulls together clinical trials, long-term studies, and earlier reviews up through late 2023. What I like about it is that it goes beyond asking whether exercise helps with depression. It asks how: what actually changes in your brain, your hormones, your immune system, and your daily routine.

They also looked at which kinds of exercise have been studied, how much seems to matter, and how exercise fits in alongside therapy and medication.

What Moving Does for Your Brain and Body

Here's the part I find encouraging. Exercise doesn't just help in one way. It works on several fronts at once:

• Brain chemistry. Exercise boosts endorphins, serotonin, dopamine, and norepinephrine. These are the same mood messengers many antidepressants work on.
• Brain growth. It raises BDNF, a protein that helps brain cells grow and connect. People with depression often have low levels of it.
• Inflammation. Long-running inflammation in the body is increasingly linked to depression, and regular exercise helps turn it down.
• Stress hormones. Over time, exercise lowers your resting cortisol and helps your body handle stress better.
• Sleep. It helps reset your body clock and gives you deeper sleep, which so often falls apart with depression.
• Mind and habits. It breaks the cycle of pulling away from things, quiets the looping thoughts, and gives you a sense of accomplishment. Doing it with others adds connection too.

Which Kinds of Exercise Help, and How Much

There's no single “right” workout, which I think is good news. The review found benefits from several types:

• Aerobic exercise like brisk walking, cycling, swimming, or running. This is the most studied, and it helps most with mild to moderate depression.
• Strength training with weights or resistance bands. It's linked to real drops in depression symptoms and is easier on the joints than a lot of cardio.
• Yoga, which brings together movement, breathing, and focus. The results are encouraging, including for people with clinical depression.
• Tai chi and qigong, slow and mindful movement that worked especially well for older adults.

The general goal is at least 150 minutes of moderate activity a week, which works out to about 30 minutes on most days, or 75 minutes of harder activity. But please don't let that number scare you off. Any movement counts. Even a 10-minute walk can lift your mood. What matters most is choosing something you enjoy enough to keep doing, because the benefits build up over weeks and months.

A Few Things I Want You to Keep in Mind

• Exercise works alongside treatment, not instead of it. Even the researchers say it shouldn't replace therapy or medication. If you're on an antidepressant, please don't stop it on your own. Talk with me or your doctor first.
• The evidence is strongest for mild to moderate depression. If your depression is severe, you'll likely need more support than a workout plan, and that's completely okay.
• Some of the science is still being worked out. A few of the brain and hormone findings come from animal or small studies, and we still don't know exactly who benefits most from which type of exercise.
• Depression makes getting started hard. Low energy and low motivation are symptoms of the illness. They aren't a sign that you're lazy or doing something wrong. Starting small is the plan, not a shortcut.

What You Can Actually Do

• Start with 10 minutes. A short walk after dinner or around the neighborhood is a real start. Add a little more as it gets easier.
• Pick something you'll actually do. Walking, a class at the base gym, swimming, yoga, or a weekend hike in the Tanzawa mountains. Enjoying it matters more than how hard it is.
• Bring someone along. A walking buddy, a group class, or a local sports club adds connection, and that helps on its own.
• Plan around Japan's seasons. In the sticky summer months, go early in the morning or exercise indoors. In winter, try to get outside while it's still light.
• Add some strength or mind-body work. Two sessions a week of strength training, yoga, or tai chi round things out nicely, especially if your joints limit cardio.
• Keep your care team in the loop. If you're on medication or seeing a therapist, add exercise on top of that. And if you have heart, joint, or other health concerns, check with us before you start.
• Reach out if you're struggling. If your low mood has lasted more than two weeks, please come see us. If you ever have thoughts of hurting yourself, contact your doctor or a crisis line right away.

If you've been feeling low, I'd really like to help you build a plan, whether that means exercise, therapy, medication, or some of each. Come in and we'll figure out a starting point that fits your health and your life here.

Partnering in your care,

Dr. Kenji Taylor, MD

Torii Health & Iris Dental and Medical