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Can Exercise Cure Depression?
Alone or in combination with drugs and talk therapy, exercise is proving itself to be an effective treatment for depression, especially for women in midlife. Set off on your road to recovery.

By Laura Fraser

Running from Depression

As Maureen Gibson dashed across the finish line at New York City's Fifth Avenue Mile race, friends from her running group, Mothers Across America (MAAM), cheered wildly. Afterward, they surrounded and hugged her as she wiped away the tears and sweat streaming down her face. At 58, Gibson had just run the fastest mile in her life -- in seven-and-a-half minutes -- and she was elated.
With her exuberant red hair, youthful freckles, and obvious energy, Gibson seems an unlikely candidate for depression. But like several other women on her team, she has had long periods when it felt as if all she could do was sleep or cry -- staying at home, listless, fearful of everything. The worst was the postpartum depression that hit after she had her first baby, at 47. She and her husband were thrilled with the surprise pregnancy -- after 15 years of marriage, they had long since given up -- but after the baby was born, Gibson spiraled into an anxious, unshakable dark mood. "I knew I had so much to be grateful for, and everyone was so supportive, but I couldn't pull myself back up," she says.
Her worst bouts of depression lasted on and off for eight years, despite psychological treatments, as she went straight from depression to perimenopause. In 2003, in the midst of one of her blackest moods, she saw a poster at her daughter's school of a mother and daughter running -- MAAM founder Charlotte Gould with then 3-year-old India -- that asked "Do you want to run a marathon?" The idea of a mothers-only running group sparked something inside Gibson, who had been a runner years before. For what seemed the first time in months, she said yes to something.
It was tough for Gibson to show up for her first MAAM run. "I pictured a bunch of twenty-somethings, and I didn't want to seem like Grandma," she says. But the other women -- all mothers, and most over 40 -- were supportive and understanding. From that first day, Gibson felt better. After several weeks, the sense of well-being became more than an afterglow of exercise; it was something she woke up with. "Physically, running got me back into shape; emotionally, it gave me stability," she says. Exercise hasn't cured her depression, but it's given her a powerful tool to cope. "When I'm exercising, I'm less prone to depression; when I'm depressed, it's treatment for the problem." Just eight months after she joined MAAM, Gibson ran her first marathon.
The Sweat Effect
Although rarely prescribed by physicians or psychologists, exercise can be a profound means of preventing and treating mild to moderate depression. Numerous studies have shown that the more you exercise, the less likely you are to be depressed. Regular exercise (it doesn't have to be training for a marathon) also significantly reduces levels of existing depression at all ages, though the effect is strongest in people who are middle-aged and older. It works equally well for both sexes, but because twice as many women as men are clinically depressed -- 21 percent of us experience at least one major depressive episode -- it may be twice as important for women to get moving.
Studies comparing exercise with psychotherapy and drugs show that, overall, it is at least as effective in alleviating mild to moderate clinical depression. (But every case is different, so you should always talk with a professional if you are depressed.) The effects of exercise are more immediate and enduring. "When you first start exercising, you feel a marvelous head-clearing relief and calm afterwards," says psychologist Keith Johnsgard, PhD, author of Conquering Depression & Anxiety Through Exercise. "After you've been at it for weeks, your base levels of anxiety and depression decrease. After five or six months, your base level of depression is profoundly lower."
Unlike medication, exercise has few side effects, except good ones: You're stronger, healthier, and more likely to maintain a stable weight and resist disease. "When I'm talking to a psychotherapist who's dealing with someone depressed, I'd say a high priority is to put the person on an exercise program," says psychologist Robert Thayer, PhD, author of Calm Energy: How People Regulate Mood with Food and Exercise.
Scientists believe that exercise may activate neurotransmitters associated with pleasure and tension relief, such as serotonin, norepinephrine, and dopamine. Regular exercise creates a brain cocktail that puts us in a state in which we feel alert, not tired, and calm, not tense.
Psychologically, exercise works to ward off depression in several ways. One is what psychologists call distraction -- it gets us out of a routine of everyday preoccupations. Psychologist Kate Hays, PhD, author of Move Your Body, Tone Your Mood: The Workout Therapy Workbook, says that exercise gives you a legitimate time-out from daily hassles. Exercise also increases self-esteem, because accomplishing something healthy on a regular basis gives you a sense of achievement. And for depressed people who feel isolated, exercise can serve as a vital means of social support.
The Ties That Bind
Charlotte Gould, 41, started Mothers Across America after a debilitating period of postpartum depression. She knew running would make her feel better, but she simply couldn't muster the energy or will to do it alone. "I realized if there'd been someone around to say, 'Come on, let's do this together. I'm a mother; I know what you're going through,' I could have gotten out there to run," she says.
Although Gould had always been an athlete, depression stopped her in her tracks. When her daughter was born, she was switching careers, from running a catering business to considering veterinary school. Unable to afford childcare, she stayed home, gave up the idea of veterinary school, and felt trapped. Usually a toned 96 pounds, Gould gained half her body weight while pregnant. "I felt like hell," she says.
Medication helped Gould out of depression, but running got her back to feeling like her old self. She was determined to help other depressed mothers. She got a national certification as a distance running coach and began forming a team. Gould put up the posters for MAAM, and today she has more than 100 women on the New York City running team, a virtual coaching Web site, and plans for teams in other cities.
The two keys to starting and sticking with exercise, according to Johnsgard's research, are support and convenience. Gould emphasizes both. "When you're isolated and have to struggle to get up and out the door, it's easier, more rewarding, and fun to do that with other people," she says. Being on a team requires the women to keep commitments to others that they might not keep to themselves. "There's someone to call you to say 'Get out of bed' when you don't want to," Gould says. With time to talk while they run, teammates develop intimate relationships. When one MAAM member became so depressed she was hospitalized, her teammates visited her and cheered when she finished a race just a couple of months later.
Gould focuses on running partly because it's a convenient form of exercise. "Running is really portable and accessible," she says. You just lace up your shoes and go outside. Key to her team strategy is setting and achieving goals. Everyone who joins has to have a goal, whether to do a marathon or just run once around the park. "When you push yourself to meet a goal, you develop extraordinary confidence," she says. Having successfully finished three marathons, Gould ran the MORE half-marathon in Central Park this March. The atmosphere at that race is one she tries to foster in her team: challenging but not pressured. "As I was running, I'd hear compliments about my hair or my shorts. It's great camaraderie," she says.
Building Momentum
Nasim Alikhani, 46, who also ran the MORE half-marathon, is an example of how exercise-induced confidence can spill over into the rest of your life. Originally from Iran, Alikhani was a student-athlete studying to be a judge in Iran. She saw her life come to a standstill in 1978, when the revolution forbade her to compete in sports or continue her education. She moved to the United States, married, had children and a successful business, but she felt unfulfilled. "At 25, I gave up and stopped dreaming," she says. "I spent five years in absolute depression. People look at someone who is financially secure and has two beautiful children, and they think, 'What's wrong with her?' But if you're sitting in your house with no dream, no hope and no goals, no matter how perfect your life looks to others, you're depressed."
In 2002 she picked up one of Gould's flyers and, never having run before, decided to try it out. She set her sights on running a marathon and even trained when she visited Iran for two months, getting up before dawn and running in hundred-degree heat, covered head to toe in a burka. Once, followed by a policeman, she was afraid she would be arrested. Instead, he pulled over and saluted her.
Alikhani ran the Philadelphia marathon two years later. Reaching one goal gave her confidence to tackle another. "When I finished, I decided to complete a master's program in international affairs. I went back to school after 18 years," she says. Last year, she started a nonprofit organization to help single women in Iran.
These days, Alikhani is training for her next marathon, in Stockholm. "From being a person who felt so stuck three years ago, now I feel like a woman who can reach her full potential," she says. "Thanks to running, I feel fulfilled."
Want to Get in the Running?
To reach Mothers Across America, go to www.mothersacrossamerica.com. Members of MAAM can subscribe to a virtual coach, with personalized training schedules, tips, and motivation to keep on track. For other, local groups, Google "women-only running groups."
Originally published in MORE magazine, June 2006.