Running is an antidepressant.

Side effects may include fitness, euphoria, and great legs.

Disclaimer: mental health medications are absolutely appropriate for some people. If you are taking one, do not stop without discussing it with your healthcare provider.

Mental health advocates have been quietly recommending exercise to combat depression and anxiety for years. Now, thanks to a recent study, we have data showing just how effective running can be at treating depression— while also improving overall health. According to this study (and others before it), aerobic exercise is on par with commonly prescribed antidepressant medications, but has few negative side effects and considerable added benefits.

Often, people see exercise, sleep, or nutrition changes as less effective than pharmacological treatment. Something so commonplace can’t possibly actually work, right? Give me the good stuff, doc. Don’t hold out on me.

But the numbers don’t bear that out. Changing behavior does change health outcomes, significantly. The data are clear.

So why hasn’t exercise been embraced as a first-line treatment for these common mental health problems?

Part of the hesitance to accept exercise as a viable treatment option is likely because healthcare providers don’t present it as an evidence-based treatment strategy. 

They may not know how to or may not have the resources to offer protocols and support to implement exercise programs. “Exercise more” isn’t effective advice in the way that “Spend 45 minutes two or three times per week running, preferably outdoors and with other people, with your heart rate elevated to 75% of your heart rate reserve, for at least 12 weeks to start” would be.

But you can do it, without a prescription.

Get started

Depression can kidnap your get up and go, and anxiety can put up barriers. Starting a new behavior– especially one that can be physically difficult– is harder than normal under these circumstances.

This might be part of why supervised group programs have been the most effective in the literature. As with psychotherapy, it requires you to show up at a certain time, be present with another human, and engage actively in the treatment. That’s hard, but it could be some of the magic.

The benefits of exercise start accruing at a pretty modest amount. The depression study asked participants to target 45 minute running sessions, which included warmups and cooldowns, two or three times per week. They started at a very low intensity and gradually increased as they started to adapt. And that’s it. It’s a sensible, doable plan, and that was enough to be as effective as medication.

Making a commitment— even a small one— is a great first step. Can you meet another person, connect with a coach, or join a running group, training program, or class, or even just tell someone you’re close to what you plan to do? 

Stick with it

It’s hard to stick with a new exercise program. In the study, the running group had significantly lower adherence than the medication group. That makes sense, but if you know this going in, you can plan how you’ll manage it.

One way to help yourself stick with it is to list the reasons you’re doing it. Do you want to feel better? Get back to things you used to enjoy? Make progress at school or work? Just get through a day feeling a little less awful?  Keep that front and center.

If you’re having trouble talking yourself into an hour-long session, give yourself permission to bail after fifteen minutes if you need to. That’s a small ask. And you’ll get benefits from that, even if you don’t finish the session (but you might find that you want to afterall).

Another thing to try is making notes about how you feel right afterwards. One of the great things about exercise is that you can feel immediate benefits in mood and sleep. If you write this stuff down when you feel it, you can use it to cue yourself when you need it.

Finally, don’t let the perfect be the enemy of the good. You don’t need to hit 100% of your planned sessions to get results. If you skip a day, just get back to it the next day. Allow yourself that grace. Just go back to it. 

Monitor progress

Most progress isn’t like a light switch flipping on. It’s gradual. It can be hard to see. That’s one of the reasons I recommend tracking both behaviors (did you run, and for how long?) and symptoms (how are you feeling day to day?). 

Give yourself a check-in every two weeks. And keep track– write it down, use a calendar, make a note in your phone— whatever’s easiest for you. But do it. You might think you’ll remember. . . but you probably won’t.

This is also a good safety mechanism. You can check in with your doctor or therapist around your progress, because some people do need different kinds of therapy in addition to behavior change.

Avoid unsavory side effects

Some recent travel had me holed up in a hotel rooms with cable, and I got a full dose of drug industry commercials, complete with the litany of rare but horrific-sounding side effects. It was a reminder that, although medications are often beneficial, they aren’t without downsides.

Side effects of drugs commonly used for depression and anxiety include dizziness, dry mouth, sexual dysfunction, upset stomach, sleepiness, agitation, difficulty sleeping, and a lot more. Not everyone experiences these, but they’re pretty common. Sometimes worth it, but what if it didn’t have to be a trade-off between, say, functioning better as a person and feeling foggy?

Embrace the process

That got me thinking: what are the side effects of non-drug treatments for mental and physical health problems? As the study on running demonstrated, they’re overwhelmingly positive: immediate improvement in mood and sleep, favorable change in body composition, decrease in blood pressure and resting pulse, and increased self-efficacy, among others. 

There’s something to be said for an approach to treatment that relies on the body’s innate healing mechanisms. It’s not immediate or easy, but engaging with this kind of healing seems to have a positive domino effect rather than a negative one. The practices (and benefits) can be life-long.