Should therapists be “prescribing” exercise for patients with mild to moderate depression*?

We’ve known for a while that exercise increases endorphins and the neurotransmitter norepinephrine (which may improve mood) and improves overall well-being. It also boosts the immune system and helps people feel good about their bodies.

In 2011, a study showed that exercise worked as well or better than drugs in treating depression in some cases. Another study, cited by Harvard News, showed that individuals with depression who exercised, whether or not they took the anti-depressant, Zoloft, were less likely to have relapses than those who took anti-depressants and didn’t exercise.

So, why aren’t more therapists doing more to encourage their clients to exercise?

We don’t have to be exercise physiologists; all we have to do is work to create a holistic treatment plan for our clients which includes, in addition to talk therapy, a range of recommended supportive therapies, treatments and/or activities. (This might include medication.)

Exercise recommendations or suggestions (and plenty of verbal encouragement), sleep therapy, nutritional and other complementary treatments,  spiritual and social activities, creative activities, educational and career services all help the depressed patient feel better, gain confidence, develop relationships with others, and stay healthy. Creating a treatment plan with your client, and helping them choose a physical activity can even give you additional, helpful insights into their personality.

With highly-motivated clients, assigning “homework” works well.  Asking for the support of family, friends, and community may be helpful to clients who find it difficult to get motivated enough to participate in treatments, including exercise. For some clients, it might be necessary to enlist the aid of a variety of social services, programs, and professionals who are willing to work together your client.

Sure, this is more work for therapists, and in all honestly, it’s time consuming. But in order for therapy to be truly effective, it must continue when the client leaves the office.

What goes on the office (and a prescription for an anti-depressant), is all too often relied on to be the only possible course of treatment for depression. But in some cases, patients leave their therapy session without experiencing any insights that manifestly help them with their depression and its symptoms.

Also, today many patients are having a hard time financially—they’re often really struggling to cover the cost of therapy. By utilizing a range of supportive options, it may even be possible to help patients spend less time and money on talk therapy. I’m not advocating brief therapy for clinical depression, but I am advocating that therapists do everything possible to help patients feel better as quickly as possible, without sacrificing necessary treatment steps, of course.

I believe the implementation of a treatment plan which has been created with your client and which delineates goals is  fundamental to progress. The plan should include helpful out-of-office therapies, treatments and activities, and should be discussed, reviewed, and amended as needed with the client. In my experience, this can help enable your client to heal from depression more quickly than therapy that does not have a treatment plan.


*This post does not address severe depression, or depression with other factors. Clients should check with a physician about what type of exercise would be most appropriate.