Guest Blog: How Exercise Helps Us Fight Depression and Addiction

Exorcise addictive and depressive demons the way celebrities do — with exercise. You’ve probably heard how many famous people have chosen exercise to effectively prevent and even treat mental health problems like addictions and depression. This is because exercise helps support and normalize mood-stabilizing neurochemicals like dopamine and glutamate, as well as serotonin.

One key neurochemical that may not trip off your tongue is brain-derived neurotrophic factor (BDNF). This is a protein in the brain and spinal cord that is vital for developing and maintaining the central nervous system (CNS). BDNF is especially concentrated in the hippocampus, cortex, and basal forebrain. This substance promotes the survival of nerve cells (neurons) by helping growth, maturation, and maintenance. It also helps control synaptic plasticity — the ability of brain connections to change and adapt over time — and consequently is important for learning and memory. Low levels of BDNF can cause difficulties in learning new things, as well as lead to depression and mood swings.

Strangely, exercise and using drugs of abuse act on similar parts of the brain. For example, each similarly activates the reward pathway, triggering the release of feel-good chemicals like serotonin and dopamine. This is another reason why people turn to drugs repeatedly. However, exercising itself may build up the amount of dopamine, regenerative proteins, and other synapses. As a result, these added connections increase the quantity of available dopamine and support other brain chemicals. The end result is feeling much better.

Intense physical exercise has received major attention as an effective way to reduce cravings and remain sober by celebrities like the rapper Eminem. In 2024, Em posted his annual updated AA pin on his social media account, where he reported being sober for 16 years. He explained drugs had loomed large in his life after the release of his 1999 album, The Slim Shady LP. The singer didn’t think he had a problem; however, as his fame increased and drugs became more plentiful—especially on tour—Eminem realized he was battling addiction. Things were bad in 2000-2002 when he was taking Vicodin, Valium, and alcohol. The performer said he took “75 to 80 Valiums” a night.

Eminem battled his addiction using running and exercise. He also did push-ups and sit-ups, tried boxing, and attended recovery meetings. Eventually, he moved to the “Body Beast” workout, using free weights, the pullup bar, and the bench.

According to the scientist who showed exercise could help people addicted to cocaine, Panayotis K. Thanos, Director of Behavioral Neuropharmacology and Neuroimaging Laboratory, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, “Our research has proven aerobic exercise has many benefits, but it has a profound effect on dopamine and the dopamine receptor.” Adds Thanos, “Aerobic exercise can decrease drug-seeking behaviors, cocaine preference, cocaine relapse, and cocaine stress-induced reinstatement.” Exercise also appears to have the same potential positive effects on cigarette smokers, opioid users, and others with drug use disorders.

Why do people shun exercise as a possible answer to substance abuse or severe depression? I asked former Olympian and Olympic psychiatrist Dave Baron this question.

Baron said, “People don’t see exercise as an intervention, but more of a lifestyle choice. The best available scientific data is overwhelmingly positive yet is not well-appreciated by the general public. In addition, exercise is not aggressively promoted, as the pharma industry does with medications.” Baron says too many people regard exercise like their gym class—an annoying and sweaty requirement they left back in high school.

Most data supports the role of exercise in the following:

Curbing cravings. After cutting down or off drugs, the brain sends alarm or anxiety signals caused by abstinence. These symptoms may be intense and may also drive relapse. Many people who successfully avoid drugs still may develop urges to use them again. Exercise is an excellent way to reduce the intensity of cravings, make them feel much less powerful, and help the recovering person control or reduce the frequency and intensity of these cravings.

Replacing triggers for abuse. It’s best for substance abusers to trade their old drug buddies in for some new exercise pals. Exercises like running in a group or club or training with a class and trainer, can become a positive routine—an important activity to perform and build up a person’s social network. This change of places, people, and things is important, as key recovery axioms include avoiding triggering people, places, or things and reminding the person of drugs used when abuse formerly was an active problem.

Improving sleep. If a person has a substance use disorder (SUD), often they take drugs to sleep. It is also true that recovering SUD patients suffer sleep problems as they struggle to avoid drugs or alcohol. Regular exercise helps individuals fall asleep faster and obtain a better quality of rest at night.

Helping the body and brain become stronger. Abused drugs have numerous harmful effects on the heart, lungs, liver, brain and immune functions. In contrast, exercise has the opposite effect. Exercise can also help recovering people think more clearly; often they report their mind starts working much better. Regular physical activity continues this positive process.

Improving self-image. Exercise can make people feel more self-control, which is very important for substance abusers who feel like they’ve lost control. Exercise also has positive anti-anxiety and antidepressant effects, making it easier to manage stressful situations and feelings.

With all the benefits described, I wondered if exercise might be treated differently if people compared the activity to taking a pill or other medication. Baron liked this idea and said, “If exercise were a medication in a double-blind FDA qualifying clinical trial, the trial would be stopped by the FDA, because exercise is so effective, and with virtually no side effects, that it would be unethical to not treat everyone with it.” Baron says that if exercise were a pill, it would be a blockbuster drug.

He continued, “Exercise has been shown effective in virtually every age range for virtually every form of psychopathology and as a primary and adjunctive treatment. It would be very difficult to find another treatment as effective and safe in maintaining mental and physical health, improving overall quality of life, and effectively treating psychopathology.”

Early research shows that aerobic exercise and resistance training may be most effective with addiction recovery. However, the evidence so far is insufficient to recommend one kind of physical activity over another. So if a person prefers yoga or mountain biking, either option may be helpful to combat addiction. Future studies should help us learn more and create programs tailored to individuals.

Major depressive disorder (MDD) is characterized by a depressed mood, loss of interest, and a reduced ability to experience pleasure in daily activities for at least two weeks. In 2020, the World Health Organization (WHO) estimated 264 million people worldwide were affected by depression, or 3.8% of the population. The WHO also estimates that depression is the world’s leading cause of disability.

Individuals with this disorder face an increased risk of type 2 diabetes, cardiovascular disease, lower back pain, and an overall decline in life quality. It is also the leading cause of suicide deaths worldwide, with an estimated incidence of up to 800,000 suicides annually.

Physical exercise is not only an effective intervention for depression, but researchers also report that exercise may be a viable adjunct treatment in combination with antidepressants.

Clinical practice guidelines recommend psychotherapy and/or pharmacotherapy for MDD. But at least 30% of people with depression have treatment-resistant depression, which means medications and therapy don’t help. Consequently, there is an urgent need to explore non-pharmacological and patient-centered strategies that are safe, feasible, and easily integrated into adult daily routines. A recent major study published in 2024 showed exercise is an effective depression treatment.

In addition, exercise apparently is about as effective for reducing depression as cognitive behavioral therapy (CBT) or medications, although combining exercise with antidepressants may improve symptoms more than medication alone. The more intense the workout, the more effective at managing depression. But even low-intensity physical activity helps.

Current National Institute for Health and Care Excellence (NICE) guidance on treating depression in adults says the condition may respond to a variety of options, with group exercise recommended as cost-effective and easy to implement.

Commenting on the results of the study, Jonathan Roiser, professor of neuroscience and mental health at University College London, said, “The headline result is that all types of physical activity (especially aerobic exercise) cause a reduction in depressive symptoms; a similar conclusion to many reviews over the past decade.”

Many people severely undervalue—or don’t even consider—that exercise decreases addictive cravings as well as depressive symptoms. People can exercise at home or in a gym or begin a walking or running program in their neighborhood or at a local mall after checking with their doctor.

To find a therapist, visit the Psychology Today Therapy Directory.

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