I don't know about you, but I am so tired of reading articles telling us that exercising, eating right, and sleeping enough is “as good as therapy.” As a therapist and an athlete, I think it's important, and potentially life-saving, to point out the fallacy of this broad statement.
Exercise is not therapy, but it can save your life.
Yes, what you do with your body matters. What you put into it matters. How much you sleep matters. These things are all important, and your needs around all of them are as individual as your fingerprints and will change depending on your life circumstance. But if you are disabled, neurodivergent, injured, grieving, or otherwise in emotional, physical, or psychic pain, it may be much more complicated than this. Advice like “eat right and exercise!” can actually amplify the problem if you’re beating yourself up for not being able to do something that everyone is telling you you should.
Even though these ways of taking care of ourselves are beneficial, for some of us, being told to eat right and exercise and get enough sleep can feel critical, judgmental, and shameful. Shame shuts down one’s ability to think and make healthy decisions, and is a common response from folks who feel criticized. It's true that exercise can help you find strength to navigate your mood or distract you from overwhelming feelings, and I would recommend it to people as part of a larger approach to making it through a depressive episode. Minimizing alcohol, eating enough food, and getting whatever amount of sleep your body needs every night are also helpful things when you’re not feeling well. But these things are not a replacement for therapy or medication for someone with depression.
Here are some things that I think are true about exercise:
Exercise can save people’s lives. As a therapist, I have worked with people in the deepest caverns of depression, for whom any amount of exercise that’s manageable can help redirect self-harming behavior and even bring something unexpected to an otherwise “useless” day. And if you’re accustomed to exercise and stick with the habit, you might find your mood changes as your blood starts to flow.
Exercise can be therapeutic. It offers structure, a sense of aliveness, a connection to your power and aggression, and feelings of accomplishment. Whether you’re an athlete in a sport that offers community and accountability or you take a walk in nature, allowing yourself to just show up can give you a reminder that you haven’t always felt this way, and you will feel differently again. It’s also a great way to tell your judgmental inner voice to fuck off as you punch a heavy bag or lift a barbell over your head, or to calm your inner world down by doing a walking (or sitting) meditation through a labyrinth.
Exercise is not therapy. Therapy is a relationship built over time with someone who is trained to listen to you and help you understand your suffering. Only another mind can do that with you. Apps and barbells just can’t. Depression can play tricks on your self-confidence by repeating horrible shit over and over again in your mind. Talking to someone else gives that narrative a place to go, where it can be exposed, processed, and healed. Not all therapists are the same, and it may take a while to find a good fit. So, as with exercise, it can be easier to start the process of therapy before you’re actually in the pits. But, sometimes we need to hit the pits before we can make that call, and that’s okay.
Here is some advice I would actually give someone struggling with depression:
If you are not already in therapy, please try it. There are more structured and less structured styles of therapy, and sometimes you will need to try a few out before you find the right fit. Please know that if it’s not working for you, you can always try a new therapist. If you want a recommendation for a therapist, try Psychology Today, or ask a friend who’s in therapy for a referral. (Or try Google! Seriously. It can work.)
If you are interested in medication, make an appointment with a psychiatrist. Again, you can always try it out and see if it works and if you like it.
If you are already an athlete or consistent with your exercise, don’t worry about your numbers right now. Leave the competition for another time. Right now, just show up when you can, and take the rest that you need. Everything is just going to feel harder for a while. If you’re burned out, here are some additional things that may be helpful to try.
If you have not tried exercise, don’t like it, or for any other reason it doesn’t work for you even during your well times, it might not be right for you. If you want to move your body, try to spend some time outside, go for some walks/rolls, get a massage or hot tub, or try a Yin yoga or restorative yoga class. Or maybe being in contact with your body is too intense right now, in which case, just make sure you’re physically safe.
Eat whatever the hell you want. Let me say this again. Eat. Whatever. You. Want. Just make sure to eat. And drink lots of water. This might not make you feel better, but any amount of self-care is a good thing right now. Food and water are high priority. If all you do today is eat food and drink water, that is very much okay.
Call people if you want. Text if you prefer. Tell someone that you’re going through a hard time. You can say something as simple as: “I’m going through a hard time. I’m safe and okay but I just want someone else to know.” You don’t have to talk about it any more than that if you don’t want to. But sometimes it can relieve some of the pressure if someone else knows what you’re going through.
Practice self-compassion. When that nagging, critical, punishing voice goes through your head, offer yourself some understanding. You’re going through a lot right now. Depression is not a visible illness, but that doesn’t make it any less real.
Your feelings are valid and you don’t deserve to be beaten up, even by your own mind. There are no "shoulds" in this game, only things you want to try in order to take good care of yourself. If you are sick, get help. Tend to where you are wounded, and you can heal.