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A man I know, who I’ll call Joe, has long battled depression. He’s tried everything from antidepressant drugs to individual and group psychotherapy. While he’s gotten better at times, nothing has ever been able to help him completely overcome his debilitating emotional lows.

Then one day, on a friend’s advice, Joe started exercising. He began with short walks and gradually built up to daily jogs alternating with weight-lifting sessions.

Today, he feels much better. He still sees his doctor for medical care and supplements it with regular exercise. The combination has made a world of difference to Joe; he now has a more upbeat mood and an improved ability to function.

Here’s what the latest research shows about the benefits of physical activity for people suffering from depression.

Evidence suggests that exercise may be as effective as counseling and drug therapy for the treatment of mild-to-moderate depression. In one study, 18 depressed people were assigned to either a running group or a psychotherapy group. Researchers found that those who jogged regularly improved just as much as those who underwent psychotherapy. Studies from Duke University reached similar conclusions when they compared the use of antidepressant medications with participation in an exercise program for the treatment of depression.

Despite the documented mood-elevating effects of exercise alone, physical activity in conjunction with conventional therapies appears to work even better. Research published in the Journal of Psychiatric Practice studied 17 depressed patients who had not received much benefit from using medication.

The patients were asked to continue taking their medicine while starting a 12-week exercise program. Those who completed the full program showed significant improvements in their depression scores. The final conclusion was that exercise can reduce depressive symptoms in patients who haven’t responded completely to antidepressant medication.

Exercise seems to ease persistent symptoms of depression in several ways. Physical activities have been shown to promote feelings of self-esteem, self-confidence, self-image, self-control and self-discipline. It can also provide you with greater levels of energy, endurance and persistence.

Scientists have made some exciting discoveries about how exercise brings about these improvements. Physical activity stimulates your body to release serotonin, a brain hormone that makes you feel more relaxed and satisfied. Low levels of this hormone are often associated with depression.

Your body produces other neurotransmitters when you exercise vigorously. Some of these substances, called endorphins, ease pain and enhance feelings of well-being. Your body produces greater amounts of these hormones as you gradually improve your level of physical fitness.

To get the depression-easing benefits of exercise, you don’t need rigorous exercise. Mild physical activities can help, too. First check with your doctor since some antidepressant medications don’t mix well with exercise. Then start with easier activities that fit into your lifestyle such as walking, gardening, light sports or playing with the kids.

Later, when you’re up for it, you can incrementally increase the time and intensity of your workouts. A study published in the American Journal of Preventive Medicine showed that 30 to 40 minutes of aerobic exercise three to five times a week cut symptoms of minor to moderate depression nearly in half.

Back to Joe: Though he started out slow, he has steadily built up from there. And his mood has markedly improved. He now feels much happier, thanks to a combination of good medical care and regular exercise.

For more information: National Institute of Mental Health, www.nimh.nih.gov.

Contact Dr. Elizabeth Smoots, a board-certified family physician and fellow of the American Academy of Family Physicians, at doctor@practicalprevention. com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column consult your health care provider.

2007 Elizabeth S. Smoots