Young woman performing warming up exercises.

More than what type of exercise you do or how long you do it, how consistently you do it matters most for symptom relief. (Getty Images)

Most people know Joe English as someone who's always eager to exercise. As an elite athlete and running coach, it's his job to do so. But when English, a 47-year-old in Portland, Oregon, was struggling with depression about six years ago, staying active was even a challenge for him.

"There were days when I just couldn't see a path forward and felt like I was drowning in fear and a lack of hope for the future," says English, who was going through a divorce and the loss of his home when his symptoms were most severe. "On those days, it might be all I could do to go for a short easy run, or even walk."

Of course, you don't have to be depressed to not feel like working out. After all, only 1 in 3 American adults exercise the recommended amount – or at least 150 minutes of moderate-intensity exercise each week. Even athletes and fitness fanatics sometimes just want to stay in bed, watch sports on TV (instead of playing one) or run to the fridge instead.

But for people with depression – a condition in which low motivation to do regular daily activities (say, taking a shower, getting dressed or going to work) is a prominent symptom – finding motivation to exercise can feel like a fool's errand. Indeed, in a study of 245 patients at a Michigan mental health outpatient clinic, 80 percent of patients wanted to exercise more, but most said their mood limited their ability to do so.

"All people experience procrastination on tasks that feel like they're going to take a lot of effort – that's universal," says Rachel Hershenberg, an assistant professor of psychiatry and behavioral sciences at Emory University in Atlanta. "That urge to avoid – that's what gets magnified in depression."

And yet, succumbing to that urge only fuels the disease. Resisting it, though, can help treat it. In fact, one recent study in the American Journal of Psychiatry of nearly 34,000 adults found that 12 percent of cases of depression could actually be prevented if participants had exercised just one hour each week. That's likely because exercise boosts mood, serves as a healthy coping mechanism and gives people a sense of accomplishment. "It improves your belief in yourself as an effective human being," Hershenberg says.

English, for one, certainly found that to be the case. "Running improved my mood by keeping me active and getting me outside," he says. "But more than that, it allowed me to direct some energy toward self-improvement and doing something positive for myself."

But taking that first step is the hardest part. Here's how to motivate yourself to do so:

1. Don't wait until you feel motivated to get moving.

If you tell yourself you'll exercise when you feel better, reverse that thinking. The truth is, you'll feel better when you exercise. "The action item is just knowing that [low motivation] is not going to change," Hershenberg says. "You need trust that with enough repetition, it will start to get easier, and over time that's when motivation will build."

2. Start (very) small.

Hershenberg once worked with a veteran with depression who decided to try to take an extra flight of stairs each week. Such small steps – whether literal or figurative – toward physical activity are especially important for people with depression, who are prone to spiraling feelings of guilt, frustration and self-blame when they don't meet their too-high expectations, says Lani Lawrence, a clinical and sport psychologist at the University of Southern California and an executive board member at the Association for Applied Sport Psychology. "Maybe instead of driving somewhere, you walk to the store," she says. "It’s setting expectations that are realistic."

3. Commit to consistency.

More than what type of exercise you do or how long you do it, how consistently you do it matters most for symptom relief, experts say. (Three times a week for a month is better than every day for a week, for example.) Hershenberg also recommends always working out at the same time of the day – ideally, the time of day your mood tends to be brightest. Keeping a regular schedule saves mental energy (no more hemming and hawing about where or when you'll work out), boosting your chances of success, she says.

4. Get professional help.

According to the study of 245 mental health clinic outpatients, only one-third reported their providers talked to them often or always about physical activity. But working with a professional – be it a mental health provider, personal trainer or some combination – is important to keep you accountable to your routine, say study authors Carol Janney, an assistant professor of epidemiology at Michigan State University, and Dr. Marcia Valenstein, a professor emeritus in psychiatry at the University of Michigan.

"[Personal trainers] can help with motivation, they can help with starting an exercise program that's gradual, that's manageable and based on interests, hobbies and time of day," Janney says.

5. Make it social.

Whether you join a weekly class at a community gym, join a hockey team or plan daily walks with your neighbor, involving people you like in your exercise routine will boost your motivation and commitment. "Because not every day do you wake up and say, 'I want to go exercise,' but you may want to see your friends," Janney says.

6. Keep track.

When you have depression, the verbal reel running in your head ("I'll never be good at anything" or "I always give up") often conflicts with reality. But by logging your fitness – even if it's just rating how you felt before and after moving – you can start to build proof to debunk those negative thoughts, Hershenberg says. "The more you see your track record, that you can do it, and knowing that you felt this exact way beforehand, the more it allows you to trust yourself to be able to do it again," she says.

7. Treat yourself.

Who doesn't like advice to celebrate? And that's exactly what you should do after achieving a small exercise-related goal, whether that means giving yourself a proverbial pat on the back, sharing your accomplishment with a pal or treating yourself to a manicure. "In depression, it can be easier to think about all the things you haven't done," so focusing on what you have done can help, Hershenberg says.

8. Give yourself a break.

Sometimes, you're going to sleep through a spin class, cancel on your walking partner or spend the day channel surfing instead of surfing-surfing. That's OK. "Try to view it as just one data point," and not an all-encompassing representation of who you are, Hershenberg recommends. Lawrence suggests practicing swapping "should" statements ("I should have gone to that yoga class") with self-affirming ones ("It would be nice if I went for a walk tomorrow").

For English, it took time to learn not to beat himself up for not being able to complete tougher workouts. "I had to realize that this would just add to my suffering," he says. "Instead ... I did what I was up for doing and had to accept that as what I was capable of on those days."

9. Practice patience.

When Janney first asks people with depression to walk on the treadmill in her office, they often dread it. But about six weeks later, they're eager to jump on. "When starting a new behavior, the literature suggests it takes six to eight weeks to be established," she says. In other words, don't give up if you don't see physical or mental results immediately.

"If you have a knee or ankle injury, you're not trying to run on that ankle immediately – it takes time, and depression is the same thing. You need time to heal," Lawrence says. "Being patient with yourself, kind to yourself, can help you get to that place a lot sooner."

Tags: depression, mental health, exercise and fitness, psychology


Anna Medaris Miller is a Health & Wellness editor at U.S. News, where she writes consumer advice stories on fitness, nutrition, reproductive health, medical