Every doctor, therapist, psychiatrist and psychologist knows that the best form of natural medication for depression is exercise. The most common phrases a person who says they feel depressed will hear is, “You should go for a walk.” “Try joining a gym.” Or “Just dance around your living room for 10 minutes, you will feel so much better.”

As a personal trainer who has been training clients with exercise and working with them on nutrition for 20 years, I know these are all true statements and true facts. Among my clients of all different ages, levels of fitness, ethnicities, cultures and sizes, I have had an incredible number of clients who have had some type of mental illness. And the most prevalent type has been different levels of depression. Some of these clients had been diagnosed before coming to see me and knew that it was what “the doctor ordered.” And some of these clients had no idea they suffered from depression or anxiety or had food addictions or other addictions until they started working with me and I figured it out by talking with them, discussion, and watching their behavior. I never claim to be a Psychiatrist so I always suggests that they find a licensed Psychiatrist.

But here is what I am finding in my experience with my clients and what I have seen over the years:

I believe there is a link between the chemical imbalances in a person with depression and the inability for that said person to get up off the couch and move. I believe that there is something that is either missing or disconnected and when the person actually THINKS about going on a walk, or going to the gym, something very different happens to them than to someone who does not suffer from a chemical imbalance/depression.

One of my clients who suffers from the most severe form of depression (I have learned that there are different levels of depression) described how she felt to me: “I feel as if I have a 700 lb. heavy, wet blanket on top of me at all times.” She said that sometimes her coping skills are much better than other times but that the 700 lb. heavy, wet blanket is always on top of her… every minute of every day. It broke my heart to hear this, but I was so thankful that she shared it with me because it was the first time that I actually understood what she felt like. I understood why it is such a struggle for her to do basically, anything. I thought about the “average” person. After a full day of work, most of us are pretty tired and the last thing we want to do is go to the gym or on a walk, etc. So, it is a struggle to make that effort and make the right decision and motivate to drive home and change and go to the gym…or to have packed our bags and drive to the gym from work. Now, think about if you had a 700 lb. heavy, wet blanket on top of you after you worked a full day. Think about having to stand up to get to your car with that 700 lb. heavy, wet blanket and then driving home and having to stand up and get out of your car with that 700 lb. heavy, wet blanket and going into your home and once you are inside, the idea of having to go and MOVE with that 700 lb.  heavy, wet blanket has to be the LAST thing in the world that you would want to do. And from what I understand and from what I am seeing and hearing and observing, this is not just after a full day of work. This is ALL THE TIME. The IDEA of moving is so overwhelming and feels like such a massive obstacle/chore/punishment that it just shuts them down. The part of this that makes me so sad and is the main reason I am writing this and trying to get my observation noticed is that what ends up happening is that the person does not understand what is happening. Here is what goes on in their mind:

I am LAZY. I am UNMOTIVATED. I am WORTHLESS. I have NO self control. I have NO self discipline. I am a FAILURE because I have tried so many times and I cannot do it. I am a FAT slob. I have NO will power.

So, then the cycle starts. The one thing that comes easy for someone that is overwhelmed by the idea of moving is to sit on the couch and watch TV or read a book or do a puzzle or knit and usually what goes very well with this is to also eat. I am not saying that any of these things are bad but in the context of this paper we see that  the activities that are chosen by someone suffering with these chemical imbalances are sedentary. And then I wonder about the correlation between obesity and depression because of this inability to move, the uncomfortable nature of moving, the discovery that SITTING and doing an activity is all that can be accomplished. It is not laziness, it is not being unmotivated, it has nothing to do with willpower. There is a missing step in what the doctors/therapist/Psychiatrist are telling their patients…and how they are helping them.

The missing step is FROM THE COUCH TO THE DOOR. Or even better FROM THE COUCH TO STANDING UP. A doctor can tell the patient to exercise. To walk. To go to the gym. But the issue is that this patient CANNOT even make it off the couch. Or out of bed. And this is NOT being lazy. I have to keep saying this because I have had too many clients feel shamed because they have been made to feel so worthless by statements like: “Oh, come on, it is not that hard.” “Just set your alarm an hour earlier.” “Aren’t you worth it?” “Don’t you care about your health?”

Can you imagine hearing this your whole life and BELIEVING it? Believing that you FAILED, again. And AGAIN. And AGAIN. And then finding out years later that there was something chemically in your body,  that you had no control over, contributing to all of this and no one told you. Yes, you could be very angry. Or, you could react like one of my clients. She was 67 when she contacted me to help her get in shape for a scholar walking tour in France. It was a level above the beginner tours that she and her husband had done in the past and she was scared that she would not be able to walk the 4 miles required. She made a pact with her husband that she would get a trainer and get in shape for the trip. When I first sat down with C, she told me she NEVER exercises and does not like to move. Her exact words were, “ I come from a family where, Why stand if you can sit, why sit if you can lay down?” I was cracking up when she told me but was also horrified to realize it was the truth!!! After she told me her whole story of her food addiction and some other aspects of her life, I was deep in thought. I asked her if she suffered from depression. She looked at me, eyes WIDE open and said, “how did you know?” And I told her everything that I just told you in this paper. She was speechless because she has been in therapy her whole life and no one has ever touched on anything like this in regards to seeing a correlation between  her chemical imbalances in depression and her real struggle to just, move. She actually said to me, “I just thought I was lazy.” And when I saw her the following week, I asked her if she had thought about what we talked about. She told me she had thought about it everyday and when I asked her what she was thinking, her response was exactly why I am writing this paper. She said, “ I felt a sense of relief.”

So, after this last experience with C, I realized that I wanted to try and use what I have discovered in order to help give relief to so many people in the same situations. How would that look? Here are a few ideas I have thought about:

1. It should be brought to the attention of doctors/therapists/psychiatrists to suggest to their patients that there are some cases of depression where the chemical imbalances might be part of the issue holding them hostage. Just giving the patients awareness that this is a possibility is so important and could change people’s lives.
2. As a personal trainer, I will offer services to these patients/clients. I will set up appointments to make house calls for movement. This will not be called a workout or a training session. It will be called, “Stay Put and Move.” Or, some version of that but nothing related to exercise or working out. It is me, showing up at their home and taking their hand and gently helping them off the couch and moving. We will just walk from room to room. Or just stand up and sit down. We can go to the kitchen and get a drink. We can sweep the floor. And when they are ready, we can walk up the stairs or take out the trash. What I am trying to get at it that I will just get them moving and talking and laughing. And hopefully they will see that it is not that bad or hard and it might actually feel good and be fun. There will never be any pressure to do it on their own if they do not want to because I understand that is not in their control. If they end up doing it on their own, it is a huge bonus.
3. I get a mini bus and make a group house call. This means that I get at least 5 people (or it is a group of 5 friends) and I drive to each home and walk in and actually take their hand and walk with them out to the bus. Once I have all 5 people I will go to a rented space and we will have a group move class. Not a workout, just moving. Fun, laughter, movement with other people who are dealing with the same chemical imbalances and who struggle with the same issues. The key here is that a friendly face comes to YOU and gently takes your hand with a smile so you are not thinking about the fact that you are about to go and do something you do not want to do like move. A friendly face will be walking you to a bus full of people who are going through the same thing but will all be supportive of each other and end up feeling great at the end of the hour. The bus will drop off each person to their home and I will walk them back inside and leave them with a hug and a smile.
4. I start an online FaceTime/skype 10 minute movement. For 10 minutes I will be on FaceTime/skype with my client and I will have them stand up and sit down. We will walk into the other rooms of their home “together.” I will have them get up and get a glass of water. They will vacuum a room or sweep a floor. But all in the privacy of their own home, in their own clothes, without having to see or face anyone in person and only for 10 minutes. But this 10 minutes will be so important for someone who might be 400-600 lbs. and feels helpless. I will understand what they are feeling and going through and instead of pushing them hard or making them uncomfortable by going too fast, this will be based on them and what they can do in that 10 minutes with me. And when they are finished, they will feel a sense of accomplishment because no one is judging that they only did 10 minutes. THEY know that they picked up the phone and MOVED and did the work and no matter how long or what they did, for them, it is a huge accomplishment.

So, in conclusion, my purpose is to look at depression and the chemical imbalances it creates as it relates to exercise. Does the chemical imbalance in someone suffering from depression cause that person to severely struggle with movement/exercise. Have people who suffer from depression lived long enough with the idea that they are “lazy” and can we change that so there is an understanding of why they are struggling to move/exercise? Are there ways that we can help them by focusing on the missing steps? If the struggle is from the couch to the door, that is where we need to start. I gave C “homework” of the movements and stretches that we did together to do at home until we met again the following week. I did not expect her to have done the movements because most of my clients do not do their “homework” unless they are with me. When I arrived at her house the following week, I asked her what she had done on her own. Expecting to hear “nothing,” I heard, “I did 15 minutes on the bike and the stretches you told me to do and the neck exercises. I did all my homework.” I did not let on that I was shocked but I did let her know I was very proud of her, which I was. It also made me think that because she had this knowledge that she had an extra obstacle (chemical imbalance) it gave her the green light to move. Maybe having the awareness that it is not her being lazy, it is something bigger than her, it took a different meaning to get up and move. Maybe this gave her a freedom from her own label of “lazy” and now that she knows she is not lazy, she is free to get up and move. If this is the case, can we please pass out this awareness and hand out the relief?