Swim Yourself Happy?

Published on May 14, 2013


It’s well known that exercise is an effective treatment for depression, but recent research has enabled psychiatrists to give guidance on precisely how much exercise is enough exercise to give the desired results when treating depression. So how are therapists using exercise in their treatment regimes, and should they be using it more? Are there psychological benefits to exercise as well as biochemical ones, and can exercise help with addiction?

Exercise and Depression

Research into the levels of exercise needed in order to lift depression has been undertaken by Chad Rethorst, PhD, and Madhukar Trivedi, MD, of the Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas, and their results have been published in the Journal of Psychiatric Practice. Rethorst and Trivedi compiled figures from all the available data from randomized controlled trials and came up with a figure for the optimum amount of weekly exercise needed to treat major depressive disorder (MDD). It’s a surprising amount in fact. Aerobic exercise came out tops, with a recommended 45 to 60 minutes, three to five times a week. This seems a lot for someone who is suffering from a major depressive illness, but Rethorst and Trivedi point out that the studies reveal a drop out rate from therapeutic exercise is comparable to that from psychological and medication treatments. They also emphasise that there are beneficial effects from exercise taken at a lower level than the optimum, and that all clinicians should be encouraged to prescribe exercise for patients suffering with depression.


So what can those treating addiction take from these findings? There is a strong emphasis on medication for the initial stages of some addictions. Early treatment can include Chantix prescriptions for smoking cessation, sedation, buprenorphine (Subutex) and methadone prescribed for heroin withdrawal and disulfiram (Antabuse), Naltrexone (Revia) and Acamprosate (Campral) for alcohol withdrawal. But some rehab centres are turning to exercise as a good form of early addiction treatment, with some surprising results. Anecdotal evidence suggests that addicts respond extremely well to exercise as an effective form of therapy for helping them with their addictions. Exercise stimulates the brain chemicals that encourage the growth of nerve cells, encourages the production of ANP, a stress-relieving hormone, and boosts neurotransmitters, including serotonin, which is known to lift mood. One particular addiction treatment centre in Cape Town, the Tabankulu Recovery Centre, is actively using using surfing in their addiction recovery programs and are finding tremendous benefit to patients. But is it simply a psychological boost that addicts are getting from being in the water?

Swimming and Mood

There is clearly the experience of being in a group of people, in the fresh air, challenging oneself and mastering a new skill to bolster mood. The sport requires determination, courage and focus. But, for those who don’t have access to a surf beach, there is good evidence that swimming causes cause biochemical changes that researchers are convinced are acting in a very similar way to drug treatments. Moby Coquillard, is a psychotherapist and keen swimmer, practicing in San Mateo, California. He is so convinced about the advantages of swimming that he prescribes it for his depressed patients. He says, For me, it represents a potent adjunct to antidepressant medication and, for some patients, it’s something you can take in lieu of pills.” A bold claim, but what is the mechanism at work here?

Aside from the known benefits of endorphin release, a boost in circulation serotonin levels, Coquillard points out that swimming requires the “alternating stretch and relaxation of skeletal muscles while simultaneously deep-breathing in a rhythmic pattern.” This is not a million miles from the process involved in deep relaxation, or Hatha yoga, which both induce the body’s relaxation response. Added to this is the meditative nature of swimming, due to its repetitive nature. “There’s even a built-in mantra, be this the slow count of laps, or self-directed thoughts like “relax” or “stay smooth.” says Coquillard. This mimics ‘mindfulness’ techniques of depression therapy. Researchers believe that it can stimulate the growth of new brain cells - “hippocampal neurogenesis” - in areas of the brain that becomes damaged by chronic stress.


Exercise has been proven again and again to stimulate a boost in brain health and an improvement in mental wellbeing. It’s interesting to see new water sports based approaches being implemented in field of addiction rehabilitation, and we look forward to further research into water-based activities as an aid to treating mental health problems.




Depressed woman



Depressed adolescent by pool



Swimming can help with depression




Surfing can help young addicts



Water sports can help addicts





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