The Role of Exercise in Treating Postpartum Depression: A Review of the Literature

Amanda J. Daley, PhD, C. Psychol; Christine MacArthur, PhD; Heather Winter, MD, MROG, FFPH

Disclosures

J Midwifery Womens Health. 2007;52(1):56-62. 

In This Article

Proposed Mechanisms

There are various hypothesised mechanisms by which exercise is thought to influence mental health outcomes and several biologic, psychosocial, and psychological theories have been suggested. Proposed mechanisms for how exercise improves mood are speculative at present, because no study has directly investigated the causal pathway in depressed patients successfully treated with exercise.[31] Each mechanism will be discussed briefly here, and readers are directed to other publications[16,32,33] for more detailed discussions.

One possible mechanism is biochemical change, such as increased levels of endorphins.[34] The endorphin hypothesis proposes that the effects of acute exercise on psychological well-being, in particular, "euphoria," is caused by the release and subsequent binding of endogenous opioids (β-endorphins) to receptor sites in the brain, leading to improved mental health outcomes. Despite very limited support, the endorphin hypothesis remains one of the most popular explanations of the psychological benefits of exercise.[32,33]

Psychological hypotheses, such as increased sense of mastery and self-esteem, have been proposed,[34,35] and there is a well-established link between depression and negative self-evaluations.[36] The positive relationship between exercise and depression could be explained in terms of the physical signs associated with exercise (e.g., weight loss and muscle tone), and these physical signs could be viewed as positive cues towards a sense of achievement in one's physical self. In the context of postpartum women, this is an important consideration, given that new mothers may have negative feelings about themselves and their bodies after giving birth, and may be keen to exercise to achieve weight loss.[25] Other researchers[37] have suggested that exercise can serve as distraction or "time-out" from daily hassles and stressful stimuli, and is responsible for the improvements in mental health associated with exercise. In this respect, women with postpartum depression may find exercise a useful strategy to help them focus on events other than their particular life circumstances.

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