Drowning the Demons
Could swimming be a viable cure for depression?
by Elaine K. Howley
When my sister died, I blamed myself. She was just three-and-a-half years old, and I, the big sister at age 8, had been the bone marrow donor in the last-ditch effort to cure her aggressive leukemia. It didn’t work, and in my kid’s brain, that failure translated to my failure.
I fell into a dark depression. The adults around me were well aware, quite concerned, and worked hard to help me understand the complexities of oncology. But it took a long while before I came out of that tailspin. It also took me finding something else to refocus this misplaced energy and feel better: swimming.
I threw myself into club swimming. I took out my anger and frustration on the water. I was never blazingly fast, but I did well enough to earn some accolades, enough to buoy my battered self-confidence. Tapping into a competitive fire I’d not found before helped smooth out the deepest troughs of my grief and despair. Swimming helped lift my depression, and it seems I’m not alone.
A recent case study published in British Medical Journal Case Reports made headlines around the world for detailing the experiences of a 24-year-old British woman named Sarah who has severe anxiety and depression. In an attempt to ditch the drugs that she said made her feel foggy, she took up open water swimming with the encouragement and supervision of Dr. Chris van Tulleken at the University College London. After just a single session, Sarah’s symptoms improved, and over the next several weeks of regular open water swimming, she was able to taper off her medications. Two years into the program, she’s still drug- and symptom-free, a remarkable outcome from cold-water swimming alone.
The study was the first of its kind to examine the effect of open water swimming therapy to treat depression, and while these findings are still anecdotal, Sarah’s results are promising and may well encourage larger studies to prove the efficacy and mechanisms of how swimming can alleviate depression. And those findings can’t come soon enough, as so many people around the world are struggling with depression. What’s worse is that many people don’t get any treatment at all.
Everybody in the Pool!
According to the National Alliance on Mental Illness, depression and anxiety are the two most common mental health disorders in America, affecting approximately 1 in 5 adults in the U.S. More than 18.1% Americans are living with an anxiety disorder and 16 million—nearly 7% of the population—are living with major depression. Many people have both conditions simultaneously. A 2019 report from Mental Health America, a nonprofit founded in 1909 that’s dedicated to addressing the needs of people living with mental illness and promoting good mental health in America, reported similar findings, noting that more than 44 million American adults (18.07% of the population) have a mental health condition. MHA also noted that more than 56% of adults with a mental illness received no treatment. If exercise could be used as medication, would it improve those figures?
How Exercise Helps with Depression and Anxiety
Although it’s not entirely clear exactly how exercise alleviates depression, science has known for some time that it does make a difference. According to a 2004 review in the journal Current Psychiatry, “exercise has been shown to be more effective at reducing depressive symptoms than no treatment, occupational therapy, cognitive therapy, health seminars, routine care, or meditation.” Exercise has also been favorably compared with medications in treating depression. Though study subjects typically engage in land-based activities such as walking or biking, it seems likely that swimming could induce similar benefits.
One thing we do know is that exercise triggers the release of endorphins—feel-good chemicals produced by the central nervous system that work like painkillers. Endorphins engage the same neurotransmitter receptors as opioids, and are responsible for the sensation known as runner’s high—a sense of euphoria that can result after a certain length of time working at a certain intensity level. The time and intensity needed to trigger a runner’s high varies by individual. Running is not the only exercise that causes this feeling—most any intense activity can induce it.
Howley with her husband, Mark, and Mr. Bear after she finished Catalina Channel, her first major channel swim, in 2008. Read more about Mr. Bear here.
Exercise also encourages the brain to create more of several other neurotransmitters that also regulate mood—noradrenaline, serotonin, and dopamine. An increase of these chemicals has been associated with improved mood. Simultaneously, vigorous physical activity increases steroid reserves, allowing your body to better counteract stress. It’s no secret that stress can greatly exacerbate the symptoms of depression and anxiety.
More recent research has found that vigorous aerobic exercise also promotes the creation of brain-derived neurotrophic factor, a protein that promotes nerve cell survival and promotes the growth of new cells in the brain. It’s been implicated as helping to stave off the arrival of age-related cognitive decline and dementia. Depression is a major symptom of dementia, so it’s believed that BDNF might be protective against depression as well by creating new neural pathways.
Regular physical exercise also helps you sleep better at night; insomnia and poor sleep are distressing symptoms very commonly associated depression and anxiety disorders. And, it boosts self-confidence—getting in a good workout provides a sense of accomplishment that can color the rest of the day. Although it can be a complex undertaking for swimmers with body image issues to don a suit in public every day, studies have found that overall, exercise improves body esteem in patients with body image disturbances.
For most of us Masters swimmers who train with other people, there’s a social piece of the puzzle, too. Connecting with others, particularly when you’re engaged in a physical activity together, has been shown to boost brain health and mood and is increasingly being recommended as a way to combat dementia. Socializing while depressed can be challenging, as a major symptom of depression is isolation, or removing oneself from social settings. But taking some of the thought out of socializing by simply turning up to an organized workout could make connecting with others and finding like-minded friends to support us through the dark times easier for many people dealing with depression.
Taken all together, there’s a growing body of evidence that any form of exercise helps ease depression. But swimming may yet have one more ace up its sleeve as the superior depression-beating option—the water itself. Wallace J. Nichols, a marine biologist, made waves in the field of psychology with the release of his bestselling 2001 book “Blue Mind: How Water Makes You Happier, More Connected and Better at What You Do,” which detailed the psychological effect being in or near water can have. In short, he wrote that water calms and soothes the human psyche, providing cognitive and emotional benefits that may be challenging to exactly quantify but that are very real all the same. Researchers at the University of Exeter in the United Kingdom have picked up this thread and are studying how something as simple as watching a video of the ocean while exercising on a stationary bicycle might elevate mood.
How about cutting out the middleman and getting your exercise in the sea instead?
An Ongoing Therapy
At its core, exercise is good for the body. And what’s good for the body is good for the brain, too. Because depression and anxiety are disruptions to normal brain activity, it makes sense that something like exercise—that has demonstrated benefits for the body—would support the brain, too. While science tinkers with the exact dosages that help individuals with different types and severity levels of depression and works out the specific mechanisms of how it all works, I’ll keep putting one arm in front of the other, knowing that my own body of evidence says swimming is a major help for keeping my mental health above water.
Elaine K. Howley is an accomplished marathon swimmer and freelance journalist who is a member of the New England LMSC.
The piece was supported by the New England Masters Swim Club (NEM).
Photos provided by Elaine K. Howley. Header photo by Andrew Malinak.