'I know that if I do go out, I will feel better': understanding the process of change in exercise for depression

White, Karen, Kendrick, Tony and Yardley, Lucy (2006) 'I know that if I do go out, I will feel better': understanding the process of change in exercise for depression. British Psychological Society Division of Clinical Psychology Annual Conference, London, United Kingdom. 14 - 15 Dec 2006.

Abstract

Objectives: studies have shown that exercise is consistently associated with lower levels of depression and that exercise interventions can alleviate depressive symptoms. The aim of the present study was to explore the experience of exercise and the process of change from the perspective of individuals with depression, focusing on both those who do and do not believe that exercise has helped their depression.

Design: a qualitative approach was taken, in which semi-structured interviews were conducted with participants. The study followed a grounded theory approach, whereby data collection and data analysis operated in parallel. The grounded theory method was used as it is ideally suited to studying and identifying process.

Methods: twenty-six participants took part in individual one-off, semi-structured interviews. The participants were recruited from one general practice in Southampton (n = 11) and from non-clinical sources (n = 15), e.g. university sports clubs. Thus, a variety of experiences of exercise and depression were obtained, including participants who had attended exercise referral schemes and participants who exercised upon their own initiative. Each interview focused on the participant’s current and previous involvement in sports and exercise, the management of exercise in everyday life, the emotional, physical and mental experience of exercise, and thoughts and beliefs about whether exercise had any impact on their depression. Later interview questions were adapted to explore the emerging analysis further.

Results: the data were analysed using grounded theory methods. Categories relating to experiencing change, maintaining exercise, feelings from exercise, the exercise environment and managing depression were identified, and were all related to a core category of ‘knowing (from experience)’. Exercise emerged as a process of ‘experiencing change’ for these participants, e.g. a sense of participating rather than feeling isolated, becoming more active and being more motivated to do other things. For some, experiencing changes gradually led them to ‘knowing’ that exercise could make them feel better and to using exercise as a way of actively controlling the symptoms of their depression. This also represented part of a shift over time in motivations for exercise from initial reasons such as weight loss to exercising for reasons such as enjoying exercise and ‘knowing that I’ll feel good’. The shift to more intrinsic motivations helped to overcome barriers to exercise such as feelings of lethargy and promoted continuation of exercise. The results also highlighted the importance of the feelings derived from exercise, e.g. finding it feels good, and the importance of environmental factors, e.g. feeling comfortable, for perceiving benefit and maintaining exercise.

Conclusions: the results can help practitioners understand the role that exercise may play in helping clients with depression and point to practical considerations such as the exercise experience, environmental factors and shifting motivations in promoting exercise with clients.

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Contributors

Author: Karen White

Author: Tony Kendrick

Author: Lucy Yardley

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