Why Americans don't exercise

For the better part of a year in 2017, I could barely will myself to leave my house. I was experiencing a prolonged depressive episode with daily, sometimes hourly, panic attacks, and I couldn't see the point in continuing on.

Many things helped me survive. Talking it through in therapy several times a week was like opening a pressure valve in my brain — it kept me functioning just enough to get by. Medication had mixed results — I felt less panicky, but also less joy, excitement, and other essential emotions. Crying to friends provided temporary catharsis. But it wasn't until I discovered Muay Thai, a form of kickboxing, that it felt as if day-to-day life might provide something other than hopelessness.

Every other form of healing I'd tried had focused my mind — its disordered thoughts and supposed chemical imbalances. What I hadn't tried was getting out of it altogether. When firm but well-meaning coaches yelled at me to fix my form, do five more pushups, and kick the bag until my shins were red and nearly bleeding, it jump-started my nervous system. It made me feel human again.

It's a trope to say you should not tell a depressed person to go outside, take a walk, or go for a run. Doing so would dismiss the severity and reality of their illness, like telling someone with a broken arm to go play catch. To some extent, this is true: It's probably not the best idea to tell someone struggling deeply with mental illness to simply suck it up and walk it off. But it's also true that when someone encouraged me to get out there and use my body, it was precisely what I needed at my lowest moment. I ended up at the gym only because my friends repeatedly encouraged me to come with them to a class until one day I finally did. It wasn't a cure-all, but it made me believe that a solution might exist.

Many of our collective crises — depression, anxiety, unhealthiness, and loneliness — are made worse by the same thing: our tendency toward a sedentary, shut-in lifestyle. We live in a society that makes it extremely difficult to find the time and space to be active. An abundance of research shows that exercise is good for depression, and yet most of the time when I hear people talk about the mental-health crisis — on TikTok, on X, and in real life — it is rarely mentioned. In my experience, it's much more common to hear people talk about finding the right diagnosis, the right medication, and the right kind of therapy than it is to see people encouraging their loved ones to get the heck outside.

Many of us know exercise is good for us. All that's left is getting up off our asses.

The evidence is overwhelming that physical activity is good for both our bodies and our brains. A meta-review of studies that included 128,000 participants found that exercise of any kind significantly reduced symptoms of anxiety and depression. There are several theories as to why this is — exercise could increase the availability of neurotransmitters like dopamine in the brain, or it could help the brain form new neural pathways that are helpful to escaping cycles of depression. Either way, moving is good for our brains.

And the physical consequences of not moving enough are well-documented: heart disease, diabetes, high blood pressure, cancer, and a host of other maladies are linked to low physical activity. It is also bad for our mental health: A 2014 meta-analysis of more than 100,000 people found that increased sedentary time was positively correlated with rates of depression. A study from the beginning of COVID found that it was harder for people to stop being depressed if they spent too much time sitting.

Despite the research, Americans have become less active over time. By one estimate, we're getting 27 fewer minutes of physical activity on average each day than we did 200 years ago. And for the past several decades, only about a quarter of American adults have met the recommended guidance of at least 20 minutes of exercise a day, according to the Centers for Disease Control and Prevention. One 2019 study found that we spent 82% of our time sedentary.

For kids, who need even more physical activity, the decline is stark. A 2022 Report Card on Physical Activity for Children and Youth gave the US a D- score, concluding that America, while never sufficiently supportive of physical activity, had become even worse at making the space and time for it. In 2007, an estimated 30% of adolescents completed the recommended 60 minutes of moderate-to-vigorous activity every day. By 2020 that number had fallen below 9%. Far fewer kids participate in team sports or walk or bike to school than did in the past, the report found. In Canada, as one study put it, pediatricians are so concerned about the decline in physical activity that they are encouraging parents to let kids engage in "thrilling and exciting forms of free play that involve uncertainty of outcome and a possibility of physical injury."

Instead of getting enough exercise, we're stuck lounging around on our phones. We've replaced real-world, bodily stimulation with mental stimulation from our screens. Meanwhile, our brains are rotting. In one study, nearly half of Americans ages 18 to 29 reported experiencing depression or anxiety in 2023. And over the past few decades, mental illness for teens and children has been on the rise.

Instead of looking at the situation and concluding that we all need to exercise more, some people are doing the opposite. Certain trends circulating social media emphasize not using your body: "hurkle-durkle," aka "bed rotting," involves wrapping yourself in comfy clothes and bed linens and staying in bed way past the time you should be waking up. But while there is a time and place for doing nothing and relaxing, Americans aren't actually getting more rest. Much of the country is chronically underslept.

In this trend, I see the logic of depression — the sense that nothing can or will change so there's no point in trying. Much of America, it seems, has given up on trying to be active.

Over time, my year from hell faded from my mind. But eventually, my exercise routine went with it. I didn't need to work out to stay sane, I thought, and so I stopped committing to it. Then I moved away from the Muay Thai gym and completely fell out of the routine. After a few years, the depression caught up to me. It wasn't as catastrophic as before, more of a persistent ennui that was hard to shake. I tried to figure it out in therapy. I tried to intellectualize it. I tried to excuse it: There was no point in trying anything, life was just inherently bad, the political state of the world was scary, the outside world was too expensive. It wasn't working.

Then one day, early in the pandemic when I was prone to languishing in my room for hours on end, a roommate suggested I come to the tennis court with them for an hour. I was immediately hooked. Playing tennis with friends several times a week wasn't just fun, and it didn't just help get me into shape — it became a main focal point of my life. It provided me with a new relationship to my body and mind. I'd forgotten that exercise, while not a cure for my mental illness, was a necessary precursor to my mental wellness. After years of intellectualizing my sadness and discomfort, I once again had something that got me into my body, got my endorphins going, and, most important, got me to stop thinking about anything other than where to place the ball on the other side of the court.

Depression is a vicious cycle; it pits your brain against itself. When I was at my worst, the usual advice of "don't tell a depressed person what to do" wasn't helpful to me because I needed someone to help me break that cycle by telling me to stop repeating the same patterns. What saved me was friends who helped me get out of the house, suggested I join the gym with them, or encouraged me to do anything to get me out of my head.

I still sometimes get depressed. I still struggle with mental health. But I now feel as if I have a reliable way to help myself out of it. I've gotten to the point where exercise — being in my body, sweating — is more important to me than more mind-oriented forms of therapy. It's not a magic cure, but I now see it as a fundamental baseline. If I'm not moving, nothing will help my sad state.

SSRI prescriptions continue to rise and more people are seeking therapy, but depression and anxiety rates remain sky-high. If you've tried nearly everything else, why not simply get moving?

P.E. Moskowitz runs Mental Hellth, a newsletter on psychology, psychiatry, and modern society. They are also the author of the forthcoming book Rabbit Hole, a combination of memoir and reportage about the role drugs play in our happiness.

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