No, Working Out Is Not a Replacement for Going to Therapy

Photo: Getty Images/Oleg Breslavtsev
I was talking with a fellow fitness-obsessed friend recently about how much therapy has helped me. While I wasn’t preaching the gospel of cognitive behavioral therapy to try to persuade anyone to seek it out for themselves if they don’t want to, there’s no denying that it has transformed my own mental health for the better.

“I don’t go to therapy because I work out so much,” she responded. It completely caught me off guard.

Sure, working out is beneficial for your mental health—the science and research clearly state this. Exercise releases neurotransmitters, notably feel-good endorphins, which increase feelings of pleasure and decrease feelings of pain. It also boosts dopamine, which also increases pleasure and feelings of motivation, and can help relieve feelings of depression.

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In fact, a meta-analysis published in 2016 found that exercise had a “large and significant antidepressant effect” in people with depression, including major depressive disorder. Another review published in Advances in Experimental Medicine and Biology found that exercise “has been shown to significantly reduce the symptoms of anxiety” thanks to a combination of biological and psychological factors. Exercise is also a powerful stress reliever. A study published in Frontiers in Psychology found that healthy adults who exercise regularly were better able to handle acute stressors and develop emotional resiliency.

I’m sure that’s where my friend was coming from, that she views her gym classes as an opportunity to relieve stress and get in a positive headspace. I know she didn’t mean to be invalidating or offensive, and I don’t even think she realized what she was saying. But it really got me thinking about how dismissive some people can still be about therapy and how many conflate the benefits of physical activity with the work that's done in therapy.

Although I’ve been a champion for mental health in the 12-plus years I’ve been a writer, I personally have only been in therapy for two years. Within that time. I’ve learned positive coping mechanisms, how to work through the guilt and shame of my late ADHD diagnosis, what to do when I’m plagued by scary intrusive thoughts, and I've unpacked some unresolved feelings that I’ve held on to for years, to name just a few positives. Honestly, therapy has completely changed my life.

To be clear, I’m also very physically active. I’ve been working out consistently in a gym since I was 14, and in a past life, I was a full-time fitness editor. I lift weights about four days a week and do cardio another two to three days a week. And I’m diligent about getting in my 8,000 to 10,000 steps a day.

I view exercise as not only something I need to do as an adult to take care of my physical health, but also as a tool in my arsenal to treat my mental well-being. As someone prone to depression and anxiety, I find that regular physical activity helps balance my mood and relieve some of that anxiety.

All of this is to say—exercise is beneficial for my mental health, but it’s by no means a replacement for therapy.

“They’re really two different things,” explains licensed therapist and board-certified behavior analyst Laurie Singer, LMFT. “Exercise is a great way to relieve stress, and it also can get you on track to utilize the strategies that you're using in therapy. But it is different than therapy.”

Singer says that she always recommends physical activity as part of a treatment plan for her clients. It depends on their abilities and how much time have to exercise, but she says she typically encourages them to work out at least four times a week.

“[Exercise] relieves that tension, that stress,” she says. “It boosts your physical and mental energy... It enhances your well-being all from those endorphins. Isn't that amazing?”

The best part is that you don’t have to pay for pricey gym classes or use fancy equipment to get those benefits. Lacing up a pair of walking shoes and going for a brisk walk is free—anything that gets your body moving and your heart rate up is going to be beneficial.

Still, physical activity isn’t therapy. Think about it: While you might feel better mentally after a workout, Singer points out that you could experience intrusive thoughts while exercising or you might ruminate on worst-case scenarios—which might keep coming back if you don’t deal with them head-on. A therapist can offer an outside perspective and tools to help you deal with distressing situations. For example, Singer says she often helps patients manage their anxiety, especially around catastrophizing or dealing with the dozens of “what-ifs” we all experience. She also can offer solutions around communication issues people might be experiencing in their relationships—things you won’t get from a HIIT class.

Conflating regular exercise with clinical mental health treatment might just boil down to misconceptions around therapy. While it’s become more acceptable to talk about therapy in recent years, there is still so much that’s misunderstood. For instance, therapy isn’t just lying on a couch in a psychologist’s office and crying about your childhood (although, no shade to people who use their therapy sessions that way!). There are a variety of therapy modalities that therapists utilize, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and mindfulness-based cognitive therapy, to name a few.

And while I’ve been exercising regularly for 20 years, it wasn’t until I started seeing my therapist that I noticed a dramatic shift in my mental health. Running gave me energy, but it didn’t help me deal with feelings of guilt and shame. Lifting weights helped relieve some stress, but it didn’t help me learn to be a better communicator. And while I certainly feel better mentally after a tough spin class, it doesn’t erase my depression, anxiety, or intrusive thoughts.

Singer says that, along with therapy and medication if people are prescribed it, taking care of your mental health also requires other lifestyle factors like eating well, getting enough sleep, not drinking too much alcohol, and yes, exercise. As Sepideh Saremi, LCSW, running therapist and founder of Run Walk Talk told Well+Good in 2020, "It's not good to be too reliant on one tool."

That’s just the strategy I believe in—I know my mental health requires a diligent 360-degree approach. But that doesn’t prevent people from making off-color comments.

“If somebody does say, ‘Well, I don't need to go to therapy because I exercise’” suggests Singer, “I would say, ‘That’s great that exercise is helping you, it’s creating those endorphins… if you ever do need [therapy], let me know, I have a great therapist.’”

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