New research suggests that a workout before therapy might help you connect with your therapist and implement their advice. 

Your therapist isn’t going to judge you if you show up to your appointment in sweaty gym clothes. And new science from the University of Wisconsin-Madison suggests that going to therapy fresh off a workout might actually help you get better results.

A pilot study published in the Journal of Affective Disorders found that 30 minutes of moderate exercise before therapy sessions helped people with major depressive disorder build stronger connections with their therapists and take greater initiative to change their behaviors to improve recovery.

The Therapeutic Benefits of Exercise

The researchers broke the group into two and instructed people to either cycle on a stationary bike for 30 minutes or sit quietly for the same amount of time. “To provide a standardized experience across conditions,” both groups also watched a calming nature documentary (Blue Planet II) for 30 minutes before their 50-minute weekly cognitive behavioral therapy sessions. 

After eight weeks, the exercisers scored higher than the rest group on scales measuring their bond with their therapist and their intentions to implement what they learned in their therapy session.

Preliminary results also suggested that 69% of people who did the pre-therapy sweat sessions achieved remission from their major depressive disorder, compared to just 33% of those who watched the documentary on sea creatures.

“In terms of a depression treatment trial, that’s really powerful, and so obviously replication of larger samples, seeing if that tends to hold up over time, would be really important,” says study author Jacob D. Meyer, PhD, FACSM, FSBM, Assistant Professor of Exercise Psychology at the University of Wisconsin-Madison and Director of the Wellbeing and Exercise Laboratory.

The Importance of the Client-Therapist Bond

Therapists can practice from an alphabet soup of modalities, such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT). But who delivers the therapy might matter as much as (or more than) the type of therapy you receive.

“There’s evidence to suggest that there are common factors across all therapeutic encounters that may be important for long-term effects, and that includes things like creating a relationship with your therapist that you feel positive about,” says Meyer. “There’s a lot of work that says it doesn’t matter what therapy you’re doing, if it’s CBT or DBT, or a family-focused therapy, if you have a strong relationship with the people you’re working on that with, you’re going to be more likely to have a better result.”

Prior research points to a few simple explanations. Building a positive relationship with your therapist might boost your ability to navigate other relationships. And when you feel safe and comfortable with your therapist, their guidance is more likely to stick.

How Exercise Complements Therapy

What is it about working out that makes therapy land differently?

Well, for one, it helps regulate your nervous system, potentially priming you for a calmer and more receptive session. The Mayo Clinic suggests thinking of it as “meditation in motion,” decreasing our sympathetic nervous system, which responds to stress, and increasing our parasympathetic nervous system[par-uh-sim-puh-thet-ik nur-vuhs sis-tem]nounThe part of your nervous system that supports relaxation and digestion.Learn MoreClose, which helps us relax.

“After a game of racquetball, or a long walk, run or swim, you may find that you’ve forgotten the day’s irritations. You also may find that you focus only on your body’s movements and breathing during exercise,” their experts write.

Beyond that, exercise can improve emotional regulation, helping you open up to your therapist. It also aids cognition and mental flexibility to help you understand the information and advice your therapist shares. 

Finally, working out boosts brain-derived neurotrophic factor, or BDNF, a protein that nourishes brain cells to support neuroplasticity[noor-oh-plas-tis-i-tee]nounThe brain’s ability to change and adapt through experience.Learn MoreClose, including the growth of new neural networks. 

“As we learn new things, BDNF helps us put down the traps that allow those connections to persist,” explains Meyer. New brain connections can mean learning, growing, and implementing insights learned in therapy. 

Exercise also curbs anhedonia, a symptom of depression in which your favorite activities no longer feel enjoyable. Afterward, you might enter therapy more willing to talk about activities you once enjoyed and your plans to try them again, notes Meyer.

All these benefits can add up beyond the time you spend in therapy. Exercise helps reduce depression overall, according to a study review published in BMJ.

How to Exercise Before Therapy

This was a small study with 40 people, so it’s too early to make blanket recommendations about exercise before therapy, Meyer acknowledges. However, given the potential benefits and limited downsides it might be worth trying.

“We’re looking at how we can use the acute benefits of exercise in the context of other treatment modalities to make the most effective options,” the professor says.

Consider the following:

• Take the long way to your therapist’s office. “It could be something as simple as actively commuting to an appointment,” said Meyer. “Maybe you bike, walk, or run.”
  
• Shake up your schedule. If you work from home and see a virtual therapist, try blocking off 30 minutes on your calendar beforehand to work out.
  
• Squeeze in what you can. Meyer emphasizes that any kind of movement helps. While it’s unclear whether, say, ten minutes of light walking would boost your therapy results, it might be better than nothing, and comes with other known benefits for cardiovascular health and blood sugar control.

• Don’t overdo it. One study found that exhaustive exercise could have a counterproductive effect on the nervous system, dialing down the calming, restorative side and dialing up the stress response.
  
• Try it in other contexts. Therapy can be intense. You relive past events, including emotionally charged moments. A workout could help soothe the nervous system in this stressful environment, and in others like it.
  
  “Think about this not just in terms of how it might make therapy better, but how it might make other things better too,” Meyer suggests. “So, if I have a particularly hard thing coming up, maybe exercising beforehand can be helpful to give me a frame of mind that is going to be better suited to handling whatever that is.” 

The very act of trying to get more out of therapy could help you see better results, increasing both intention and engagement. But if nothing else, adding exercise to your routine should boost endorphins[en-dawr-finz]nounMood-boosting chemicals released by the brain during exercise or joy.Learn MoreClose, reduce stress, and contribute to a better night’s sleep — all part of a solid foundation for better mental health.

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