Focused steps most effective

It’s tough to fight the initial urge to climb back into bed rather than get out and get moving, but taking that first step makes progress possible.

Teri Jo Oetting, a community dietitian at the University of Missouri Health and Sciences Center, helps her depressed patients make strides toward physical fitness by taking small, singularly focused steps.

Oetting recommends that her patients concentrate on one health and nutrition area at a time to keep themselves from becoming overwhelmed and frustrated. “Like getting at least five servings of vegetables and educating yourself on the benefits,” she says, “and keeping meal preparation as simple as possible.”

Since depression sufferers often isolate themselves, spending free time at home rather than out mixing with others, Oetting suggests easy but significant actions that point her patients in the direction of better habits.

“I might tell one person to walk outside at night, find the moon, and take three deep breaths,” she says.

In the beginning, patients may balk and find her suggestions silly, Oetting admits. But beyond those first steps, the door opens to a world of positive feelings that lead to bigger, brighter options. “Once outside, they end up doing more,” she explains. “Maybe 10 deep breaths in and out, telling themselves things like, ‘I walked outside. I’m getting better.’ Once they take that first step, they really feel good.” The bigger the steps, the more positive the feelings—leading to more activity and more success.

“Depressed patients who combined medication and exercise did not respond as well as those who simply worked out.”