I recently went for a swim for the first time in over a year. Standing over the sparkling, blue pool at my local gym, I tried to recall many of the stressful events from the past 16 months: moving to a new city -- Baltimore -- during a pandemic, starting a new internal medicine residency training program, and taking care of both Covid and non-Covid patients in the hospital had all taken their toll.
My first thought as I dove under the surface of the water was that I felt a little more buoyant than usual, likely due to the added pounds brought on by quarantine. But as I continued to glide through the water, my initial concern about weight gain was replaced by a feeling of catharsis, as though the water were cleansing me of the stress that had accumulated during the coronavirus pandemic. Stroke after stroke, I could feel my mood lifting, my mind clearing and my body loosening.
Thirty minutes later, I got out of the pool feeling confident and level-headed, ready to begin the first of four night shifts in the intensive care unit. I usually dread the first of these night shifts, but somehow the task seemed more manageable than usual. "Whatever happens tonight, happens," I told myself encouragingly. "No matter what, there will always be tomorrow."
My improved mood was in no doubt related to my recent dip in the pool. Like all types of physical activity, swimming can improve your mood by stimulating the production of endorphins -- natural opioids produced in the brain -- as well as other neurotransmitters such as dopamine and serotonin.
But the benefits of taking a swim go far beyond a momentary lift in spirits -- especially right now.
Changing your mind
As we all emerge from isolation, experts say attending to our mental health needs to be a top priority.
"Americans have faced unprecedented hardship in the past months, but by focusing daily on caring for our own emotional well-being and supporting the well-being of those we love, we can successfully mitigate the mental health effects of the COVID-19 pandemic," said former US Surgeon General Dr. Jerome Adams in a news release earlier this year.
"Although this is a difficult time in our nation's history, I remain steadfast in encouraging Americans to use healthy mechanisms to cope," he added.
The prevalence of depressive symptoms in the United States increased more than threefold as Covid-19 spread, according to a recent study in the journal JAMA. Some high-risk groups, including health care workers and those under the age of 30, were at an even greater risk of developing anxiety or depression due to the pandemic, according to a different study published in the Journal of Psychiatric Research.
Regular exercise -- including swimming, running, yoga, weight training and even tai chi -- remains one of the most powerful tools we have to improve our mood and overall mental health. A 2016 meta-analysis that combined data from 23 randomly controlled trials showed that exercise was comparable to both antidepressants and psychotherapy in the treatment of depression.
While part of this is due to the production of endorphins, exercise also results in important structural changes in the brain, particularly in a primitive brain structure called the hippocampus. Along with another brain structure called the amygdala, the hippocampus is heavily involved in memory formation and the regulation of emotions.
Over time, regular aerobic exercise -- such as running and swimming -- reduces inflammation and promotes nerve growth in the hippocampus, with positive effects on both mood and memory, studies have shown. Conversely, atrophy, or shrinkage, of the hippocampus has been linked to the development of mood disorders such as depression and bipolar disorder.