Every one of us has been handed the same advice at some point in a low stretch: get some fresh air, go for a walk, you’ll feel better. Host, Michael Dargie opens this episode by admitting how much that advice used to irritate him. “If I had the energy to go for a walk,” he says, “I wouldn’t need the walk. That’s the whole problem — the thing you’re prescribing requires the thing I’ve run out of.”

So he puts it straight to his two guests My Viva’s Chief Medical Liaison Dr. Prerana Rudrapatna, and My Viva’s Director of Fitness, Shara Vigeant. When you tell someone to exercise for their mental health, is that real medicine with real biology behind it? Or is it just a socially acceptable way of telling someone to cheer up?

The answer, it turns out, is both more scientific and more forgiving than expected. Dr. Prerana walks through what actually changes inside the brain when you move — brain-derived neurotrophic factor, serotonin, the same molecular targets our antidepressants are aimed at — and points to a 2024 BMJ network meta-analysis of 218 studies and more than 14,000 participants that found something genuinely counterintuitive: people with depression did better when their exercise was prescribed for them than when they were handed choice and autonomy. Shara translates all of it into the language of the coaching chair, breaks down the three neurotransmitters she explains to every new client, and makes the case that has become her signature on this show — that five minutes counts, that movement snacks are not a consolation prize, and that 150 minutes a week is the destination, not the entry fee.

Along the way the conversation goes places a fitness episode usually doesn’t. Michael asks the two of them how they handle their own sedentary days, and neither pretends to be perfect. Listeners write in with the questions they were too embarrassed to ask out loud — about still having bad days on medication, and about how intimidating it feels to walk through a gym door when you are in pain, out of shape, or barely holding it together. And the episode closes on a piece of homework so small it almost sounds like a trick: write down five ways you could move your body this week that would actually bring you joy.

The through-line is self-efficacy — the belief, built by doing rather than by being encouraged, that you can handle hard things. As Shara puts it: opening the gym door is the biggest lift you’ll make all day.

Key Highlights

“If I had the energy to go for a walk, I wouldn’t need the walk.” Michael’s opening confession sets the tone for the whole episode. Shara’s response is the one every listener in a low stretch needs to hear first: that objection isn’t resistance or laziness — it’s an accurate description of how depression works. People know they should walk. They know movement helps. What they don’t have is the energy or the motivation to start. “If it were that easy,” she says, “everybody would be doing it.” Before anything else, the feeling gets acknowledged as real.

Exercise used to be the last thing offered. That’s changing. Dr. Prerana explains that in conventional treatment planning, exercise has typically arrived as the complementary or adjunct option — something suggested after medication or cognitive behavioural therapy has already fallen short. Over the past two or three years, the lifestyle medicine movement has been pushing hard to move it to the front of the line, prescribed early and alongside medication and therapy, because the effects have proven comparable and robust. She’s also noticing the push coming from an unexpected direction: patients themselves, asking their psychiatrists what else they can do.

The 2024 BMJ finding that surprised everyone: prescription beat choice. Dr. Prerana cites a large network meta-analysis published in The BMJ — 218 studies, more than 14,000 participants — examining what type and dose of exercise works best for major depression compared with therapy and medication. Walking or jogging, yoga, and strength training showed the strongest effects, and effects were proportional to the intensity prescribed. But the finding that stopped the room was this: interventions that gave participants more autonomy and more choice showed weaker results than structured, prescribed programmes. Told “do a bit of exercise, whatever you like, see you in three months,” people did worse. Which may say a great deal about the self-starting trouble that comes with depression in the first place.

BDNF, in plain English. Michael stops the conversation to make someone define it, which is exactly his job. Brain-derived neurotrophic factor is a protein your own body makes. It tends to sit low in people experiencing depression, and exercise raises it. It supports the growth and survival of neurons and the strength of the connections between them, which is what underpins emotional regulation, resilience under stress, neuroplasticity, and learning. Dr. Prerana noted on air that it’s found on chromosome 11 and flagged it for fact-checking — we checked, and she’s right. The practical version: get in the habit of building resilience through daily activity, and when traffic makes you late and the negative self-talk starts, you bounce back faster.

Shara’s three chemicals. When a client asks why exercise is going to help, Shara doesn’t hand over a workout — she explains the mechanism first. Serotonin regulates mood, emotional well-being and sleep. Dopamine drives motivation, reward, pleasure, and the feeling of being engaged with your life. And endorphins — her personal favourite — are the feel-good chemicals that reduce stress and lift your mood after. Understanding why the prescription works is itself part of the prescription.

Movement snacks, and the case for five minutes. “It doesn’t have to be grandiose to be effective.” If 15 minutes feels impossible, does five feel doable? Laps around the house. Up and down the stairs. Enough to shift the chemistry and shift the mood. Shara argues the fitness industry has been too rigid for too long, and that what works for you today might not work tomorrow — which is fine, because the goal is finding what you can realistically do and what brings you joy.

150 minutes is the destination, not the entry fee. The guidelines — 150 minutes of moderate activity plus two muscle-strengthening sessions a week — are excellent, and both guests stand behind them for long-term cardiometabolic health. But for someone struggling with their mental health who can’t yet manage five minutes, that number reads as a barrier rather than a goal. Start where you are. Five minutes gets you closer to 150 than zero does.

Exercise and the drug are often aimed at the same target. This is the episode’s most quietly radical idea. Antidepressants work on serotonin — helping it hang around in your body longer before it gets broken down. But serotonin is endogenous: your body already makes it. Same with insulin in type 2 diabetes; the problem often isn’t that you have none, it’s that it isn’t working properly, and exercise increases the sensitivity of your GLUT4 receptors so the insulin you do have gets used more effectively. Same molecules, same pathways, same targets. Dr. Prerana’s ask of her colleagues: clinicians routinely explain how a drug works — take the extra minute and explain the mechanism of action of exercise too.

Different exercise for different conditions. Aerobic exercise and strength training — cycling, swimming, running — carry the strongest evidence for raising BDNF and helping with mild-to-moderate depression. Strength training in particular, and especially in women, builds a sense of accomplishment that improves self-efficacy and directly counters feelings of worthlessness. Exercise isn’t one undifferentiated thing any more than medication is.

Self-efficacy: showing up mad, sad, happy or angry. Shara’s definition is refreshingly unacademic — it’s the strong sense of self that comes from doing hard things and finishing them. I did the thing. I didn’t want to do the thing. I did it anyway. You can build it on five minutes a day. And the way you build it is not by hitting a perfect hour in a perfect window, but by showing up however it looks. Shara is candid that she uses exercise to manage her own anxiety, and that she can feel it creeping in on the days she doesn’t move.

The clinician is a patient too. Michael flips the question on his guests, and neither dodges it. Shara — 25 years in the industry — says simply, “walk the talk,” and describes a watch that nags her to stand, scheduled workouts, lunch-break walks, and the discipline of zooming out to look at the week or the month rather than judging herself on a single bad day. Dr. Prerana talks about charting standing up, pacing during phone appointments, doing squats between calls, a sit-stand desk, and a walk right after a meal to blunt the blood sugar spike. Her most useful confession is about her own internal dialogue: instead of overcorrecting for a week of sitting with a heavy gym session that leaves her injured and out for a fortnight, she tells herself today I’m going to stretch and foam roll, and the gym is tomorrow.

Eventually your body starts asking. Shara’s observation is that once movement is genuinely part of your life, your body — not your brain — becomes the one issuing reminders. Miss a few days and you’ll wake up to a body that is, in her words, a little angry with you. Dr. Prerana had felt exactly that on the morning of the recording.

The momentum cascade. Dr. Prerana describes something most people have lived without naming: on the mornings she’s headed to the gym, everything downstream improves. Breakfast gets built properly — where’s the protein, where’s the fibre? The first meeting goes better. On the mornings she doesn’t, it’s coffee first and food an hour later, and the balance of the day is gone. “The heaviest door,” as she puts it, “is the front door.”

Community, and the nod. Michael is at the Y at 6:30 every morning with the same group of people — from all over the map socioeconomically — who spot each other on the floor and offer encouragement to whoever looks like they need it. Shara has the same thing at 6:00 a.m., Monday, Wednesday, Friday. Nobody talks. “It’s the nod.” Pick a time, go at that time, and the community assembles itself. For anyone who needs a lower-stakes entry point, Dr. Prerana recommends Meetup — she once found a group called single dads’ basketball on Sunday mornings in Chicago, which is exactly the point: shared circumstance takes the shame out of the room.

The homework: five things, and make one of them joyful. Asked for the one thing a listener should do before the end of the week, Dr. Prerana offers a “thinking goal” — write down five activities involving movement, from parking further from the grocery store to a Zumba class, that would genuinely fill your cup. Shara takes the same goal and adds a filter: which of these would actually bring you joy? She tells the story of a client with osteoporosis who had to choose between a workout and her enormous garden, and Shara — the trainer — told her to garden. It’s movement, and she loves it, and that matters for her mental health as much as her physical health.

Questions People Are Afraid to Ask

Michael brought three uncomfortable questions to this one — two of them written in by listeners who heard the topic was coming.

“I’m on medication for my mood and I’m doing the walking. And I still have bad days. Does that mean it isn’t working, or that I’m not doing enough?” Dr. Prerana’s answer starts with a saving analogy: put a dollar a day aside and it adds up, and missing a day doesn’t undo it — it’s still better than never saving at all. Behaviour change takes roughly six months to move through the stages into the action phase and on into maintenance, so what matters is the pattern over time. Are you moving toward this more often than not? Five days out of seven is great. She also points out that the bounce-back itself improves with practice: early on, one missed day can derail you for three months; nine months in, a missed day comes with a very different internal conversation, one that ends with scheduling the next one. Shara’s addition is blunt and kind — bad days are not failures. Mood improvement is not linear, life is not linear, and every human being has bad days regardless of what they’re managing. Zoom out. Are there more good days than bad? If the answer is no, that’s the signal to check in with a healthcare professional or someone supporting you. And it may simply be that you’ve locked yourself into an activity you don’t enjoy, which makes commitment harder than it needs to be. Dr. Prerana closes the loop with a coaching tip: treat the setback as an opportunity for learning. What happened? Were you too sad? Did you have to pick up your kid? Name the behaviour, name the emotion, then plan for how you’ll handle it next time.

“Walking into a gym when you’re out of shape, in pain, or not doing well mentally is genuinely intimidating. It can feel like everyone in the room knows you don’t belong there. How do you start when the starting line itself feels like punishment?” Shara doesn’t minimize it — that discomfort is real and it’s a genuine barrier for a lot of people. But two things are also true. First, from 25 years on gym floors: roughly 90% of the people in any gym feel uncomfortable, regardless of how fit they look, and virtually nobody is paying attention to you. Second, and more usefully, the gym is not the only option. Home workouts, a community group, a friend, something entirely outside the building — don’t put yourself in a box thinking there’s only one way in. Dr. Prerana points to My Viva Plan’s home workouts, which include video for every exercise and an assisted beginner setting, with Shara herself demonstrating much of the form. She also notes that some gyms now offer women-only rooms, and recommends Meetup for finding an activity where you already share something with everyone else in the room. Shara’s closing thought on community is the funniest line of the episode and also completely sincere: find people with common values, goals and barriers, and if what you have in common is that you all hate exercise — great. You’ll hate it together.

“Clinic is a very sedentary life. What advice are you giving yourselves?” Michael’s own left-field question, aimed straight at the two people giving the advice. Neither claims to have it solved. Shara: “I’m a human, I’m not perfect, every day is not perfect. I have good days and bad days, but when I zoom out I’m pretty happy at the bigger picture.” Dr. Prerana: stretching and mobility count, desk yoga counts, standing to chart counts, and the mental dialogue that keeps you from overcorrecting matters more than the workout you didn’t do. It’s a rare and useful few minutes of two professionals declining to pretend.

Links & Resources Mentioned

• My Viva Plan — home workouts with video and an assisted beginner setting, wellness journeys for managing a chronic condition through the stages of behaviour change, desk yoga routines, and worksheets including counteracting sitting all day and counteracting standing all day: myvivaplan.com

• Meetup — for finding local activity groups built around shared circumstance: meetup.com

• The BMJ (2024) — “Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials” — the study Dr. Prerana cites; 218 studies, 14,170 participants: bmj.com/content/384/bmj-2023-075847

• American College of Lifestyle Medicine — the conferences Dr. Prerana references: lifestylemedicine.org

• Canadian 24-Hour Movement Guidelines — the source of the 150 minutes plus two strength sessions target: csepguidelines.ca

Crisis and mental health support (Canada)

• 9-8-8: Suicide Crisis Helpline — call or text 9-8-8, free, 24/7, in English and French: 988.ca

• Kids Help Phone — 1-800-668-6868, or text CONNECT to 686868: kidshelpphone.ca

• Government of Canada mental health services directory: canada.ca/en/public-health/services/mental-health-services/mental-health-get-help.html

Disclaimer: This podcast is for informational and educational purposes only and is not a substitute for professional medical advice. Always consult your treating physician or a qualified health care provider before making any changes to your diet, exercise or lifestyle. Never disregard professional medical advice