Fitness Mental health

The role of exercise in managing obsessive compulsive disorder

A woman runs down a pathway.

Obsessive compulsive disorder (OCD) is a chronic condition characterized by persistent thoughts and/or rituals, and affects about 1 in every 40 people.  Treatment has typically included cognitive behavioural therapy (CBT), which is a form of psychotherapy aimed at giving people skills and strategies to manage their condition, as well as the use of medications. There is now growing evidence that exercise may also play an important role. This was discussed at the latest Speaker Series event, Treatments for OCD: New Options and How They Work.

Here at Sunnybrook, we piloted a program a few years ago that combined 15 weeks of CBT treatment with 12 weeks of aerobic activity, which included things like biking, running and using an elliptical machine. We found there were symptomatic improvements for all the participants, and they found exercise to be a “doable” component of their treatment.

While we know exercise appears to provide benefits, more research is needed to understand why that happens. Exercise could be likened to a form of exposure therapy, in that it exposes the person to uncomfortable feelings that they get through and feel better afterwards. Exercise may also improve cellular function and blood flow in the brain, as imaging scans have actually shown that exercise changes brain activity and structure.

Combined with a few earlier studies looking at aerobic exercise in OCD, we can say that exercise does appear to provide benefits. Exercise also seems to have a synergistic effect when combined with CBT. In short, the more people do, the better they feel. This is great news, as exercise is generally low cost and accessible in some form to most people.

OCD is not the only mental health condition that can benefit from exercise. There is a larger body of research around exercise (mainly aerobic) and its beneficial effects for major depression. Regular physical activity has also been associated with a decreased prevalence of panic disorder, agoraphobia (a type of anxiety disorder), social phobia and general anxiety. Increased physical activity in childhood has also been associated with a reduced risk of depression in adulthood.

So how much exercise is enough? For general health, Canadian physical activity guidelines recommend adults aged 18-64 get 150 minutes of moderate-to-vigorous physical activity (meaning activity that makes you sweat) every week. That equals about five proper workouts lasting 30 minutes, five times per week. Despite this recommendation, research has found only 15 per cent of Canadian adults currently meet this standard.

For depression specifically, current guidelines recommend about three exercise sessions per week, each lasting about 45 minutes to one hour. While aerobic activity has been studied the most, there is no indication that other types of exercise won’t be also beneficial.

The bottom line is that exercise is important for your physical and mental health. If you’re not sure where to start, talk to your doctor about setting up a program that is the best and safest for you.

View the whole Speaker Series event here:


About the author

Dr. Neil Rector

Psychologist and Director of Research,
Thompson Anxiety Disorders Centre