Why Exercise Beats Antidepressants + The Lithium Discovery You Haven't Heard About

Anxiety, depression, and sleep problems are becoming increasingly common—especially for people living with MS and other autoimmune conditions. If you're struggling with any of these issues, you're not alone. Over 50% of people with multiple sclerosis report symptoms of anxiety, depression, or difficulty sleeping,^{(1, 2)} and these challenges tend to increase the longer you've been living with MS.⁽³⁾

Many adolescents and young adults are now also dealing with these issues, in part because of smart phone and social media usage late into the night.⁽⁴⁾

As someone who has dealt with mood and sleep issues since adolescence, I understand how isolating this can feel. While talk therapy remains a cornerstone treatment, there's currently a national shortage of mental health professionals, making it difficult to get timely appointments.

In this blog, I'll share the lifestyle strategies I've found most effective in my own journey and in my clinical practice for supporting better mental health and sleep.

My Personal Journey with Mental Health and Sleep

I've struggled with mood and sleep issues since my teenage years. During college and medical school, these challenges intensified—likely due to poor sleep habits, reduced physical activity, and declining vitamin D levels from spending too much time indoors.

Over the years, I've worked with mental health professionals, seen psychiatrists, and tried various medications. Through this process, I discovered that increased physical activity was key to stabilizing my mood, while talk therapy helped me break some of my negative thought patterns. Both of these interventions were key to improving my sleep habits.

In my clinical practice today, I encourage patients to work with talk therapists while also implementing lifestyle changes that support better mental health and sleep quality. That’s what we’re going to look at next.

Move Your Body, Improve Your Mood

One of the most powerful tools for mental health is also one of the simplest: physical activity. Research shows that exercise performs just as well as antidepressant medications for treating people with confirmed depression.^{(5, 6)}

You don't need to become a marathon runner overnight. Focus on activities you actually enjoy—walking, jogging, dancing, or any movement that gets your heart rate up. The key is consistency, not intensity.

I recommend exercising in the morning or early afternoon when possible. Later workouts can be too stimulating and may interfere with your ability to fall asleep at night.

Manage Your Screen Time

How much time are you spending on your devices each day? The applications on our phones are intentionally designed to capture and hold our attention. Too often, we find ourselves totally absorbed in our phones, sometimes losing several hours that way. This interferes with your sleep hygiene as well as your connection with friends and family.

Research shows that increased smartphone use is linked to reduced physical activity and greater risk of poor mental health and sleep problems.⁽⁷⁾

Consider these strategies for reducing screen time:

• Move your phone out of the bedroom
• Delete apps that don't serve your wellbeing
• Try a 24-hour social media break each week
• Set boundaries around phone use during family time

Improve Your Nutrition

The quality of your diet has a direct impact on your mental health and sleep. Ultra-processed foods—including sugar-sweetened beverages and products made with white flour like cereal, bread, and pasta—are linked to higher rates of anxiety, depression, and poor sleep.⁽⁸⁾

A comprehensive meta-analysis of diet studies in people with MS found that the Mediterranean and Paleolithic diets both led to improved mental quality of life.⁽⁹⁾

For most people, additions are easier than eliminations. Start by eating more non-starchy vegetables and berries. Include adequate protein from meats, fish, legumes, or whole grains like rice. Then work on reducing or eliminating sugar-sweetened beverages and white flour-based products.

Targeted Supplements for Mental Health Support

The chemistry of life depends on enzymes that require vitamins and their associated mineral cofactors to function properly. Unfortunately, those with mental health issues are more likely to overconsume ultra-processed foods, which makes them more likely to develop deficiencies in key vitamins and minerals.

Meta-analyses of studies using vitamin D⁽¹⁰⁾ and fish oil⁽¹¹⁾ for mental health have shown that these supplements can reduce the risk of mental health symptoms. Research in prison settings also found that adding a multivitamin, multimineral supplement, and fish oil reduced aggressive and violent behavior among inmates.⁽¹²⁾

Magnesium is another essential mineral for proper brain cell function. Magnesium deficiency has been linked to anxiety, depression, and poor sleep.⁽¹³⁾ You can find a more in-depth look at the importance and impact of magnesium here.

I've combined these four key mental health support supplements—vitamin D, fish oil, a multivitamin/multimineral, and magnesium—into a basic support kit for convenience. These provide excellent foundational support for your mental health and sleep quality.

Lithium: A Promising Mineral for Brain Health

Lithium is a naturally occurring mineral that has been used in high doses as a prescription medication to treat bipolar disorder for decades. But recent research suggests that much smaller, nutritional doses of this same mineral may offer significant benefits for mood, sleep, and brain protection—without the side effects associated with psychiatric dosing for bipolar disorder.
The doses being studied for general brain health are roughly 100 times smaller than those used to treat bipolar disorder, putting them in the same category as other mineral supplements rather than psychiatric medications.
Studies have found that areas with lower levels of lithium in the drinking water have higher rates of depression and suicide.(14) This connection led researchers to investigate whether small amounts of lithium might support mental health in the general population.

The high-dose lithium used to treat bipolar disorder has significant side effects, but low-dose lithium orotate (less than 1/100th of the dose used for bipolar disorder) can reduce oxidative stress and inflammation, improve mitochondrial function, and increase protection of the brain cells and synapses.(15) Animal studies suggest it may also amplify the benefits of nutrition and exercise for mood stabilization, sleep quality, and protection of muscle mass, bone minerals, and blood sugar control.⁽¹⁵⁾

A recent meta-analysis compared eight studies of low-dose lithium studies with three antibody drugs used for Alzheimer's disease (donanemab, lecanemab, and aducanumab). The researchers found that the Alzheimer's drugs had more side effects and were less well-tolerated than the placebo, while low-dose lithium outperformed two of the three drugs with fewer side effects.⁽¹⁶⁾
Another study confirmed that people with cognitive impairment and Alzheimer's have low brain lithium levels compared to healthy individuals.⁽¹⁷⁾ In mouse models of Alzheimer's, researchers found that insufficient lithium intake accelerated cognitive decline, while low-dose lithium orotate could restore lithium levels and improve severe cognitive impairment.

While these studies need to be confirmed in larger, randomized human trials, restoring lithium levels in the brain and body could become an important nutritional strategy for improving health.

Final Thoughts

Anxiety, depression, brain fog, and poor sleep are becoming increasingly common across multiple health conditions. They're also rising among young people. While I strongly recommend working with a therapist, I also encourage you to improve your nutrition, exercise, and other self-care routines as foundational support.

Focus on eating more vegetables and protein while reducing ultra-processed foods. Check with your medical team about adding targeted supplements, including the four-supplement mental health support kit I mentioned, and—potentially—looking into low-dose lithium orotate.

I plan to thrive to 120 and beyond, and I hope that's your goal too. Great nutrition, regular exercise, and targeted supplements, including lithium orotate, are all part of my daily routine.

Citations

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2. Zeng X, Dorstyn DS, Edwards G, Kneebone I. The prevalence of insomnia in multiple sclerosis: A meta-analysis. Sleep Med Rev. 2023;72:101842.
3. Stanciu I, Anderson J, Siebert S, Mackay D, Lyall DM. Associations of rheumatoid arthritis and rheumatoid factor with mental health, sleep and cognition characteristics in the UK Biobank. Sci Rep. 2022;12(1):19844.
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10. Jamilian H, Amirani E, Milajerdi A, Kolahdooz F, Mirzaei H, Zaroudi M, et al. The effects of vitamin D supplementation on mental health, and biomarkers of inflammation and oxidative stress in patients with psychiatric disorders: A systematic review and meta-analysis of randomized controlled trials. Prog Neuropsychopharmacol Biol Psychiatry. 2019;94:109651.
11. Gao X, Su X, Han X, Wen H, Cheng C, Zhang S, et al. Unsaturated Fatty Acids in Mental Disorders: An Umbrella Review of Meta-Analyses. Adv Nutr. 2022;13(6):2217-36.
12. Cortie CH, Byrne MK, Collier C, Parletta N, Crawford D, Winberg PC, et al. The Effect of Dietary Supplementation on Aggressive Behaviour in Australian Adult Male Prisoners: A Feasibility and Pilot Study for a Randomised, Double Blind Placebo Controlled Trial. Nutrients. 2020;12(9).
13. Kumar A, Mehan S, Tiwari A, Khan Z, Gupta GD, Narula AS, et al. Magnesium (Mg(2+)): Essential Mineral for Neuronal Health: From Cellular Biochemistry to Cognitive Health and Behavior Regulation. Curr Pharm Des. 2024;30(39):3074-107.
14. Barjasteh-Askari F, Davoudi M, Amini H, Ghorbani M, Yaseri M, Yunesian M, et al. Relationship between suicide mortality and lithium in drinking water: A systematic review and meta-analysis. J Affect Disord. 2020;264:234-41.
15. Shen Y, Zhao M, Zhao P, Meng L, Zhang Y, Zhang G, et al. Molecular mechanisms and therapeutic potential of lithium in Alzheimer's disease: repurposing an old class of drugs. Front Pharmacol. 2024;15:1408462.
16. Terao I, Kodama W. Comparative efficacy, tolerability and acceptability of donanemab, lecanemab, aducanumab and lithium on cognitive function in mild cognitive impairment and Alzheimer's disease: A systematic review and network meta-analysis. Ageing Res Rev. 2024;94:102203.
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