Maybe from the couch you can see your front door. Beyond it, there’s perhaps some vague sense of possibility. But it seems like more miles stand between you and getting out the door than you could possibly ever run if you do.

It can be difficult for anyone to find the motivation to exercise. However, for people who suffer from depression, research shows physical activity can reduce symptoms, just as it’s shown to boost mood for all comers and goers to exercise. The problem is, being depressed can also make it even more difficult to make positive lifestyle changes, seemingly putting the best intentions out of reach.

“Exercise is an antidepressant,” says Brandon Alderman, an associate professor of kinesiology and health and the director of the Exercise Psychophysiology Lab at Rutgers, The State University of New Jersey–New Brunswick. However, most people who are depressed — as with the vast majority of the general population — fall well short of meeting exercise guidelines that adults engage in at least 150 minutes of moderate physical activity a week, and many never lace up at all.

[See: 11 Simple, Proven Ways to Optimize Your Mental Health.]

So how can one get on the path to healing, when it seems impossible to even get to the trailhead? One possible approach, experts say, is to incorporate mindfulness — staying focused on the present moment — into your routine.

Research Alderman led, published in February in the journal Translational Psychiatry, found participants with major depressive disorder who did 30 minutes of focused-attention meditation and then 30 minutes of moderate-intensity aerobic exercise — either running on a treadmill or cycling on a stationary bike — twice weekly for eight weeks reported significantly less depressive symptoms and ruminative thoughts following the intervention. The research suggests that combining the two disciplines, which have been individually shown to reduce symptoms of depression, may enhance results. It also offers a possible peak into how mindfulness may help a person get going and stay on track when depression trips up efforts to exercise.

A hallmark of depression, Alderman explains, is the ruminative process, including fixating on past, present or future events. “You tend to overthink those things,” he says. “One of the things meditation allows you to do is just understand that your mind wanders and your thoughts trail from this idea to that idea, and to let them go without judgment and without emotion.”

In addition to mind-body disciplines like yoga that have been shown to combat symptoms of depression, a mindful approach can be carried right into running or other physical activities, like swimming.”Exercise can be enormously meditative,” says Dr. Antonia Baum, a psychiatrist in private practice in Bethesda, Maryland, and immediate past president of the International Society for Sports Psychiatry. “You get into this rhythm in a pool or during a run, and that becomes a form of meditation.”

[See: Coping With Depression at Work.]

Mental health experts, however, say that doesn’t mean exercise should be viewed as a panacea, or the only game in town for treating depression — but rather one option, where often a combination of approaches from medication to therapy may work best.

Baum points out that it can be difficult initially to engage someone who is severely or profoundly depressed with non-pharmacological tools that could help, whether it’s meditation, exercise or psychotherapy. “So sometimes, depending on the severity of the depression, medication may be a very important early aspect of treatment to kind of raise the platform from which you have to work.” She recommends starting with having a medical work-up done, since depression can have many underlying causes — from a chemical imbalance in the brain to anemia to thyroid disease — and to look at all possible causes.

In recommending exercise to treat depression, Smits suggests taking steps to improve follow through. For starters, he advises: Focus on the immediate effects of physical activity. People report exercise makes them feel less stressed, more at ease and less anxious, and improves mood, among other benefits, he notes. “Start exercising to feel better now, and then if you stick with it, you’ll see the long-term benefits as well,” he says.

Smits also recommends people self-monitor — for example, taking note of how they feel after a run and how improved other aspects of their day are to use as fuel for the next go. “They can see the immediate benefits of exercise and how it helps them get through the day, and through that overcome their mood problem, or at least see more enduring and significant symptom change,” Smits says.

Still stuck on the couch? Try chaining, he suggests, or essentially breaking up your path from the sofa to the run into more manageable pieces and stringing it all together. Make it easier to work out as scheduled — or on a whim — by having workout clothes ready. You could literally begin by rolling off the couch into floor exercises — maybe do sit-ups or crunches. See how you feel, then walk down the block, then jog the next block if you’re up to it, and so on — doing what you can to be active within your abilities and limits.

Rather than fixating on achievement or even focusing on how physical activity might help treat depression while you’re exercising, experts say enjoy the moment and stay within it. Whether getting out depression-related angst through punching a bag or pounding the pavement, Baum says, it’s less about being a distraction as a physical way to break up a thought process that’s in overdrive. “Many of us have had the experience of being pissed off, and you go for a run or a swim and you feel better,” she says.

Smits says it’s important to personalize your exercise routine to account for what’s causing the mood disorder. “For some people it might be stress reactivity — that they have lots of stressors they react to and that maintains their anxiety or depression throughout the day,” he says, like work-related stressors, in which case he’d advise exercising earlier in the morning. “Because we know if you do that, you build a buffer and you have less reactivity to that stressor.”

[See: Could Your Summer Blues Be Seasonal Depression?]

Finally, experts say, try to take your exercise ups and downs in stride. “I think people have to go by feel, and it’s important not to set the bar so high that they talk themselves right out of doing it in the first place,” Baum says. “Start low, go slow, do what feels good, take joy in it and do it!”

More from U.S. News

How to Find the Best Mental Health Professional for You

6 Ways Obesity Can Weigh on the Brain

Coping With Depression at Work

Is It Possible to Outrun Depression? originally appeared on usnews.com