Exercise for Depression – A Gold Standard Therapy




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Depression has become a common medical issue worldwide. Conventional treatments, generally, have not been effective in preventing recurrence of this condition. SSRIs can take months to provide a beneficial effect. Adverse side effects of antidepressant medications are a further concern, based on individual physical and mental health status. Additionally, in order to achieve remission, the most depressed patients require two or more different treatments.

A number of studies have shown exercise to be beneficial in the treatment of depression or depressive symptoms. Further, exercise has remarkable positive, and few negative effects on other disorders. From a physical standpoint, exercise engagement may improve hippocampal volume, pre-frontal cortex blood flow, and increase brain mediators such as brain-derived neurotrophic factor (which may be a key marker of depression).

With several other diseases, there is a concern regarding the effectiveness of different types of exercises: resistance or aerobic. However, in the context of treating depression and its symptoms, research shows that little difference exists between them, making  the prescription far easier to physicians and the engagement almost limitless to patients.

Moreover, major depression is now well recognized as a risk factor for some of the most serious chronic diseases such as cardiovascular disease and diabetes, and similar in potency with traditional risk factors. Therefore, exercise prescription as a medical treatment would result not only in the improvement of depression, but also in preventing the occurrence of other diseases.

Vitally, data from several studies have shown exercise to be just as effective as medication in the treatment of depressive disorders. Furthermore, engaging in regular physical activity can reduce medication dependence. Even more importantly, other studies have demonstrated that exercise is more effective than medication in preventing relapse of the disease. It is also well established that additional benefits of exercise to individuals suffering from depression include reduced moodiness, better attitude, improved outlook, increased self-confidence, and enhanced mental well-being.

While the benefits of exercise as a depression treatment are undeniable, it may also have some barriers, for example intimidation, cost, or physical limitation. Therefore it is necessary to develop strategies for successful compliance by the patient, setting reasonable goals and preparing them for setbacks or obstacles.

Whether exercise is used as a first-line treatment or as a supplement to medication or psychotherapy, patients have virtually nothing to lose and much to gain from adopting an exercise approach in dealing with the symptoms of depression. Therefore, beyond the documented and aforementioned benefits of exercise on overall health, it is also time to more avidly begin considering exercise as a therapeutic strategy for patients suffering from depression.

References

Berlin AA, Kop WJ, & Deuster PA (2006). Depressive mood symptoms and fatigue after exercise withdrawal: the potential role of decreased fitness. Psychosomatic medicine, 68 (2), 224-30 PMID: 16554387

Blumenthal JA, Sherwood A, Babyak MA, Watkins LL, Smith PJ, Hoffman BM, O’Hayer CV, Mabe S, Johnson J, Doraiswamy PM, Jiang W, Schocken DD, & Hinderliter AL (2012). Exercise and pharmacological treatment of depressive symptoms in patients with coronary heart disease: results from the UPBEAT (Understanding the Prognostic Benefits of Exercise and Antidepressant Therapy) study. Journal of the American College of Cardiology, 60 (12), 1053-63 PMID: 22858387

Booth FW, & Laye MJ (2010). The future: genes, physical activity and health. Acta physiologica (Oxford, England), 199 (4), 549-56 PMID: 20345416

Pilu A, Sorba M, Hardoy MC, Floris AL, Mannu F, Seruis ML, Velluti C, Carpiniello B, Salvi M, & Carta MG (2007). Efficacy of physical activity in the adjunctive treatment of major depressive disorders: preliminary results. Clinical practice and epidemiology in mental health : CP & EMH, 3 PMID: 17620123

Rozanski, A. (2012). Exercise as Medical Treatment for Depression Journal of the American College of Cardiology, 60 (12), 1064-1066 DOI: 10.1016/j.jacc.2012.05.015

Rozanski A, Blumenthal JA, Davidson KW, Saab PG, & Kubzansky L (2005). The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. Journal of the American College of Cardiology, 45 (5), 637-51 PMID: 15734605

Image via Dmitry Berkut / Shutterstock.

  • onergk69

    No question that aerobic excercise results in significant health benefits! I’ve been doing this myself for 40 years now.

    As far as clinical depression, I point out that there is unipolar & bipolar variations. In addition, it’s acuity levels range from moderate to severe & profound. Clients in the latter categories are psychotic, highly suicidal, & present w GAF’s of 10 or less.

    In my review of the clinical literature, AE is very useful for mild & moderate presentations. Psychotherapy combined w appropriate psychotropics are important. When severly depressed folks do not respond, ECT can be a life-saver!

    Rich

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  • http://www.lifestylemenu.com/ Lyn Ashby

    Great post! I do agree that exercise and meditation can do wonders for the mind and body. I have been on a regular exercise routine and I have seen great improvements on my health and well-being. Thanks for the post!!

  • _beltie

    I thought there was strong evidence that truly depressed patients are UNABLE to exercise? So I was told by a top orthopaedic physician.

  • http://none onergk69

    beltie & 0thers,

    Indeed, at the most serious levels of CD, clients show morbid lethargy & anergia, & psychomotor retardation. PET scans show marked inactivity in most areas of the brain!

    So you are correct!

    Rich

  • http://www.nuwaveovencritic.com Lonnie Thaler

    I agree with this article. When I am so stressed out and feel so depressed, I go to the gym and workout. Exercise is really effective. It relaxes my mind and makes me feel confident afterwards.

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  • http://beachsidephysio.com.au/ Ysabel@Physio Adelaide

    Since then, exercise plays a major part in releasing our stress as well as depression. When we exercise we tend to release the toxic that trigger some depression and stress because it calm your body and your mind. I love this article because you shared something really informative.

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  • Brian

    Exercise is one of the top things I would tell somebody with depression to get into. It works wonders for your self belief and helps fight the disease.

  • http://brainblogger.com Daniel Albright, MA

    This is something that I’ve done some reading on in the past, and something that I’ve actually dealt with, as I’m currently undergoing pharmaceutical treatment for depression (and have been for . . . holy crap, ten years!).

    I think it’s important to point out that exercise can be helpful in a lot of cases, especially when depressive symptoms are acute or only brought on by specific factors (like stress). I know that when I’m really stressed, my medications don’t quite do the trick, and exercise makes a big difference.

    However, there have been a few times over the past decade that I’ve gone off my medications, and exercise loses a lot of its efficacy. It still makes me feel better for a bit, but it’s only transitory relief. And exercise gets exponentially harder when I’m feeling depressed—completing a workout takes a lot of motivation, dedication, and mental energy, and I’m seriously deficient in all of those things when I’m not on my meds.

    Anyway, I just thought I’d chime in with my experience and point out that there are degrees of depression, all the way from “I’m busy at work and school, and I’m stressed and depressed” to “Life is not worth living,” and that everyone experiences depression differently.

    To be completely honest, I haven’t read the articles that you cited, so most of this could be addressed there. Anyway, thanks for the article—I found it quite interesting!

  • http://www.want-end-depression.info/2013/11/what-to-do-about-depression.html diva

    good exercise I think it’s important to point out this type of exercises coz can be helpful in a lot of cases, especially in depression thanks a lot

  • Anonymous

    Serious depression can lead to suicidal behavior. One of the best therapy is to do exercise and this is what I did every time when I’m depressed. It will helps you a lot not only for depression.

  • http://www.donannwellness.com Rawle Williams

    I do agree that depression is on the rise worldwide, especially in the developed world and particularly during the winter period.
    Exercise indeed helps as well of behavioural therapy.
    Medication only help temporally and I am not certain of the long term usage in helping patient with depression.

  • http://www.inonit.in shruti bhatia

    Depression is a problem and we all must take it seriously. When we lose control of our mind then this happens. So we need to take charge. We have to be mentally fit.
    Exercise keeps us busy , which keep our mind working. This article provides and amazing insight.

  • http://www.axuedu.com John Peter

    I do agree that depression is on the increase worldwide, particularly within the developed world and significantly throughout the winter amount.

Cristiano Batista, PhD

Cristiano Batista, PhD, is a Portuguese lecturer and researcher with more than 10 years of experience. He hold s a PhD in Public Health from the University of Porto, Portugal. Additionally, he is the author and reviewer of several peer-reviewed publications within health issues. He is an expert in the epidemiology field, particularly focused on its relationship with physical activity or inactivity. When he is not lecturing or researching, he enjoys writing about distinct health related findings. He has written both in English and Portuguese. He is now developing an investigation on the association between exercise and psychological and neurological disorders.
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