Exercise May Help Depression

Depression and Exercise: Why is it not prescribed as a treatment?

                Depression is a complex issue as it encompasses mental, emotional, and physical symptoms.  Like many ailments most people turn to doctors, namely psychologists or psychiatrists, and like most doctors, treatment is considered in the form of medication.  As a trainer, I believe that exercise is all too often under-prescribed, if prescribed at all, as a form of treatment for almost any problem.  I have seen firsthand with several of my clients that regular exercise may improve a person’s ability to live with depression.  Admittedly, exercise rarely accomplishes this on its own.  Often these clients are often using medication and/or undergoing some form of professional counseling.  Yet I have also know of people that utilize medication and counseling that continue to struggle for years seeing little or no improvement.  Unfortunately, little research exists about the effect of exercise on depression.  I would assume that this is because with the field of psychiatry, like many other forms of medical practice, standard operating procedure is to pop pills and schedule a follow up appointment.

                However, research is beginning to show that exercise can often be that “Ace up the sleeve.”  A review of four different studies conducted examining the effect of exercise on depression all showed signs of positive benefits.  Exercise makes a person feel better and, in my opinion, it should not take research to verify this but research makes for common acceptance in the general public.  In fact, exercise has been shown to be an effective method of treatment for mild depression without medication.  One study in particular focused on examining older adults with Major Depressive Disorder (MDD).  This study looked at 156 middle-aged and older adults diagnosed with MDD.  The adults were randomly subjected to supervised exercise, sertraline, or a combination of the two.  The exercise treatment lasted for sixteen weeks and consisted of moderate aerobic activity three times per week.    At the end of the treatment period the improvement was the same between the medication and exercise only groups.  This indicates the exercise may be a positive alternative to treatment for those who do not wish to have medication.  A follow up performed six months after the conclusion of the sixteen week period found that those who exercised only experienced lower rates of depression than those on medications or on a combination of medication and exercise.  In addition to this, only 9% of the exercise participants had relapsed into severe depression while in the medication and combination groups the relapse rate was near 30%.  It is important to note that 64% of the people who exercised in this study continued to exercise on their own during the six months between the end of the study and the follow up.  Furthermore, those participants who reported exercising independently showed a 50% reduction in the risk of depression symptoms.

                This leads into the important discussion of exercise prescription; specifically, frequency, duration, and intensity.  What are the levels needed to see positive results?  Another study put 80 sedentary adults into five groups: low intensity exercise three days per week; low intensity five days per week; high intensity three days per week; high intensity five days per week; and a group that did only stretching and flexibility control.  The results showed that the high intensity exercise reduces depression symptoms by 47% over twelve weeks while low intensity exercise showed a 30% reduction in symptoms.  These results were consistent regardless of whether or not the participants exercised three or five times per week.  This seems to indicate that the amount of energy expended when exercising is more important than the total amount of time spent exercising.

                If exercise is not something that is currently a part of your lifestyle check with your doctor to see if it may be useful in helping to treat depression.  Start with this basic goal: 30 minutes of exercise three days a week.  One a scale of 1 to 10, with 1 being not moving at all and 10 being so intense passing out is a real possibility, the intensity should feel like it is in the range of 4-7 to see positive benefit.  Lower intensity will have minimal, if any benefit, while higher than 7 may be such intense exercise that it cannot be repeated frequently enough for long term improvement.