Depressed, Exercise it Away!

The NZ Herald reported in September that the New Zealand government spends yearly NZ$30 million over a million prescriptions for antidepressants. Concerns are raised are made about the high prescription rate that includes antidepressants prescribed to adolescents and children as young as one year old and less. This is a shocking number in a country of only 4 million people. The fear was expressed that depression awareness campaigns have boosted pharmaceutical sales rather than providing public education about alternative treatment pathways for depression.

So what are the alternative treatments available? Often people who seek help for depression will be advised to exercise. However, people who are depressed often find it really hard to motivate themselves to exercise. This is really unfortunate, because people are usually depressed because their life is depressing and a pill a day does not change depressing life circumstances. As a result you often hear of patients who have been on antidepressants for many years.

Research supports exercise as depression treatment

What then are the facts about the effectiveness of exercising? Recent research found that exercise is just as effective as antidepressants. Indeed, both treatment options showed significant remission of depressive symptoms and an improvement of daily functioning. Interestingly assessments after 4, 6, and 10 months showed that participants of the exercise group had a significantly lower relapse rate than the participants that were treated with antidepressants, and of course less unpleasant side effects.

The research had a supervised exercise group (gym), a home-based exercise group, a group on antidepressant medication, and a group on a placebo (meaning a pill that looked like the antidepressant but did not have active ingredients). After 4 months 41% of participants no longer met the diagnostic criteria for depression. A similar percentage of participants improved in all three groups with placebo ranking the lowest with 31%, of the home exercise group 40% of the participants improved, the gym group scored 45%, and 47% of the participants of the group that received medication improved. Thus no particular treatment was able to demonstrate to be superior to the other options. The sad story is that 59% of the participants did not respond to any of the treatments offered in any significant way.

Therefore, exercise does not seem to be the magic cure. However, exercise seems to appear equally effective as medication. As a bonus: people might benefit from the ‘side-effects’ of exercising such as improved fitness, weight-loss, and improved self-confidence. Not tested in this research has been psychotherapy as a treatment option for depression. Although, older research has shown that the success of psychotherapy treatment is comparable to the success of drug treatment. The talkingcure website presents an overview over a vast amount of studies that compare both approaches.

How much exercise could help?

See for yourself whether exercise will help. The exercise programme in the research mentioned involved three times per week 45 minutes exercise for 16 weeks. Participants spent 10 minutes of walking for warm-up, 30 minutes walking or jogging at a speed that raised their heartbeat up to 70 to 85 % of their maximum heart rate, and 5 minutes cooling down exercises.

References

James A. Blumenthal, Michael A. Babyak, P. Murali Doraiswamy, Lana Watkins, Benson M. Hoffman, Krista A. Barbour, Steve Herman, W. Edward Craighead, Alisha L. Brosse, Robert Waugh, Alan Hinderliter, and Andrew Sherwood. (2007). Exercise and Pharmacotherapy in the Treatment of Major Depressive Disorder. Psychosomatic Medicine 69(7): 587-596.

Article posted 14 November 2007