Millions of people worldwide are affected by depression. In fact, depression is the leading cause of worldwide disability {1}. In the United States, this disease affects almost twice as many women as men.

Symptoms of depression may include: difficulty concentrating and making decisions, fatigue, feelings of guilt, sadness, and/or worthlessness, feelings of pessimism, insomnia and/or excessive sleeping, irritability, loss of interest in pleasurable activities.

Overeating or appetite loss, persistent aches or pain including headaches, digestive problems that are not helped with treatment and thoughts of suicide and/or suicide attempts.

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Not All Depression is the Same

The intensity and amount of symptoms is what differentiates major depression from moderate depression. Physical activity and exercise have been recommended for the treatment and prevention of many diseases and medical conditions including, but not limited to coronary artery disease, diabetes mellitus, osteoporosis, obesity, and certain cancers {1}.

It stands to say that physical activity and exercise have also been shown to be an effective treatment for depression {2}. In fact, since the time of Hippocrates, physical activity has been recommended by physicians to prevent depression {3}.

Physical activity is bodily movement produced by skeletal muscles that result in energy expenditure beyond resting level while exercise is a subset of physical activity with the criteria of being planned, structured, repetitive and purposeful.

The Nurse’s Health Study was an extensive study of over 120,000 US female registered nurses aged 30-55. The follow-up period began in 1996 and ended in 2006 {3}. The study focused on the average amount of time the nurses spent per week being physically active. It compared that to their average weekly time watching television.

Exercise for depression to have a relaxed life2

The results showed that the women had a lower risk of depression with an increase in time being active {3}. Women who were more physically active (>90 minutes/day) also showed the lowest sedentary behaviour (0-5 hours/week).

Aerobic exercise is the preferred mode of exercise for patients with depression

Exercise for depression…

Strength training has also been proven to show benefits for people with depression {2}. Recommendations for aerobic conditioning are a frequency of 3-5 days per week at an intensity of 50-85% of maximum heart rate and duration of 45-60 minutes per session.

Strength training criteria includes a variety of exercises for both the upper and lower body with a program consisting of three sets of eight repetitions at 80% of 1-repetition maximum (RM). The data found suggests that patients may see improvement in depressive symptoms in as little as four weeks after starting this type of an exercise program.

Aerobic or Resistance?

It might be in the best interests of the patient to alternate aerobic and strength training sessions in the beginning stages of a new program as not to overwhelm the patient. Intensity, duration and frequency may also have to be adjusted accordingly as to the patient’s ability and deconditioning.

Another study by Weyer found the odds ratio for depression to be significantly higher for the physically inactive compared to people who exercise regularly {1}.

Another smaller study done by Mata et al. showed that when people with MDD not only exercised on a program, but added activity during their non-scheduled days, their positive affect increased greater from one occasion to the next {4}.

Knapen et al. found that self-selected exercise intensity, and not prescribed exercise intensity, increased positive well-being in depressed individuals {4}.

Physical activity and exercise have been shown to cause neurobiological changes. It is thought that exercise decreases depressive symptoms by increasing the brain’s ability to generate neurons, similar to anti-depressant medications {1}.

Physical activity and exercise have also shown the ability to improve mood by increasing levels of endocannabinoids and decrease cortisol production. Exercise also improves self-concept in depressed patients, which may lead to decreased depressive symptoms {1}.

While depression is one of the most prevalent neurological disorders in the US, exercise has been shown to reduce symptoms of this disease with the ability to possibly lower a person’s dependence on medications.

Physical activity and exercise have been shown to compare well to antidepressant medications when it comes to initial treatment for mild to moderate depression.

Physical activity and exercise has also shown well in improving depressive symptoms when used in conjunction with medications {1}. More research may be needed as to the mode of exercise that is most beneficial for treatment, but the current research has shown that the mode of exercise is not as important as having the activity reach an intensity that is appropriate for the person {1}.

Exercise for Depression references:

Carek, Peter J. Md, MS, Laibstain, Sarah E., MD and Carek, Stephen M. Exercise For The Treatment of Depression And Anxiety. International Journal of Psychiatry In Medicine; 41 (1): 15-28, 2011.

Rethorst, Chad D. PhD and Trivedi, Madhukar H. MD. Evidence-Based Recommendations for the Prescription of Exercise for Major Depressive Disorder. Journal of Psychiatric Practice; 19 (3): 204-212, 2013.

Lucas, Michael, Mekary, Rania, Pan, An, Mirzaei, Fariba, O’Reilly, Ellis J., Willett, Walter C., Koenen, Karestan, Okereke, Olivia I. and Ascherio, Alberto. Relation Between Clinical Depression Risk and Physical Activity and Time Spent Watching Television in Older Women: A 10-Year Prospective Follow-Up Study. American Journal of Epidemiology; 174 (9): 1017-1027, 2011.

Mata, Jutta, Thompson, Renee J., Jaeggi, Susanne M., Buschkuehl, Martin, Jonides, John and Gotlib, Ian H. Walk on the Bright Side: Physical Activity and Affect in Major Depressive Disorder. Journal of Abnormal Psychology; 121 (2): 297-308, 2012.

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