Exercise: The Best Antidepressant Ever?

The science behind just how and why exercise can help to reduce symptoms of anxiety and depression has been a much studied topic over the last two decades.

In a Duke University research study, published in the October 25, 1999 issue of The Archives of Internal Medicine, exercise was found to be almost as effective as medication in reducing symptoms of depression. In the study, 156 patients diagnosed with major depressive disorder were divided into three groups in order to study the impact that exercise might have on depression:

Group 1. Just did exercise.

Group 2. Just used medication.

Group 3. Used a combination of medication and exercise.

Much to the surprise of the researchers, all three groups, after 16 weeks, showed similar and significant improvements in their depression.

Here are the statistical findings of the study:

- 65.5% of the group who used medication alone, were no longer depressed after 16 weeks.

- 60.4% of the group who did exercise alone, were no longer depressed after 16 weeks.

- 68.8% of the group who did both exercise and medication were no longer depressed after 16 weeks.

The researchers did note that patients who took the antidepressants (in this case Zoloft) saw their symptoms relieved sooner, but by 16 weeks the group differences had virtually disappeared.

Though medication can be a life saver for some and no one wants to suggest otherwise, these studies open the door for other or additional strategies. "One of the conclusions we can draw from this," according to psychologist and study leader Dr. James Blumenthal, "is that exercise may be just as effective as medication and may be a better alternative for certain patients. While we don't know why exercise confers such a benefit, this study shows that exercise should be considered as a credible form of treatment for these patients. Almost one-third of depressed patients in general do not respond to medications, and for others, the medications can cause unwanted side effects. Exercise should be considered a viable option."

Depression also has a social side: people who are depressed or socially anxious tend to isolate. It's possible, reflected Blumenthal, that the structured and supportive atmosphere of the exercise program could have contributed to improving the symptoms of the exercise group.

Blumenthal feels that exercise may be beneficial because patients are actually taking a proactive role in their own physical and psychological health. "Taking a pill is... passive," says Blumenthal. "Patients who exercised may have felt a greater sense of mastery over their condition and gained a greater sense of accomplishment. They may have felt more self-confident and had better self-esteem because they were able to do it themselves, and they may have attributed their improvement to their ability to exercise. These findings could change the way some depressed patients are treated, especially those who are not interested in taking antidepressants," Blumenthal said. "Although these medications have been proven to be effective, many people want to avoid the side effects or are looking for a more 'natural' way to feel better."

Kristin Vickers-Douglas, a psychologist at the Mayo Clinic, adds that exercise is "not a magic bullet, but increasing physical activity is a positive and active strategy to help manage depression and anxiety."

What Happens in the Body?

When we exercise, our bodies release certain mood-enhancing endorphins. Endorphins trigger a positive feeling in the body, similar to that of morphine. These feelings of euphoria, sometimes associated with a "runner's high," may contribute to our good feelings about ourselves and our lives.

Endorphins also act as sedatives actually diminishing our perception of pain. They are manufactured in our brain, spinal cord, and many other parts of our bodies. Not coincidently, the neuron receptors that endorphins bind to are the same ones that bind some pain medicines. However, unlike with morphine, the activation of these receptors by the body's own endorphins does not lead to addiction, dependence or negative lifestyle patterns.

Exercise boosts the brain's feel-good endorphins, releases muscle tension, improves sleep, and reduces levels of the stress hormone cortisol. It also increases our body temperature, which may have a calming effect. All of these changes in our mind and body can improve such symptoms as sadness, anxiety, irritability, stress, fatigue, anger, self-doubt, helplessness and hopelessness that are associated with depression.

"Small bouts of exercise may be a great way to get started if it's initially too hard to do more," Dr. Vickers-Douglas says. Though the research suggests that it may take at least 30 minutes of exercise a day three to five times a week to significantly improve depression symptoms, any amount of activity, as little as 10 to 15 minutes at a time, can still improve mood in the short term.

Regular exercise has been proven to help us:

- Reduce stress

- Ward off anxiety and feelings of depression

- Boost self-esteem

- Improve sleep

Exercise also:

- Strengthens the heart.

- Lowers blood pressure.

- Improves muscle tone and strength.

- Strengthens and builds bones.

- Reduces body fat.

- Increases energy levels.

- Helps with over all fitness.

Research also shows that we're more likely to maintain good exercise habits if we get exercise to fit into our lives, say by walking or biking to work or walking, jogging or playing a sport with friends. Some forms of exercise that are user-friendly are:

- Biking

- Dancing

- Gardening

- Housework

- Jogging at a moderate pace

- Low-impact aerobics

- Golf (walking the course)

- Playing tennis

- Swimming

- Walking

- Yard work

- Yoga

"Don't wait for will power to begin exercising," says Dr. Vickers-Douglas. "Some people think they need to wait until they somehow generate enough willpower to exercise. But waiting for willpower or motivation to exercise is a passive approach, and when someone has depression and is unmotivated, waiting passively for change is unlikely to help at all. Focusing on a lack of motivation and willpower can make you feel like a failure. Instead, identify your strengths and skills and apply those to taking some first steps toward exercise." People who feel anxious feel a perceived lack of control over their lives. They feel, in other words, out of control. Both anxiety and depression can make us feel helpless, which can lead to more anxiety and depression. It's a catch 22. Exercise is proactive. Along with the obvious physiological benefits, it is helpful psychologically to feel that we can do something each day to help ourselves. So walk, bike, play a sport, go to a yoga class or dance around your house to your favorite music. It's fun, relaxing and good for you body, mind and soul.

Comments

[zizyphus]

I think I read 20 years ago that the way they created depression in lab animals was to restrict their movement.

[67bug]

It's tough though if you suffer from chronic fatigue syndrome, I can only walk about 1/2 hr. a day 2 or 3 days a week without paying for it for the next week or so. I also take Prozac and have felt much better on it than w/out it. I jus' do the best I can!

[OliviaZ]

Dr. Dayton,
you've inspired me to get back on track. I start tomorrow.

Olivia Zaleski

[drblack]

Absolutely. Exercise,s­ex,playing or listening to music,watching the wild creatures in your yard ,playing with your pet or your kids.
Medication is sometimes needed but try these other things first.
I almost forgot,helping someone who really needs it.

[nah415]

In order for exercise to be effective as an antidepressant, you have to keep doing it as the endorphins have a very short "shelf life" compared to medication. However exercise has also been shown to delay the onset of dementia in some people and has a whole host of other benefits that help a person to live better and age more gracefully.

One thing that isn't mentioned in this article is, when you stop exercising or stop the antidepressants, the depressive symptoms can return if the underlying issues have not been addressed. Oftentimes the medication will be prescribed for a depressed patient so that they can begin to feel good enough to participate actively in therapy. And research on therapy is now suggesting that it doesn't matter what TYPE of therapy you do, as long as you do something. As Dr. Dayton mentioned, being proactive in your life -- that is, taking actions on your own behalf rather than being a passive participant -- has a healing effect of it's own. When it comes to mental health issues, no one can "fix" anything for you. You have to do the work yourself. The therapist just acts as a guide or a witness, which is an important role for many people.

Exercise is good for many different ailments. And now with the price of gas, there are even more reasons to get out of the house for a walk or a bike ride!

[mario59]

Since no one can profit as easily off of exercise as pushing pills,, plus exercising can't be sold through advertising in a "convenient, easy to use, no effort" format, it won't get much attention.

[axt113]

Basically exercise improves your health and your self-image as your body becomes leaner and more toned, improved blood flow, more adrenaline, you don't feel as sluggish, your clothes fit better, or stop fitting because they are too loose, of course its an antidepressant, the only concern is finding the time and motivation

[capitalismisntamoral]

All those incredible benefits you just listed aren't enough motivation?

lose weight
feel better
look better
longer healthier better life
increased metabolism (surprised this was mentioned NOWHERE so far)

Yet another 'study' to prove the obvious.

What's next? A study to prove that eating vegetables is good for you?

[mckinley]

YES!! I have simply found that exercise is undoubtedly BETTER at seriously lifting my mood than any medication I have taken.

(I mean like swimming for over 1/2 hour, or bicycling for an hour, 4 or 5 days a week).

But.... the trick it to GET UP and exercise, when you are down -- and especially during the Northeast winters, even getting in my car to an exercise club before work in the morning..

[mergina]

Having sex sure is....;).....a good workout and anti-depre­ssant.....­..!!!

[leftLibertarian]

I find exercise is fine when I feel blue, but I would also add marijuana, MDMA, sex, and a good bottle of wine.

[mergina]

can you say marijuana in here? hehehe

[axt113]

Sex is better when you're in shape

[OrionGal]

I have used anti-depressants - I gained over 25 pounds and was miserable.

I'm not convinced pills are for everyone - they may help us for a short-term.

[anfractuous]

I vacillate between exercise and alcohol, and overall, I'd have to come out in favor of alcohol. Exercise, divorced as it usually is, from any meaningful result, ends up seeming just as pointless as all the other activities a depressive must muddle through. Chopping wood, hauling water, presented a measurable reward. Repeatedly hoisting chunks of iron over your head, upon reflection, just seems (and looks) idiotic. Modern life does not require musculature. Perhaps that's the direction we should be heading.

[capitalismisntamoral]

clearly you're doing the wrong type of exercise (for you).

lifting weights at a 'gym' isn't meaningful or motivating for you. Not surprising since
it's a corporatized form of exercise.

Get outside. Go for a walk, a run, a bike ride, a hike or a swim.

Running on a treadmill is like work. Running outside even if you don't
really take in the surrounding like you would on a walk/hike is sooo much
better.

alcohol is aight once in a while.

[Schaz]

The missing piece in that study is a control group that had no intervention. For all we know, 60-odd% of that group might also have improved after 16 weeks, which would add an important dimension to the results.

[wm1066]

left to your own devices your conscious mind will stay in your prefontal lobe area, and after awhile that gets boring and depressing. You think too much and your thought patterns get caught in a loop.
When you exercise your conscious mind goes into your body and you get out of that prefrontal lobe and start to feel the rest of your body. And the excersize slows the mental process down because parts of your brain are working to move your body. You need to get out of your prefrontal lobe to be able to brake the brain loop syndrome.

[Agentlady007]

Oh is she cute. I agree. Laughter is too.