ABOUT FOUR PERCENT OF THE WORLD’S POPULATION experiences depression. Today, I ask this provocative question: Is exercise as effective as anti-depressants for mental health?

A new study shows that running offers a health benefit similar to anti-depressants.

These results add to a growing literature illustrating the power of physical activity to improve our mental well-being. Today, I want to explore how moving can be medicine.

Thoughts About Sadness

I want to begin by sharing some thoughts of others regarding sadness and depression.

Edison Price Vizzini (1981 — 2013) was the American author of four books for young adults. He wrote It’s Kind of a Funny Story, which National Public Radio (NPR) named #56 of the “100 Best-Ever Teen Novels” and is the basis of the film of the same name.

Vizzini had depression, spending time in a psychiatric ward in his early 20s, and authored several works about the illness. He died of an apparent suicide at 32.

“I didn’t want to wake up. I was having a much better time asleep. And that’s really sad. It was almost like a reverse nightmare, like when you wake up from a nightmare you’re so relieved. I woke up into a nightmare.”
― Ned Vizzini, It’s Kind of a Funny Story

Here is the author of The Chronicles of Narnia:

“Mental pain is less dramatic than physical pain, but it is more common and also more hard to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say “My tooth is aching” than to say “My heart is broken.”
― C.S. Lewis, The Problem of Pain

Depression is Common

Nearly four percent of us experience depression. This number includes four out of ten men and six of ten women.

For those over 60, depression is more common, striking about six percent of the population.

The depression numbers worldwide are astonishing. About 280 million individuals suffer from the condition.

Here are the risk age categories:

• 18 to 29: 21 percent
• 30 to 44: 17 percent
• 45 and over: 18 percent

What Causes Depression?

Depression causes

There are several possible causes of depression. They can range from environmental triggers to biological ones.

Here are some common causes of depression:

• Brain chemistry. Some individuals may suffer from chemical balances in brain regions that manage thoughts, mood, appetite, sleep, and behavior in individuals with depression.
• Hormone levels. Changes in hormones (for example, estrogen or progesterone around menopause) can elevate depression risk.
• Family history. If you have a family history of depression or another mood disorder, you have a higher chance of suffering.
• Early childhood trauma.
• Brain structure. If your brain’s frontal lobe is less active, depression is more likely. However, scientists don’t know if this happens before or after the onset of depressive symptoms.
• Medical conditions. Certain conditions raise depression risk. For example, chronic illness, insomnia, chronic pain (including emotional), stroke, cancer, Parkinson’s disease, or heart attack increase the odds.
• Substance use. A history of alcohol or other substance misuse can affect your risk.

Depression Risk Factors

Depression risk factors can be social, genetic, biochemical, medical, or circumstantial. Here are some common risk factors:

• Sex. The prevalence of major depression is twice as high for females.
• Genetics. Those with a family history of depression have an increased risk.
• Socioeconomic status. Financial problems and perceived low social status can increase depression risk.
• Certain medications. Some medicines, including some forms of hormonal birth control, corticosteroids, hormonal birth control, and beta-blockers, are linked to a higher depression risk.
• Vitamin D deficiency. Depression can be associated with low vitamin D levels.
• Vitamin D deficiency. StudiesTrusted Source have linked depressive symptoms to low levels of vitamin D.
• Gender identity. A 2018 study shows the risk of depression is four times higher for transgender individuals.
• Substance misuse.
• Medical illnesses. Those with heart disease are twice as likely to have depression. One in four individuals with cancer experience depression.

Exercise to Fight Depression

Depression that goes untreated may have health implications, including disrupted sleep, insomnia, and poor immune health.

I am delighted to report that a new study illustrates the promise of exercise for depression.

First, I want to observe that exercise utility will vary by individual based on depression severity and other factors. Physical activity is no panacea.

Research presented at the October 2023 European College of Neuropsychopharmacology (ECNP) Congress in Barcelona (Spain) found that an exercise program also led to more favorable physical outcomes.

Here’s the bottom line:

Running therapy had effects on depression and anxiety similar to antidepressants.

However, sticking with regular activity proved to be challenging.

Study Details

Researchers followed 141 people with anxiety, depression, or both. The subjects selected one of the following:

1. Medication (with no running)
2. Running (with no medication)

Over 16 weeks, 45 took a selective serotonin reuptake inhibitor (SSRI), and 96 followed a running program.

A psychiatrist determined if the medicine dosage needed to be increased. If one anti-depressant drug was ineffective (or poorly tolerated), the patient could switch to a second SSRI.

Running therapy consisted of supervised 45-minute outdoor running sessions two to three times weekly. This amount complies with guidelines from the U.S. Centers for Disease Control and Prevention (CDC).

How Well Did Intervention Work?

At the trial’s completion, approximately 44 percent in each group had remission of symptoms of anxiety and depression.

However, physical health improvements were more apparent in the runners. Those engaging in physical activity saw drops in blood pressure, heart rate, and waist circumference. Moreover, their lung function improved.

When it came to physical health, however, changes were more favorable among the runners, who saw a decrease in heart rate, blood pressure, and waist circumference and an increase in lung function.

The anti-depressant group had a physical decline, manifesting as higher weight, blood pressure, and triglycerides. Heart rate variability, a sign of less resiliency, worsened in the medication group.

Summary

This study highlights how exercise can target the sedentary behavior often exhibited by those with anxiety or depression.

For all of us who can, whether we have mental health struggles or not, it is a reminder to go outside, set personal goals, improve our fitness, and engage in activities with others.

The study has limitations, including its small size and non-randomized nature. I also wish the researchers had evaluated the combination of anti-depressant medication and exercise therapy.

Many don’t enjoy running, so I would love to see a comparison of medicines and other activities (such as brisk walking).

If you or someone you know suffers from depression, it’s normal to want to know what has caused it. The truth is that depression is a complex medical condition that scientists do not completely understand.

Fortunately, depression is highly treatable, and there are many sources of help and support in dealing with this condition or anxiety.

For someone with severe depression, exercise alone may not be enough. Unfortunately, there is no miracle cure for depression that works for all. Still, it is nice to have more tools to battle it.

Final Criticisms of the Study

The study has a major flaw: It included non-randomized patients who chose which treatment to receive. This creates obvious bias.

In addition, the study’s statistical power is low, given the low number of subjects.

While the results seem clear, one might come to these more cynical conclusions:

The trial shows that if we can find individuals who can exercise while depressed and adhere to it, they would benefit from that practice.

If Depression Persists

For many, depression is a temporary problem. For others, it can be a long-term challenge. Treatment might not work to solve the problem.

However, treatment often makes symptoms more manageable. Managing depression typically involves finding the right combination of medications and therapies.

If one treatment doesn’t work, please talk with your healthcare professional. They can help you create an alternative approach that may be more effective.

Exercise improves my mental state. What about you?

Thank you for reading “Exercise for Depression.”