Dr. Weeks’ Comment: some 30 years ago when I first began training as the doctor it was well known that exercise was the best treatment for depression. In fact efficacy of newly developed antidepressants was established by comparing the benefits of the drug to the benefits of depression. Exercise always outperformed any antidepressant. When that became apparent the drug companies stopped testing their new drugs against oppression and switch strategy I only testing their new drugs against existing drugs. Today the only thing that’s changed is the antidepressants have become far more addictive and more dangerous. In the old days try cyclic antidepressants were the norm but now we have SSRIs and SNRIs and atypical antipsychotics being offered to depressed people. This is a highly irresponsible development of an entire profession- psychiatry. To learn more about problematic side effects of antidepressant therapy I’m happy to refer you to the very hard-hitting websites www.ssristories.net and www.drugawareness.org. Now get out and walk!
Int J Psychiatry Med 2011;41(1):15-28. doi: 10.2190/PM.41.1.c.
Depression and anxiety are the most common psychiatric conditions seen in the general medical setting, affecting millions of individuals in the United States. The treatments for depression and anxiety are multiple and have varying degrees of effectiveness. Physical activity has been shown to be associated with decreased symptoms of depression and anxiety. Physical activity has been consistently shown to be associated with improved physical health, life satisfaction, cognitive functioning, and psychological well-being. Conversely, physical inactivity appears to be associated with the development of psychological disorders. Specific studies support the use of exercise as a treatment for depression. Exercise compares favorably to antidepressant medications as a first-line treatment for mild to moderate depression and has also been shown to improve depressive symptoms when used as an adjunct to medications. While not as extensively studied, exercise has been shown to be an effective and cost-efficient treatment alternative for a variety of anxiety disorders. While effective, exercise has not been shown to reduce anxiety to the level achieved by psychopharmaceuticals.
Gen Hosp Psychiatry. 2017 Nov;49:2-10. doi: 10.1016/j.genhosppsych.2017.04.012.
Swathi Gujral 1 et al
Depression is a syndrome of stress- and emotion-dysregulation, involving compromised structural integrity of frontal-limbic networks. Meta-analytic evidence indicates that volumetric reductions in the hippocampus, anterior cingulate cortex, prefrontal cortex, striatum, and amygdala, as well as compromised white matter integrity are frequently observed in depressed adults. Exercise has shown promise as an effective treatment for depression, but few studies have attempted to characterize or identify the neural mechanisms of these effects. In this review, we examined the overlap between structural brain abnormalities in depression and the effects of exercise on brain structure in adults, to highlight possible neural mechanisms that may mediate the positive effects of exercise on depressive symptoms. The prefrontal cortex, anterior cingulate cortex, hippocampus, and corpus callosum emerged as structural neural markers that may serve as targets for exercise-based treatments for depression. These findings highlight the need for randomized exercise interventions to test these proposed neurobiological mechanisms of exercise on depression.
J Affect Disord 2016 Sep 15;202:67-86. doi: 10.1016/j.jad.2016.03.063. Epub 2016 May 20.
Siri Kvam et al
- PMID: 27253219 DOI: 10.1016/j.jad.2016.03.063
Background: This meta-analysis of randomized controlled trials (RCTs) examines the efficacy of physical exercise as treatment for unipolar depression, both as an independent intervention and as an adjunct intervention to antidepressant medication.
Results: A total of 23 RCTs and 977 participants were included. Physical exercise had a moderate to large significant effect on depression compared to control conditions (g=-0.68), but the effect was small and not significant at follow-up (g=-0.22). Exercise compared to no intervention yielded a large and significant effect size (g=-1.24), and exercise had a moderate and significant effect compared to usual care (g=-0.48). The effects of exercise when compared to psychological treatments or antidepressant medication were small and not significant (g=-0.22 and g=-0.08, respectively). Exercise as an adjunct to antidepressant medication yielded a moderate effect (g=-0.50) that trended toward significance.
Conclusions: Physical exercise is an effective intervention for depression. It also could be a viable adjunct treatment in combination with antidepressants.