Is exercise the ultimate anti-depressant?

While it may not be embedded in conventional wisdom yet, most research suggests that a little bit of exercise is the ultimate anti-depressant. A study recently publicized by the NY Times found that daily walking routines have an effect on mood swings that’s pretty darn high.

Which prompted Dr. Trivedi to look to exercise. His investigation joins a growing movement among some physiologists and doctors to consider and study exercise as a formal medicine, with patients given a prescription and their progress monitored, as it would be if they were prescribed a pill.

The paragraph above refers to a clinical study being done on depressed women who were taking drugs called SSRI’s. The drugs weren’t working.

So the researchers decided they’d prescribe their patients to start taking walks instead. The result?

At the end of that time, according to the study published recently in The Journal of Clinical Psychiatry, 29.5 percent had achieved remission, “which is a very robust result,” Dr. Trivedi said, equal to or better than the remission rates achieved using drugs as a back-up treatment. “I think that our results indicate that exercise is a very valid treatment option” for people whose depression hasn’t yielded to S.S.R.I.’s, he said.

A few interesting details about the study:

1). The subjects were separated into two groups, one that exercised more and one that exercised less. The group that exercised more had significantly lower rates of remission at the end of the study, which suggests more exercise=less depression.

2). Even though the high-exercise group had higher remission rates, they also had higher dropout rates, mitigating the beneficial effect of high exercise.

3). The people who had the lowest remission rates were people with a family history of depression, suggesting there’s a genetic component to depression that’s immune to environmental influences.

Exercise Outperforms Anti-depressants

Let’s dig a little deeper. James Blumenthal, one of the experts cited in the article, wrote two papers on exercise and depression that I want to talk about.

One studied the anti-depressant effect of exercise on old people. The depressed oldies were split into three groups: one that just received medication, one that just exercised, and another group that received medication and exercise.

The result? There was no different between the three:

It’s important to note that there’s not a significant difference between the group that just exercised and the group that exercised and took medication. This (might) mean that if you exercise to treat your depression, there are no additional benefits to taking medication.  Exercise does the entire anti-depressant job for you. The full study is here.

The second paper studied the long-term effects of exercise on people who previously had depression.

What was discovered?

People who exercised after they climbed out of depression had significantly lower relapse rates than those who didn’t. From the paper (emphasis added by me):

Self-reported participation in exercise during the follow-up period was inversely related to the incidence of depression at 10 months. Each 50-minute increment in exercise per week was associated with a 50% decrease in the odds of being classified as depressed.

The full paper is here.

Exercise is crack for our psyche.

The Psychology of Exercise

Curiously enough, people who exercised and took medication after coming out of depression had a higher relapse rate than those who simply exercised. Additional medication had a negative effect on your happiness if you exercised your way out of your funk.

What does that mean? Who knows, really. But I’d suggest it points to the importance of your attitude and self-perception on your happiness. In the study people who exercised and came out of depression reported higher attitudes of self-achievement than those who just popped pills.

Exercise in general is purported to increase one’s sense of “self-mastery”, and so people who simultaneously exercise and take medication have another alternative to associate with their positive outcome, which could lower their sense of achievement.