This is the first article in 4-part series focusing on Depression, Postpartum Depression, Anxiety, Attention Deficit Disorder (ADD/ADHD), Obsessive Compulsive Disorder (OCD) and Panic Disorder, and how exercise can be effective in their treatment.

Depression 

Depression is a state of low mood and aversion to activity that can affect a person’s thoughts, behavior, feelings and physical well-being.  Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable or restless. They may lose interest in activities that once were pleasurable, experience loss of appetite or overeating, or have difficulty concentrating, remembering details or making decisions. Additionally, they may contemplate or attempt suicide. Insomnia, excessive sleeping, fatigue, loss of energy, or aches, pains or digestive problems that are resistant to treatment may be present.^[1]

Depressed mood is a normal reaction to certain life events, a symptom of many medical conditions and a feature of certain psychiatric syndromes.  It affects more than 21 million American children and adults annually and is the leading cause of disability in the United States for individuals ages 15 to 44.   Lost revenue due to U.S. workers who are experiencing depression is estimated to be in excess of $31 billion per year.  

Depression frequently co-occurs with a variety of medical illnesses such as heart disease, cancer and chronic pain, and is associated with poor health.

Once you have a diagnosis of depression, your doctor will discuss the different treatment options with you. The treatment that is best for you depends on the type of depression you have. For example, some patients with clinical depression are treated with psychotherapy, and some are prescribed antidepressants. Others may undergo electroconvulsive therapy (ECT), also called electroshock therapy. This treatment may be used with patients who do not respond to standard depression treatment options.

Medication can help lift your mood and ease your feelings of sadness and hopelessness. You’ll need to work with your doctor to find the drug that is most effective with the fewest side effects. It is thought that three chemical messengers are involved with depression: norepinephrine, serotonin, and dopamine. These messengers are classified as neurotransmitters, and are responsible for sending electrical signals between brain cells.

Researchers have found a link between depression and chemical imbalance in these neurotransmitters. Antidepressant medications increase the availability of neurotransmitters by changing the sensitivity of the receptors for these chemical messengers. It is believed that modifying these brain chemicals can help improve mood, although the exact way it works is still unclear.

Recent research has shown that exercise can play a significant role in the treatment of depression.  In many people, the amount of serotonin that is manufactured in the brain by moderate to intense exercise is similar to the amount of increase brought about by the popular group of antidepressant drugs known as SSRIs.  

The Harvard Medical School published the results of a study that originally appeared in the Archives of Internal Medicine in 1999. 156 men and women with depression divided into three groups. One group took part in an aerobic exercise program, another took the SSRI sertraline (Zoloft), and a third did both. At the 16-week mark, depression had eased in all three groups. About 60%–70% of the people in all three groups could no longer be classed as having major depression. In fact, group scores on two rating scales of depression were essentially the same. This suggests that for those who need or wish to avoid drugs, exercise might be an acceptable alternative to antidepressants. Keep in mind, though, that the swiftest response occurred in the group taking antidepressants, and that it can be difficult to stay motivated to exercise when you’re depressed.

A follow-up to that study found that exercise’s effects lasted longer than those of antidepressants. Researchers checked in with 133 of the original patients 6 months after the first study ended. They found that the people who exercised regularly after completing the study, regardless of which treatment they were on originally, were less likely to relapse into depression.

A study published in 2005 found that walking fast for about 35 minutes a day five times a week, or 60 minutes a day three times a week, had a significant influence on mild to moderate depression symptoms. Walking fast for only 15 minutes a day five times a week or doing stretching exercises three times a week did not help as much. (These exercise lengths were calculated for someone who weighs about 150 pounds. If you weigh more, longer exercise times apply, while the opposite is true if you weigh less than 150 pounds.)

Part II in this series will explore the effects of exercise on anxiety and ADD/ADHD. 
 

ALAN FREISHTAT is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 15 years of professional experience. He is the Co-Director of the Jerusalem-based weight loss and stress management center Lose It! along with Linda Holtz M.Sc. They are available for private consultations, assessments and personalized workout programs. They have begun working with Dr. Michael Bunzel, M.D., a psychiatrist in Bnei Brak, Israel on incorporating exercise as a therapy for several mental health disorders.  Alan can be reached at 02-651-8502 or 050-555-7175, or by email at [email protected]. You can also visit the Lose It! website at www.loseit.co.il 

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