Exercise and Depression

Exercise has long been recognized for effectively helping people shed pounds, get stronger, get more physically fit, and prevent chronic diseases (i.e., cardiovascular disease, diabetes).  In short … it’s a “wonder drug”. Exercise has also been proven to be an effective treatment for major depressive disorder (MDD), also known as clinical depression.  Unfortunately, previous studies had not provided a clear indication of exactly how much exercise a patient needs to produce an antidepressant effect.

Recently, Chad Rethorst, PhD, and Madhukar Trivedi, MD, researchers from the Department of Psychiatry at the University of Texas Southwestern Medical Center, developed detailed recommendations for clinicians on how to prescribe exercise for their patients with major depressive disorder.

About Major Depressive Disorder

Major depressive disorder, also known as clinical depression, is a serious medical condition affecting 15 million American adults (approximately 5 to 8 percent of the adult population per year).  Unlike normal emotional experiences of sadness, loss, or moods that come and go, major depression is persistent and can interfere with an individual’s thoughts, mood, behavior, activity, and overall physical health.  In fact:

• Major depression is the leading cause of disability in the United States and many other developed countries (among all medical illnesses)
• Depression occurs twice as frequently in women as in men
• Without treatment, the frequency of depressive illness (as well as the severity of symptoms) tends to increase over time

Symptoms

Symptoms of major depression include the following:

• Persistently sad or irritable mood
• Pronounced changes in sleep, appetite, and energy
• Difficulty thinking, concentrating, and remembering
• Physical slowing or agitation
• Lack of interest or pleasure from activities that were once enjoyed
• Feelings of guilt, worthlessness, hopelessness, and emptiness
• Recurrent thoughts of death or suicide
• Persistent physical symptoms that do not respond to treatment (i.e., headaches, digestive disorders, and chronic pain)

Traditional Treatment

There are three well-established types of treatment for depression (used alone or in combination):

1. Medications
   • SSRIs (selective serotonin reuptake inhibitors)
   • SNRIs (serotonin and norepinephrine reuptake inhibitors)
   • TCAs (tricyclic antidepressants)
   • MAOIs (monoamine oxidase inhibitors
2. Psychotherapy
   • CBT (cognitive behavioral therapy)
   • IPT (interpersonal therapy)
3. Electroconvulsive therapy (ECT)

Exercise and depression have also been closely linked and sufficient evidence now exists to effectively prescribe exercise to treat the condition.

Exercise Recommendations for Major Depressive Disorder

According to a new report in the Journal of Psychiatric Practice, there is now sufficient research to help doctors prescribe the proper dose of exercise for depresses patients.  Based on their research, Rethors and Trivedi recommend the following for patients:

Aerobic Exercise

• 3 to 5 exercise sessions per week
• 45 to 60 minutes per session
• 50 to 85 percent of an individual’s maximum heart rate (220 – age in years = maximum heart rate)

Resistance Exercise

• Variety of upper and lower body exercises
• 3 sets
• 8 repetitions (80 percent of the weight that person can lift one time)

Rethorst and Trivedi have found patients may experience a relief in depression in as little as four weeks after starting exercise.  However, the exercise regimen should be continued for at least 10 to 12 weeks to achieve the greatest antidepressant effect.

For more information on this study, click here.