Physical activity in the treatment of depression
In March 2023, the results of research on the role of physical activity in the treatment of depression, anxiety and stress were published. Newspapers around the world quoted the results under varying titles. The Guardian in England said: Exercise is even more effective than counselling or medication for depression. In Australia, Exercise more effective than medicines to manage mental health, says study, in Poland: High effectiveness of physical exercise in the treatment of mental disorders. Here is an excerpt from this study:
There have been hundreds of research trials examining the effects of physical activity on depression, anxiety and psychological distress, many of which suggest that it may have similar effects to psychotherapy and pharmacotherapy (and with numerous advantages over psychotherapy and pharmacotherapy, in terms of cost, side-effects and ancillary health benefits). Despite the evidence for the benefits of physical activity, it has not been widely adopted therapeutically. (…)
This is the first ever study to compile the extensive base of evidence regarding the effects of physical activity on depression, anxiety and psychological distress. (…) Physical activity is highly beneficial for improving symptoms of depression, anxiety and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders and people with chronic disease. Physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress[1].
In May 2023, the results of a study comparing the use of antidepressants and running therapy as two effective methods of treating patients with depressive and anxiety disorders were published. The researchers write: Antidepressant medication and running therapy are both effective treatments for patients with depressive and anxiety disorders. However, they may work through different pathophysiological mechanisms and could differ in their impact on physical health. This study examined effects of antidepressants versus running therapy on both mental and physical health. (…)
In summary, they conclude that running and antidepressants were similarly effective, but running improved physical health, while antidepressants made it worse (particularly as regards to heart health and weight gain):
This study showed worsening of several physical health variables after antidepressant use, partly in line with commonly reported side effects of SSRIs. First, weight gain is often reported as a side effect and here too we showed that persons on antidepressants gained on average 3 kg during 16 weeks. We further showed a significant difference in waist circumference change, with an increase of 1.5 cm. In addition, our results are greatly in line with the bulk of evidence that antidepressant use decreases heart rate variability. For instance, the Netherlands Study of Depression and Anxiety (NESDA) showed antidepressant use to be robustly associated with cardiac autonomic dysregulation across nine-year longitudinal data. Also, and to be expected when autonomic tone changes, we showed parallel increased blood pressure levels in antidepressant users, again in line with earlier research. (…)
People who use movement as therapy have found the same level of effectiveness in treating depression and anxiety disorders, while increasing physical health:
This study showed various beneficial changes in physical health after a 16-week exercise intervention: (…) a significant mean decrease in heart rate of 3.4 bpm and a mean increase in lung function of 30.6 l/min. Per-protocol analyses showed that those that sufficiently adhered to the treatment protocol additionally increased their maximal oxygen uptake (VO2max) and showed decreases in waist circumference and blood pressure. These results suggest that part of the beneficial effects of regular exercise in persons with depression and anxiety disorders might be related to impact on the autonomic nervous system and lung capacity. The degree to which each of these variables can improve, in turn, determines a person’s maximal oxygen uptake. Further, the decrease in waist circumference, in the absence of a significant within-group weight change, is indicative of a decrease in abdominal fat. The changes in waist circumference and blood pressure are indicative of a lower incidence of metabolic syndrome after exercise and replicate an earlier study in 42 in-patients with moderate to severe depression. This study did not show any changes in inflammatory markers after exercise, which is in line earlier research in healthy adults. Within the depressed population, however, exercise might have particularly anti-inflammatory effects in patients with high baseline inflammation levels, which asks for future analyses in specific subgroups[2].
Studies confirm that physical activity is as effective as antidepressants and even surpasses them in terms of overall health!
[1] Singh B, Olds T, Curtis R, Dumuid D, Virgara R, Watson A, Szeto K, O’Connor E, Ferguson T, Eglitis E, Miatke A, Simpson CE, Maher C., Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. British Journal of Sports Medicine, 2023.
[2] Verhoeven JE, Han LKM, Lever-van Milligen BA, Hu MX, Révész D, Hoogendoorn AW, Batelaan NM, van Schaik DJF, van Balkom AJLM, van Oppen P, Penninx BWJH., Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders. Journal of Affective Disorders, 2023.
