Meta-Analysis: Exercise As Good or Better than Meds or Psychotherapy for Depression—41 Studies, 2,265 People w/ Depression
From Dr. Pope
The Washington Post article: “The best treatment for depression? It could be exercise” by Gretchen Reynolds.
Excerpts:
Exercise as a treatment for severe depression is at least as effective as standard drugs or psychotherapy and by some measures better, according to the largest study to date of exercise as “medicine” for depression.
The study pooled data from 41 studies involving 2,265 people with depression and showed that almost any type of exercise substantially reduces depression symptoms, although some forms of exercise seemed more beneficial than others.
<snip>
The effects were robust enough that the study’s authors hope the finding will spur a move to make exercise a standard, prescribed therapy for depression.
<snip>
The research behind exercise and depression
In large-scale epidemiological studies, active men and women become depressed at much lower rates than sedentary people, even if they exercise for only a few minutes a day or a few days a week.
But it’s trickier to test exercise as a treatment for existing depression. You have to study it like any medicine, by recruiting people with the condition and randomly assigning them to the intervention — in this case, exercise — or a control group and scrupulously tracking what happens.
<snip>
In the study published in February in the British Journal of Sports Medicine, a global group of researchers pulled together every recent experiment using physical activity as depression therapy.
They wound up with data from 41 studies about 2,265 volunteers, representing the largest sample yet on this topic.
The studies’ exercise programs included walking, running and weight training.
Some consisted of group classes, others solo workouts, some supervised, some not.
But all featured people with depression getting up and moving more.
Exercise of any kind treats depression
Pooled, the effects were potent. Overall, people with depression who exercised in any way improved their symptoms by almost five points, using one widely recognized diagnostic scale, and by about 6.5 points using another. For both scales, an improvement of three points or more is considered clinically meaningful, the study’s authors write.
In practical terms, these numbers suggest that, for every two people with depression who start to exercise, one of them should experience “a large-magnitude reduction in depressive symptoms,” Heissel said.
<snip>
Those statistics represent “somewhat better” outcomes than those seen in recent studies of psychotherapy and drug treatment for depression, said Felipe Schuch, a professor researching exercise and mental health at the University of Santa Maria in Brazil and senior author of the study.
In general, the effects were best if people exercised moderately, such as by walking, although more vigorous workouts, including running, cycling and weight training, were almost as effective, and even light activities such as gardening eased symptoms.
Overall, the study “shows that exercise is a further, effective, stand-alone treatment option” for depression, Heissel said.
<snip>
The precise mechanisms by which bodily movements alter brain functions to improve moods remain unclear, as do the differences in people’s responses. In every study the researchers included, some people’s depression lifted, while others’ symptoms remained stubbornly unchanged.
What is the right dose of exercise?
“To formulate exercise as a prescription for medicine, we still need more research to understand the optimal type, frequency and amount of exercise for different people,” said Karmel Choi, a clinical psychologist and assistant professor at the Center for Precision Psychiatry at Harvard Medical School and Massachusetts General Hospital. She has studied exercise and depression but was not involved in the new review.
“Depression is not one size fits all,” she said, “so treatment should always be tailored to the individual.”
<snip>
Certainly, more research is needed. “We do not know enough about dose, intensity and type of exercise,” Heissel said, or whether early improvements related to activity last. Future studies should dive into these questions and compare exercise head-to-head against psychotherapy and antidepressants, he said.
Perhaps most important, researchers and clinicians need to recognize how daunting exercise can be for someone who is depressed.
Ken Pope
Forwarded by:
Michael Reeder LCPC
#psychology #counseling #socialwork #psychotherapy #research @psychotherapist@a.gup.pe @psychology@a.gup.pe @socialpsych@a.gup.pe @socialwork@a.gup.pe #depression #exercise