exercise depression

Don't let depression keep you from exercising

June 27, 2018

Science Daily/UT Southwestern Medical Center

Exercise may be just as crucial to a depression patient's good health as finding an effective antidepressant.

 

A new study of nearly 18,000 participants found that those with high fitness at middle age were significantly less likely to die from heart disease in later life, even if they were diagnosed with depression.

 

The research -- a collaboration between UT Southwestern and The Cooper Institute -- underscores the multiple ways in which depression may ultimately impact health and mortality. It also highlights the importance of overcoming a common dilemma among patients: How does one cope with hopelessness and still find motivation to exercise?

 

"Maintaining a healthy dose of exercise is difficult, but it can be done. It just requires more effort and addressing unique barriers to regular exercise," says Dr. Madhukar Trivedi, co-author of the study and Director of the Center for Depression Research and Clinical Care, part of the Peter O'Donnell Jr. Brain Institute at UT Southwestern.

 

Doctor's Tips: How to Stay Fit While Treating Depression

 

Dr. Madhukar Trivedi cites previous research showing that depressed patients can often perform about three-fourths of the exercise they're asked to do. He recommends patients take several steps to boost their chances of success:

 

·     Set aside a consistent time to exercise every day, but do not get discouraged by stretches of inactivity. Resume activities as soon as possible.

·     Keep a log to track progress.

·     Vary the exercises to avoid monotony. Keep the workout interesting and fun.

·     Exercise with a friend.

·     Task someone with holding you accountable for maintaining the exercise regimen.

 

The study published in the Journal of the American Medical Association Psychiatry utilized a Cooper Institute database of participants who had their cardiorespiratory fitness measured at an average age of 50 years. Researchers used Medicare administrative data to establish correlations between the participants' fitness at midlife to rates of depression and heart disease in older age. Among the findings, participants with high fitness were 56 percent less likely to eventually die from heart disease following a depression diagnosis.

 

Dr. Trivedi says the findings are just as relevant to younger age groups, in particular college-age adults who are just entering the workforce.

 

"This is the age where we typically see physical activity drop off because they're not involved in school activities and sports," Dr. Trivedi says.

 

"The earlier you maintain fitness, the better chance of preventing depression, which in the long run will help lower the risk of heart disease."

 

Depression has been linked to several other chronic medical conditions such as diabetes, obesity, and chronic kidney disease, which studies show can affect whether antidepressants are likely to help. For patients with these conditions, the more appropriate treatment may be exercise.

 

Dr. Trivedi says the reasons behind this may partly be connected to the general health effects of physical activity, including the fact that exercise decreases inflammation that may cause depression. By reducing inflammation, the risk for depression and heart disease are lowered.

 

"There is value to not starting a medication if it's not needed," says Dr. Trivedi, who's leading a national effort to establish biological tests for choosing antidepressants. "Being active and getting psychotherapy are sometimes the best prescription, especially in younger patients who don't have severe depression."

 

Dr. Trivedi cites previous research showing that depressed patients can often perform about three-fourths of the exercise they're asked to do. He recommends patients take several steps to boost their chances of success:

 

"There is enough evidence to show that the effect of low fitness on depression and heart disease is real," Dr. Trivedi says. "But further study is needed to establish the mechanism by which this effect happens."

 

More about Depression:

·     JAMA study: Fitness at midlife

·     STRIDE study: Fitness and addiction

·     Video: Bringing help straight to schools

·     Video: EEG helps guide treatment

·     Self-test: Are you depressed?

 

Dr. Trivedi is a Professor of Psychiatry who holds the Betty Jo Hay Distinguished Chair in Mental Health and the Julie K. Hersh Chair for Depression Research and Clinical Care. He collaborated with Dr. Benjamin Willis of The Cooper Institute for the JAMA Psychiatry study.

 

"These new insights demonstrate the ongoing importance of fitness throughout the lifespan," says Dr. Willis, Director of Epidemiology at The Cooper Institute and lead author of the study. "Now we know that the long-term benefits, and the connection between mind-body wellness, are more significant than we thought. We hope our study will highlight the role of fitness and physical activity in early prevention efforts by physicians in promoting healthy aging."

https://www.sciencedaily.com/releases/2018/06/180627160453.htm

Stopping exercise can increase symptoms of depression

March 22, 2018

Science Daily/University of Adelaide

PhD student Julie Morgan from the University of Adelaide's Discipline of Psychiatry has reviewed the results of earlier studies that examined the effects of stopping exercise in regularly active adults.

 

The results of her review are now published online ahead of print in the Journal of Affective Disorders.

 

"Adequate physical activity and exercise are important for both physical and mental health," says Ms Morgan.

 

"Current public health guidelines recommend being active on most if not all days of the week. At least 150 minutes of moderate intensity exercise a week is recommended to maintain health and prevent depression, or 75 minutes of vigorous intensity exercise for added health benefits.

 

"An extensive body of clinical evidence shows that regular exercise can reduce and treat depression. However, there is limited research into what happens with depressive symptoms when exercise is stopped," she says.

 

Ms Morgan reviewed studies that investigated the cessation of exercise in 152 adults. They had each undertaken at least 30 minutes of exercise, three times a week, for a minimum of three months.

 

"In some cases, ceasing this amount of exercise induced significant increases in depressive symptoms after just three days," says Professor Bernhard Baune, Head of Psychiatry at the University of Adelaide and senior author on the paper.

 

"Other studies showed that people's depressive symptoms increased after the first one or two weeks, which is still quite soon after stopping their exercise."

 

Professor Baune says the depressive symptoms arising from stopping exercise occurred in the absence of the typical biological markers commonly involved with depressive symptoms.

 

"This suggests some kind of novel effect in these cases, although we should add some caution here, as the number of people included in the studies we examined was small. Such findings would need to be replicated in additional trials," he says.

 

Professor Baune says the lack of research in this specific area points to the need for further studies, to help better understand the way in which stopping exercise affects depressive symptoms.

 

"For now, it is important that people understand the potential impact on their mental well-being when they suddenly cease regular exercise," he says.

https://www.sciencedaily.com/releases/2018/03/180322112720.htm

Should exercise be what the doctor orders for depression?

November 8, 2017

Science Daily/Michigan State University

More mental health providers may want to take a closer look at including exercise in their patients' treatment plans, a new study suggests. Researchers asked 295 patients receiving treatment at a mental health clinic whether they wanted to be more physically active and if exercise helped improve their mood and anxiety. They also asked if patients wanted their therapist to help them become more active.

 

Michigan State University and University of Michigan researchers asked 295 patients receiving treatment at a mental health clinic whether they wanted to be more physically active and if exercise helped improve their mood and anxiety. They also asked if patients wanted their therapist to help them become more active.

 

Eighty-five percent said they wanted to exercise more and over 80 percent believed exercise helped improve their moods and anxiety much of the time. Almost half expressed interest in a one-time discussion, with many participants also wanting ongoing advice about physical activity with their mental health provider.

 

The study is now published in the journal General Hospital Psychiatry.

 

"Physical activity has been shown to be effective in alleviating mild to moderate depression and anxiety," said Carol Janney, lead author of the study and an MSU assistant professor of epidemiology. "Current physical activity guidelines advise at least 30 minutes, five days a week to promote mental and physical health, yet many of those surveyed weren't meeting these recommendations."

 

More than half of the participants said their mood limited their ability to exercise, which Janney said provides an opportunity for physicians and therapists in clinics to offer additional support.

 

"Offering physical activity programs inside the mental health clinics may be one of many patient-centered approaches that can improve the mental and physical health of patients," Janney said.

 

Marcia Valenstein, senior author and professor emeritus in psychiatry at U-M, agreed.

 

"Mental health treatment programs need to partner with fitness programs to support their patients' willingness to exercise more," she said. "This support might come from integrating personal trainers into mental health clinics or having strong partnerships with the YMCA or other community recreational facilities."

 

Both Valenstein and Janney said that psychiatrists and other providers might discuss with patients the general need to exercise, but few actually sit down with patients and create a comprehensive exercise plan for them or regularly make sure they are adhering to a specific goal.

 

"Mental health providers such as psychiatrists and therapists may not have the necessary training to prescribe physical activity as part of their mental health practice," Janney said. "But by teaming up with certified personal trainers or other exercise programs, it may help them prescribe or offer more recommendations for physical activity in the clinic setting."

 

Results also showed that over half of the patients surveyed showed interest in getting help from a personal trainer and were willing to pay a bit extra, but that the topic of physical activity was rarely discussed by their physician.

 

"This is a missed opportunity," Valenstein said. "If we can make it easier for both therapists and their patients to have easier access to physical activity services, then we are likely to help more patients reduce their depression and anxiety."

 

Once the effectiveness of this approach is proven, she added, health insurers might consider moving in the direction of covering services that help people exercise.

 

"Several insurers already do this for diabetes prevention, so it's not out of the question."

https://www.sciencedaily.com/releases/2017/11/171108151604.htm

One hour of exercise a week can prevent depression

October 3, 2017

Science Daily/University of New South Wales

Regular exercise of any intensity can prevent future depression -- and just one hour can help, a landmark study has revealed.

 

Published in the American Journal of Psychiatry, the results show even small amounts of exercise can protect against depression, with mental health benefits seen regardless of age or gender.

 

In the largest and most extensive study of its kind, the analysis involved 33,908 Norwegian adults who had their levels of exercise and symptoms of depression and anxiety monitored over 11 years.

 

The international research team found that 12 percent of cases of depression could have been prevented if participants undertook just one hour of physical activity each week.

 

"We've known for some time that exercise has a role to play in treating symptoms of depression, but this is the first time we have been able to quantify the preventative potential of physical activity in terms of reducing future levels of depression," said lead author Associate Professor Samuel Harvey from Black Dog Institute and UNSW.

 

"These findings are exciting because they show that even relatively small amounts of exercise -- from one hour per week -- can deliver significant protection against depression.

 

"We are still trying to determine exactly why exercise can have this protective effect, but we believe it is from the combined impact of the various physical and social benefits of physical activity.

 

"These results highlight the great potential to integrate exercise into individual mental health plans and broader public health campaigns. If we can find ways to increase the population's level of physical activity even by a small amount, then this is likely to bring substantial physical and mental health benefits."

 

The findings follow the Black Dog Institute's recent Exercise Your Mood campaign, which ran throughout September and encouraged Australians to improve their physical and mental wellbeing through exercise.

 

Researchers used data from the Health Study of Nord-Trøndelag County (HUNT study) -- one of the largest and most comprehensive population-based health surveys ever undertaken -- which was conducted between January 1984 and June 1997.

 

A healthy cohort of participants was asked at baseline to report the frequency of exercise they participated in and at what intensity: without becoming breathless or sweating, becoming breathless and sweating, or exhausting themselves. At follow-up stage, they completed a self-report questionnaire (the Hospital Anxiety and Depression Scale) to indicate any emerging anxiety or depression.

 

The research team also accounted for variables which might impact the association between exercise and common mental illness. These include socio-economic and demographic factors, substance use, body mass index, new onset physical illness and perceived social support.

 

Results showed that people who reported doing no exercise at all at baseline had a 44% increased chance of developing depression compared to those who were exercising one to two hours a week.

 

However, these benefits did not carry through to protecting against anxiety, with no association identified between level and intensity of exercise and the chances of developing the disorder.

 

According to the Australian Health Survey, 20 percent of Australian adults do not undertake any regular physical activity, and more than a third spend less than 1.5 hours per week being physically active. At the same time, around 1 million Australians have depression, with one in five Australians aged 16-85 experiencing a mental illness in any year.

 

"Most of the mental health benefits of exercise are realised within the first hour undertaken each week," said Associate Professor Harvey.

 

"With sedentary lifestyles becoming the norm worldwide, and rates of depression growing, these results are particularly pertinent as they highlight that even small lifestyle changes can reap significant mental health benefits."

https://www.sciencedaily.com/releases/2017/10/171003093953.htm

Moderate exercise not only treats, but prevents depression

October 28, 2013

Science Daily/University of Toronto

Physical activity is being increasingly recognized as an effective tool to treat depression. PhD candidate George Mammen's review published in the October issue of the American Journal of Preventive Medicine has taken the connection one step further, finding that moderate exercise can actually prevent episodes of depression in the long term.

 

This is the first longitudinal review to focus exclusively on the role that exercise plays in maintaining good mental health and preventing the onset of depression later in life.

 

Mammen -- who is supervised by Professor Guy Faulkner, a co-author of the review -- analyzed over 26 years' worth of research findings to discover that even low levels of physical activity (walking and gardening for 20-30 minutes a day) can ward off depression in people of all age groups.

 

Mammen's findings come at a time when mental health experts want to expand their approach beyond treating depression with costly prescription medication. "We need a prevention strategy now more than ever," he says. "Our health system is taxed. We need to shift focus and look for ways to fend off depression from the start."

 

Mammen acknowledges that other factors influence a person's likelihood of experiencing depression, including their genetic makeup. But he says that the scope of research he assessed demonstrates that regardless of individual predispositions, there's a clear take-away for everyone. "It's definitely worth taking note that if you're currently active, you should sustain it. If you're not physically active, you should initiate the habit. This review shows promising evidence that the impact of being active goes far beyond the physical."

http://www.sciencedaily.com/releases/2013/10/131028163003.htm

A Walk in the Park Gives Mental Boost to People with Depression

May 14, 2012

Science Daily/Baycrest Centre for Geriatric Care

A walk in the park may have psychological benefits for people suffering from depression. In one of the first studies to examine the effect of nature walks on cognition and mood in people with major depression, researchers in Canada and the U.S. have found promising evidence that a walk in the park may provide some cognitive benefits.

The study was led by Marc Berman, a post-doctoral fellow at Baycrest's Rotman Research Institute in Toronto, with partners from the University of Michigan and Stanford University. It is now published online, ahead of print publication, in the Journal of Affective Disorders.

"Our study showed that participants with clinical depression demonstrated improved memory performance after a walk in nature, compared to a walk in a busy urban environment," said Dr. Berman, who cautioned that such walks are not a replacement for existing and well-validated treatments for clinical depression, such as psychotherapy and drug treatment.

"Walking in nature may act to supplement or enhance existing treatments for clinical depression, but more research is needed to understand just how effective nature walks can be to help improve psychological functioning," he said. Dr. Berman's research is part of a cognitive science field known as Attention Restoration Theory (ART) which proposes that people concentrate better after spending time in nature or looking at scenes of nature. The reason, according to ART, is that people interacting with peaceful nature settings aren't bombarded with external distractions that relentlessly tax their working memory and attention systems. In nature settings, the brain can relax and enter a state of contemplativeness that helps to restore or refresh those cognitive capacities.

In a research paper he published in 2008 in Psychological Science, Dr. Berman showed that adults who were not diagnosed with any illness received a mental boost after an hour-long walk in a woodland park -- improving their performance on memory and attention tests by 20 percent -- compared to an hour-long stroll in a noisy urban environment. The findings were reported by The Wall Street Journal, The Boston Globe, The New York Times, and in the Pulitzer Prize finalist book by Nicholas Carr, The Shallows: What the internet is doing to our brains.

In this latest study, Dr. Berman and his research team explored whether a nature walk would provide similar cognitive benefits, and also improve mood for people with clinical depression. Given that individuals with depression are characterized by high levels of rumination and negative thinking, the researchers were skeptical at the outset of the study that a solitary walk in the park would provide any benefit at all and may end up worsening memory and exacerbating depressed mood.

For the study, 20 individuals were recruited from the University of Michigan and surrounding Ann Arbor area; all had a diagnosis of clinical depression. The 12 females and eight males (average age 26) participated in a two-part experiment that involved walking in a quiet nature setting and in a noisy urban setting. Prior to the walks, participants completed baseline testing to determine their cognitive and mood status. Before beginning a walk, the participants were asked to think about an unresolved, painful autobiographical experience. They were then randomly assigned to go for an hour-long walk in the Ann Arbor Arboretum (woodland park) or traffic heavy portions of downtown Ann Arbor. They followed a prescribed route and wore a GPS watch to ensure compliance. After completing their walk, they completed a series of mental tests to measure their attention and short-term/working memory and were re-assessed for mood. A week later the participants repeated the entire procedure, walking in the location that was not visited in the first session.

Participants exhibited a 16 percent increase in attention and working memory after the nature walk relative to the urban walk. Interestingly, interacting with nature did not alleviate depressive mood to any noticeable degree over urban walks, as negative mood decreased and positive mood increased after both walks to a significant and equal extent. Dr. Berman says this suggests that separate brain mechanisms may underlie the cognitive and mood changes of interacting with nature.
https://www.sciencedaily.com/releases/2012/05/120514134303.htm

 

 

Exercise can substitute effectively as second 'medication' for people with depression

August 24, 2011

Science Daily/UT Southwestern Medical Center

Exercise can be as effective as a second medication for as many as half of depressed patients whose condition have not been cured by a single antidepressant medication

 

UT Southwestern Medical Center scientists involved in the investigation, recently published in the Journal of Clinical Psychiatry, found that both moderate and intense levels of daily exercise can work as well as administering a second antidepressant drug, which is often used when initial medications don't move patients to remission. The type of exercise needed, however, depends on the characteristics of patients, including their gender.

 

These findings are the result of a four-year study conducted by UT Southwestern's psychiatry department in conjunction with the Cooper Institute in Dallas. The National Institute of Mental Health-funded study, begun in 2003, is one of the first controlled investigations in the U.S. to suggest that adding a regular exercise routine, combined with targeted medications, actually can relieve fully the symptoms of major depressive disorder.

 

"Many people who start on an antidepressant medication feel better after they begin treatment, but they still don't feel completely well or as good as they did before they became depressed," said Dr. Madhukar Trivedi, professor of psychiatry and the study's lead author. "This study shows that exercise can be as effective as adding another medication. Many people would rather use exercise than add another drug, particularly as exercise has a proven positive effect on a person's overall health and well-being."

 

By the end of the investigation, almost 30 percent of patients in both groups achieved full remission from their depression, and another 20 percent significant displayed improvement, based on standardized psychiatric measurements. Moderate exercise was more effective for women with a family history of mental illness, whereas intense exercise was more effective with women whose families did not have a history of the disease. For men, the higher rate of exercise was more effective regardless of other characteristics.

 

"This is an important result in that we found that the type of exercise that is needed depends on specific characteristics of the patient, illustrating that treatments may need to be tailored to the individual," said Dr. Trivedi, director of the Mood Disorders Research Program and Clinic at UT Southwestern. "It also points to a new direction in trying to determine factors that tell us which treatment may be the most effective."

http://www.sciencedaily.com/releases/2011/08/110824091522.htm

People at risk for panic buffered from stressor by high levels of physical activity

July 14, 2011

Science Daily/Southern Methodist University

People at risk for experiencing panic attacks respond with less anxiety to a panic-inducing stressor if they have been regularly engaging in high levels of physical activity, suggests a new study. High levels of physical activity appeared to buffer against panic-inducing stress -- inhalation of carbon dioxide-enriched air -- among people typically afraid of the nausea, dizziness, racing heart and shortness of breath that characterize panic episodes, according to psychologists

 

"Anxiety sensitivity is an established risk factor for the development of panic and related disorders," said SMU psychologist Jasper Smits, lead author on the research. "This study suggests that this risk factor may be less influential among persons who routinely engage in high levels of physical activity."

 

Regular exercise as an alternative or complementary strategy to drugs and psychotherapy

 

There is already good evidence that exercise can be of help to people who suffer from depression and anxiety problems, say the researchers. "We're not suggesting, 'Exercise instead of pharmacotherapy or psychotherapy,'" Smits said. "Exercise is a useful alternative, particularly for those without access to traditional treatments. Primary care physicians already prescribe exercise for general health, so exercise may have the advantage of helping reach more people in need of treatment for depression and anxiety."

http://www.sciencedaily.com/releases/2011/07/110712122403.htm

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