Most mornings I get up early enough that I can read the morning news over breakfast. When I pick up my newspaper on the driveway, I often see my neighbor running past me. He always greets me with a smile as he jogs briskly up the hill.
At one of his frequent barbecues, he once confided to me about his tendency toward depression, and how he feels that his daily jog keeps his spirits up and prevents more serious depression.
The health benefits of regular cardiovascular conditioning have been recognized for many years. Along with nutritious diet, physical exercise can prevent Type 2 diabetes, strengthen the heart, and extend life expectancy. Some doctors describe physical exercise as the best “drug” they can prescribe since it has relatively few side effects and helps stave off so many illnesses.
Now, thanks to recent of studies, the mood benefits of aerobic exercise have gained growing support.
Exercise Works Like Drugs
A Duke University study made headlines when investigators compared the antidepressant effects of cardiovascular conditioning to the antidepressant drug sertraline and an inactive placebo tablet.
Study volunteers with clinical depression were divided into three groups, based on the type of the type of intervention they would use (i.e., exercise vs. antidepressant vs. placebo). After four months, the investigators found that approximately 40 percent of the volunteers no longer suffered depression.
In fact, the exercise program had an effect on mood that was comparable to that of the antidepressant drug. However, the subjects who utilized to either exercise or the drug were only slightly better than those who received the placebo.
The group of volunteers who exercised at a moderate exercise level (about 40 minutes three to five days a week) enjoyed the best mood lift.
Although the scientists concluded that exercise worked as well as the antidepressant medication, this study also demonstrated the influences of placebo. The patient expectations and attention from the study personnel during monitoring visits also provided a therapeutic benefit on mood.
Other research on the antidepressant effects of physical exercise have shown mixed results. Several controlled studies have not found physical training programs to be any more effective than usual care.
However, an analysis of 90 articles involving more than 10,000 sedentary patients with chronic illness showed that exercise training significantly reduced depressive symptoms. Greater antidepressant effects were observed when the baseline depressive symptoms were higher and the patients met recommended physical activity levels in each of the studies.
The investigators concluded that patients with mild-to-moderate depression experienced the greatest antidepressant effects from exercise.
These kinds of systematic studies are very challenging. While scientists are working determine the correct extent of an exercise program for improving mood for a particular form of anxiety or depression, there’s still no reason to wait to start an exercise routine.
Anyone who has played a few sets of tennis or run a few laps around the track knows first-hand the compelling and immediate sense of euphoria. It makes us feel invigorated and clear-headed. But why is this so?
The aerobic burst not only increases blood flow to the brain, it also releases endorphins — the body’s innate antidepressant hormone. In addition, other mood-boosting neurotransmitters, such as serotonin, are also released.
Many of today’s popular antidepressants — such as selective serotonin reuptake inhibitors(SSRIs) — exert their effects by increasing brain levels of serotonin, a chemical this is low during depressive states.
Exercise also elevates levels of brain-derived neurotrophic factor, another neurotransmitter that declines during depressions.
I am convinced of the cognitive and mood benefits of exercise. I always recommend that my patients find a way to work exercise into their daily lives, whether it’s jogging, cycling, or just walking briskly.
Exercise No Cure-All
One concern about the enthusiasm of the antidepressant effects of exercise is that some patients who truly need antidepressant medications and psychotherapy may not get the help they need, thinking that physical exercise may be all that’s necessary.
Numerous systematic clinical trials of antidepressant medications have shown that these drugs are significantly more effective than placebo in relieving symptoms in people with major depression. And inadequately treated depression increases the risk for illness and death, not just from suicide but also from medical illnesses.
My neighbor hasn’t had a serious depression in years. Perhaps his morning jogs are preventing a relapse. He certainly inspires me to get in my daily workout.
If I don’t have time to get to the gym, I’ll make sure I climb a few flights of stairs at work or at least walk briskly between appointments.
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