Is Exercise As Effective For Relieving Depression As Therapy and Medication?

Depression affects over 340 million people across the globe and here in the United States it is estimated that about 16% percent of the population will suffer from a major depressive disorder (MDD) during the course of their lives,  with women being almost twice as likely than their male counterparts to develop a disorder. ^1,2 With all the emphasis with regards to health care on obesity related illnesses it is often overlooked that depression is on track to become the second largest contributor to the global burden of disease by the year 2020.³ We know that physical inactivity increases the likelihood and duration of depression and that physical activity, whether it be work related, exercise or recreation significantly reduces the risk of developing a depressive disorder. This holds true across the board for people of all races and socio-ecomomic levels, but for those adverse to conventional therapeutic interventions, the question remains, can exercise be as effective as conventional therapy and medication in relieving depression?

Studies Find That Exercise Is A Strong Preventative Against Depression

In 2001 the British Medical Journal did a review of the antidepressant effects of exercise treatments. After looking at a total of fourteen randomized controlled trials they found that the positive effects of exercise treatment for depression when compared to no treatment at all was statistically significant. There were major reductions in depression ratings among those engaged in exercise programs as opposed to those who were inactive. There was some debate over the validity of this review as some of the participants in the studies may have had subclinical mood problems rather than fully diagnosed major depressive disorders. That being said the idea that exercise treatment is more effective than no treatment at all is supported by at least two other systematic reviews^{4, 5,6} and most of the systematic reviews find as well that ‘the antidepressant effect size of exercise can be comparable to that of psychotherapy and to that of pharmacotherapy.’ ^{7, 6, 8, 9}

The Anti-Depressant Effects Of Exercise May Be Comparable To Drug & Therapy Interventions

Does this mean that you should focus solely on exercise as a way to relieving depressive symptoms? Not at all, as there is a saying that in a battle one should always go down fighting with all swords drawn from their scabbards and the same applies to clinical depression. Given the effects of exercise on mood elevation, the combined use of therapy and drug interventions might result in faster onset of antidepressant action, so drug and therapy should not be instantly ruled out.10 More trials are needed before exercise can be recommended clinically as a prescription for dealing with depression, but if exercise could act as an immediate salve to the symptoms of depression given that antidepressant medications and therapy all take weeks to months before clinical improvements can be seen whereas the positive effects of exercise occur much faster. Most importantly, the use of exercise protocols are safe and do not interact negatively in any way with other drugs or therapeutic treatments.
Some experts argue that adherence to a standardized exercise program is the number one reason for failure among the general population and that it would be far more difficult for a severely depressed individual to find the motivation to exercise on a regular basis, but given the promising fairly recent results of brief high intensity weight training programs on relieving depressive symptoms¹¹ it might indeed be viable if the duration is considerably short especially as adherence to regularly taking anti-depressant drugs is equally a problem among individuals with depression. At the end of the day what these findings really highlight is that exercise and physical activity have a major role to play in our overall mental health and that more research should be done into its potential use as a clinical anti-depression prescription. In coming articles we will explore the relevance of short high intensity training on depression and how it might make getting the anti-depressive benefits of exercise far more attainable to those that find it hard to stick with an exercise program to being with.