Clinical depression is becoming increasingly prevalent in modern times, due mostly to the lifestyle changes, stress from multiple angles, and generally, just the extremely fast-paced lives all of us lead, these days.
Most patients presenting to a psychiatrist with features of depression, who go on to be diagnosed with clinical depression, are started on pharmacological therapy, without enough importance being given to the non-pharmacological modes of treatment, predominantly, cognitive-behaviour therapy, and, the highly undervalued, exercise.
Most people know about the benefits of exercise – weight control, prevention of obesity and the multitude of diseases associated with it, a healthy cardiovascular system, etc. But what does it do for mental health?
Research shows that addition of the above-mentioned non-pharmacological treatment options to the pharmacological therapy of depression helps control symptoms better, and leads to higher overall patient satisfaction as well as clinical improvement.
Exercise not only helps with short-term improvement, but has been shown to be effective in long-term mood improvement amongst depressed people, up to a year after the period of exercise. This mood improvement is said to be caused largely by the release of endorphins and other chemicals in the brain.
Furthermore, the type of exercise, whether it is aerobic – walking, jogging, running, cycling, etc., or non-aerobic – like strength training, weightlifting, etc., does not matter. Any kind of exercise helps!
Exercise has been shown to be equivalent in efficacy to psychotherapy (counselling, cognitive therapy, cognitive-behavioural therapy) at controlling the symptoms of depression. As compared to pharmacological therapy, exercise causes mood improvement and symptom control slower than drugs do, but on long-term follow-up, the efficacy of exercise has been shown to be equal to, or even more than, the use of drugs!
While exercise has not been shown to be as effective in control of depression that is secondary to physical, medical causes, like heart attacks, or in patients undergoing dialysis, as compared to primary depression, there are unequivocal benefits of exercise even in this subset of the population.
There is a significant increase in lifespan and quality of life amongst such patients, if they exercise regularly, as compared to if they don’t.
Lack of exercise in depression is common. Most patients with clinical depression are not usually out and about, and this can cause additional physical problems, like obesity, diabetes, hypertension, cardiovascular disorders, eating disorders etc. Therefore, exercise in depression serves not only to control the depression itself, but also to prevent these additional, scary, complications.
In conclusion, exercise is an invaluable, and unfortunately, undervalued tool that can be easily and successfully implemented as a treatment option in the management of clinical depression. It improves mood, increases appetite, builds and maintains a healthier self-image, boosts self-esteem, and prevents the physical effects of inactivity, like obesity, and its associated features. It just need to be taken up and practiced more often.