DEPRESSION | Want to Pitch Your Pills?

By:  Dr. Fred Roberto & Kimberly Roberto

In this day and age if the dark blanket of depression hasn’t descended upon you or someone close to you yet, chances are pretty good it will.  According to the Centers for Disease Control (CDC), one out of every ten Americans has reported suffering from depression, and the numbers of those affected continue to rise. [1. http://www.cdc.gov/features/dsdepression/]

From 1996 to 2005, the number of Americans taking an antidepressant doubled.[2. http://www.usatoday.com/news/health/2009-08-03-antidepressants_N.htm]  In fact, a very recent study showed that over 20% of American adults are taking at least one drug for psychiatric or behavioral disorders.[3. http://www.naturalnews.com/034278_psychiatric_drugs_adults.html] Depression has been directly and indirectly linked to obesity, heart disease, cancer, diabetes, and early death. It is observed daily in missed work-days, decreased productivity, strained relationships, and long-term suffering. Statistics like these are not only alarming, but cannot be ignored and placated by a medicinal label.

A 2007 national survey published in Psychiatryonline.org found that 54% of women with depression reported the use of complementary and/or alternative approaches over the past year.  Of those, 45% reported that they did so because of the negative side effects of the drugs.  In addition, 43% said that conventional treatment simply didn’t work.

Alarming and overwhelming as these statistics are, there is some good news. An alternative practice has regained popularity despite the competition of many doctors and their medicinal money trains. This age old remedy doesn’t come from a bottle, but your own body! What is it? Good old-fashioned exercise. Not only has recent research shown it to be more effective than anti-depressant medication, exercise actually helps to prevent depression. It may also lessen or even eliminate symptoms, protect against relapse, and has numerous other health benefits.

Why does exercise play such a dominant role in our mental health? Depression has been associated with decreased neurogenesis (the generation of new neurons in the brain).  Antidepressant medications attempt to promote neurogenesis however; numerous studies show that exercise is just as, if not more effective in accomplishing this task.

Place the two remedies side by side and take a closer look.  Exercise has been a part of a healthy lifestyle in every culture since the beginning of time.  Unfortunately, too many Americans have become ill, sedentary, and/or just plain lazy.  Studies associated with the effects of exercise on depression began to crop up in the 1980’s, and the results were astounding.  A 2001 study showed that “young and elderly individuals who engage in programs of exercise display fewer depressive symptoms and are less likely to subsequently develop Major Depressive Disorder (MDD).” [4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1413959/]

Further evidence shows that the more intense the exercise, the higher the antidepressant effect.  Other good news is that these positive effects last much longer than the exercise program itself.  Although exercise should be a consistent part of anyone’s lifestyle, many studies show that even when exercise is stopped for a period of time, its positive effects can linger for months afterward.

How does exercise work to help the brain, prevent and alleviate depression?

-Exercise increases blood flow and oxygen to the brain helping it to function more optimally, has positive impact on endorphins which have been commonly associated with a “runners high” or a feeling of euphoria related to exercise, and help encourage new neuron generation.

-It has a positive impact on serotonin which is known for its ability to influence mood, sleep, appetite, and overall feeling of well-being.  (Antidepressants seek to alter serotonin levels.)

-Increases levels of brain-derived neurotropic factor (BDNF), which has been shown to increase the survival rate of the newly generated neurons.

There is also remarkable evidence that exercise can ward off relapse rates of depression. A study published in Psychosomatic Medicine in 2000 stated that, “Individuals who had been physically active in the past who became inactive were 1.5 times more likely to become depressed than those who consistently maintained a high level of physical activity.” [5. http://www.psychosomaticmedicine.org/content/62/5/633/F1.expansion.html]

The chart below shows the benefits of exercise significantly outweigh the use of drugs.

graph

 

Babyak M et al. Psychosom Med 2000;62:633638

Fig. 1 Clinical status at 10 months (6 months after treatment) among patients who were remitted (N = 83) after 4 months of treatment in Exercise (N = 25), Medication (N = 29), and Combination (N = 29) groups. Compared with participants in the other conditions, those in the Exercise condition were more likely to be partially or fully recovered and were less likely to have relapsed.

 

Depression is a very real problem for many Americans. However due to our dependencies on quick fixes or a “pill for that”, exercise is often overlooked as a viable approach to addressing it.  Too many people jump into or are persuaded into starting on an antidepressant only to find that there are serious side effects, unwanted health consequences, and that they are very difficult and even dangerous to come off of.  Please consult with your Doctor prior to coming off any medication.  If only exercise was prescribed before the medication, outcomes may be very different.