Depression and Exercise

Tonight, as with most nights lately, I've definitely been hit with the biggest obstacle in my weight loss and achieving any other goals I've set for myself - the depression is most definitely back. As I mentioned before, one of my goals is to make sure I get 7 hours of sleep a night. Lately, the only way to get 7 hours is to exhaust myself all night, tossing and turning and thinking about my failures, and then sleep in till noon. Ugh. That's not really a success. Tonight (well, at about 4am, so I guess "This morning"), I just decided to screw it and get up.

Came down stairs, read the SparkPeople emails that showed up in my inbox, checked off the various SparkPoints on my list that I could do this morning, and looked up some information about depression and exercise. I know that I've heard exercise can be as valuable as anti-depressants in the mild to moderately depressed, so I wanted to find out if that was just myth or if there was some substance there.

I found a great article from the Mayo clinic that discussed the relationship, and although it didn't put the exercise in Prozac-equivalents, it did suggest that at least 30 minutes of exercise three to five days a week is necessary to see significant improvement. For the last week, I've been doing 30 minutes, three days a week, so now I wanted to find out when this supposed improvement should be coming along.

A 2005 study showed that, for the population of subjects with major depressive disorder (MDD), there were definate actue gains - people "felt better" for the hour after a 30 minute exercise routine than did people who had taken a 30 minute "quiet time." This matches my experience - I always feel good when I come back in from a run. That "glow" feeling usually lasts at least until I'm done with my shower routine - about an hour later.

Still, I'm continuing my quest for a more quantitative study proving or disproving longer term effects on depression, rather than just an acute "mood boost." In 2001, an article in the same magazine stated that the literature didn't show any randomized clinical trials (a gold standard that is also close to my heart, weird as that may sound) testing the link between depression and anxiety. Another 2001 study in the BMJ came to the same conclusion.

"The effectiveness of exercise in reducing symptoms of depression cannot be determined because of a lack of good quality research on clinical populations with adequate follow up." (Effectiveness of exercise in managing depression is not shown by meta-analysis. BMJ 2001 322: 0)

Disappointingly, this article lead me to another, describing an observational study of twins. This study concluded that exercise and decreased anxiety and depression appear to be related, but that there is not a causal relationship between the exercise and decreased symptoms. I was not to be disuaded by this; as a patient, I don't care so much if there is a direct, causal link. I care that, for whatever reason, more exercise = happier Bethlin. And, being Bethlin, I'd also like to quantify "more." :)

A randomized clinical trial of non-twins (just regular people with MDD) had results that made me feel a little more positive. The abstract is published for all to read, but I wasn't able to access the full text without paying for it. This is the most positive information I've seen so far, stating that this experiment showed that exercise was pretty comperable to medication. Interestingly, it also showed that placebo had a good response. To me, this means that just taking the steps to get care, no matter which type of care, can bring about a response. Also important to note - they define success as "remission" after 4 months. Other studies I looked at were also concerned with long-term effects rather than acute feelings.

The best news I found was this full text article (starts on page 158), published in 2008 as well. It also references the meta-studies that found there is just not enough information out there, but that what information is available is "favorable." The article sites the study referenced in the previous paragraph as well as another, similar study. There is a lot of information about exercise used in combination with medication that I skimmed right through - I guess what I'm looking for is information about exercise as "monotherapy." Really interesting, although not something I'm going to summarize here, was a section titled "Psychological and psychosocial factors influencing exercise as a treatment for mood disorders." The summary of the transtheoretical model/Stages of Change was eye opening. I think I'll keep this around to read when I need motivation for my diet/exercise plan or when I need to come back from a set-back in my behavior.

"Age or gender did not have a significant effect; neither did exercise frequency, suggesting that the amount rather than the frequency of exercise is critical to mood improvement."(The Benefits of Exercise for Mood Disorders. Depression: Mind and Body 2008;3(4):158–65.)

All in all, the hour or so it took me to research the links between exercise and depression isn't going to come up with anything earth shattering. It was good for me though; better than spending the time tossing and turning in bed, trying to figure out if I'm self-centered or self-absorbed or just trying to be self-aware (this is my current DepressedBethlin debate). It also has helped me keep up my motivation to put on my running shoes as soon as it's light out and go for my morning run with Bailey.

Next time I end up not sleeping well, I might come downstairs a little earlier and try researching something similar. This has been great therapy for me! Keeps my mind off of my obsessive thinking patterns...hmmm,there's a strategy to consider....