Exercise for People with Depression

Question 1

Why is physical activity proposed as a treatment for depression?

Answer 1

• Further reach, access and lower cost than other treatments (therapy has stigma and is expensive)
• No known side effects, unlike antidepressants
• Alternative choice for those resistant to other treatments
• Just as effective as antidepressants and therapy according to some research

Question 2

What are the psychological mechanisms by which exercise can help treat depression?

Answer 2

• Self Esteem due to positive physical self perception
• Social Support due to exposure to people
• Self Efficacy due to skill mastery and transferable sense of coping with challenges

Question 3

What are the physiological mechanisms by which exercise can help treat depression?

Answer 3

• Neuroplasticity, positively changing brain chemistry
• Improved neuroendocrine responses, more HPA regulation
• Decreases inflammation
• Resilience to oxidative stress

Question 4

What is the current prevalence of depression in the UK?

Answer 4

1 in 6

Question 5

What is the bidirectional relationship of exercise and depression?

Answer 5

-Does physical activity help with depression or are less depressed people more able to be physically active?

Question 6

What does Rush et al 2006 say about the effectiveness of medication and therapy for treating depression?

Answer 6

1/3 of people do not respond to the treatment

Question 7

What does Schuh et al 2018 say about the relationship between physical activity and depression?

Answer 7

-Physically active people had a 17% lower likelihood of depression.

Question 8

What are the problems of prescribing exercise to people with depression?

Answer 8

-They may not be able to stick to it due to depression

Question 9

What did Blumenthal et al 2007 show about the comparative impact of various forms of exercise to medication on depressive symptoms?

Answer 9

Similar number of people that achieved remission (no longer depressed) between home exercise, group exercise and meds, all higher (40-47% than those recieving a placebo pill (31%)

Question 10

What did Blumenthal et al 2000 show about the impact of exercise, meds, or both, on the impact of depression relapse?

Answer 10

• Exercise had highest preventative impact 6 months after the end of the study. They most likely kept doing exercise.
• Meds and Both had the same. This might be due to the fact that people only associated the changes with the meds and not the exercise, so they probably stopped exercising.

Question 11

What did Chalder et al 2012 show about the impact of adding exercise counselling onto usual care had on depression symptoms?

Answer 11

• No improvement on top of usual care
• BUT this is probably because it was only exercise counselling and not an exercise program. Also, physical activity is proposed as an alternative to meds and therapy, not an addition.

Question 12

Why may physical activity and medication have similar effects?

Answer 12

They share mechanisms: Both meds and exercise improve availability of neurotransmitters, and both therapy and exercise target the negative spiral of cognitions/behaviours/emotions that facilitate depression