Dr Pam Popper on Exercise for Depression

 

Exercise vs Drugs for Depression Pam Popper, President Wellness Forum Health According to a new study, running works just as well for relieving depression and anxiety as drugs. Researchers partially randomized 141 patients with depression or anxiety disorder to either an antidepressant (Lexapro or Zoloft) or group-based running therapy two to three times per week for 16 weeks. Mental health, symptom severity and physical health were evaluated at baseline and then at the end of the 16-week period. Forty-five of the patients took meds, and 96 underwent running therapy. The reason for the difference in the size of the groups is that most of the patients did not want to be randomized and preferred to be part of the running group.  Running resulted in a small but statistically insignificant greater remission rate than drugs. But there were much greater differences in other markers of health. Runners fared better on weight loss, waist circumference, systolic and diastolic blood pressure, heart rate and heart rate variability. The subjects taking drugs showed deterioration in these metrics.[1] This study is not an outlier in showing that exercise works as well or better than antidepressants. First, research shows that inactivity is associated with higher risk of psychological disorders, and that exercise improves mental health.[2] This is not new information. Case reports published in the early 1900s showed that moderately intense exercise improved depression and mood.[3] Research also shows that almost any type of exercise works. In one study, 90 patients were randomized to aerobic exercise (running or brisk walking) or strength training, relaxation, or flexibility exercise. After 60-minute sessions three times per week for eight weeks, both groups experienced the same level of improvement in symptoms.[4] This study is also not the first to compare the effect of exercise with drugs for mental health improvement. A 1999 study randomized 156 patients to exercise, Zoloft, or exercise plus Zoloft. Medication worked more quicky, but at 16 weeks there was no difference and people in all groups were better.[5] Ten months later, patients in the exercise group were significantly less depressed than those in the medical or combination group.[6] In addition to the fact that exercise is effective for reducing or eliminating depression, exercise does not have the negative side effects associated with drugs. Side effects of Zoloft include nausea, diarrhea, loss of appetite, nose bleeds, increased sweating, fatigue, insomnia, anxiety, loss of bladder control, tremors, agitation, and sexual dysfunction.[7] Side effects of Lexapro include a black box warning that the drug can cause suicidal thoughts in pediatric patients and young adults; in addition to diarrhea, drowsiness, headache, insomnia, nausea, constipation, dizziness, dyspepsia, and decreased libido.[8] Diet and lifestyle changes, combined with effective mental health therapy, are the best options for addressing depression and anxiety. The drugs were developed based on the false assumption that chemical imbalances in the brain cause psychological disorders. They don’t. But taking these drugs will cause chemical imbalances in the brain that make them terribly difficult to withdraw from. Long-term users, particularly those taking more than one drug, sometimes take years to completely discontinue these infective and dangerous medications, and a significant minority are unable to accomplish withdrawal. The bottom line: Human bodies are meant to move. Exercise improves both physical and mental health. 1] Verhoeven JE, Han LKM, Lever-van Milligan B et al. "Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders." J Affective Disord 2023 May;329:19-29 [2] Carek PJ, Laibstain SE, Carek SM. "Exercise for the Treatment of Depression and Anxiety." Int J Psychiatry Med 2011 Jan;41(1) [3] Vaux CL. "A discussion of physical exercise and recreation." Occ Ther Rehab 1926 Oct;5(5):329-334 [4] Martinsen EW, Hoffart A, Solberg O. "Comparing aerobic and nonaerobic forms of exercise in the treatment of clinical depression: a randomized trial." Compr Psychiatry. 1989 Jul-Aug;30(4):324-31. [5] Blumenthal JA, Babyak MA, Moore KA. et al. "Effects of exercise training on older patients with major depression." Arch Intern Med. 1999 Oct 25;159(19):2349-56. [6] Babyak M, Blumenthal JA, Herman S. et al. "Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months." Psychosom Med. 2000 Sep-Oct;62(5):633-8. [7] https://www.drugs.com/zoloft.html [8] https://www.drugs.com/sfx/lexapro-side-effects.html