Exercise Can Treat Major Depression

Health care providers often believe that alternative treatments for depression are only appropriate for mild depression. For more serious depressions, the patient needs DRUGS. But is that true? As I mentioned in a previous post, there are a number of non-drug treatments for depression. For this posting, I’d like to focus on exercise.

Two recent studies at the Duke University Medical Center tested exercise as a treatment for depression by putting it head-to-head with Zoloft in two randomized clinical trials. The patients were older adults with major depression. In both studies, exercise was as effective Zoloft.

Other studies have found that exercise prevents or treats depression with a wide range of people. The strongest effects are for aerobic exercise, but weight lifting and stretching/yoga are also helpful. If you exercise at a moderate level, exercise is safe during pregnancy or breastfeeding. The guidelines for treating mild-to-moderate and major depression with exercise are listed below.

The recommended exercise regimen for treating major depression requires more effort than the regimen for mild-to-moderate depression. But it is a viable alternative to medications and many women find that it is worth the effort. In the second Duke study, the researchers found that the group that came to the lab to exercise had a lower rate of depression than the group that followed a home-exercise program. The fact that they needed to come to the laboratory probably meant that they also received social support from study staff and fellow participants in addition to benefits of exercise. The participants were also probably more likely to exercise regularly when they knew that they were expected to show up some place. You might find that exercise in a group setting works well for you too.

How much exercise do you need to do? Here are some guidelines summarized from several recent studies.

For mild-to-moderate depression
• Frequency: 2 to 3 times a week
• Intensity: moderate
• Duration: 20 to 30 minutes

For major depression
• Frequency: 3 to 5 times a week
• Intensity: 60% to 85% maximum capacity
• Duration: 45 to 60 minutes

Exercise is another thing you can do for yourself to increase your physical and mental well-being. Get off that couch and just do it! You’ll be happy you did.

Alternative Treatments for Depression in Pregnant Women

There has recently been a lot of discussion in the news about the potential hazards of taking antidepressants while pregnant. Some are concerned that they increase the risk of birth defects. Proponents of antidepressants point out, correctly, that depression during pregnancy is also risky and can lead to premature delivery and other complications.

Health care providers often make treatment decisions by balancing the risks and benefits of a medication. Is the risk of using the medication less than the risk of the mother getting depressed again? In most cases, the risk of using the medication is less than the risk of possible depression, so clinicians will prescribe it. But are antidepressants the only choice?

Curiously, while people debate about antidepressant use in both research studies and the popular media, non-drug treatments for depression are largely absent from the discussion. Fortunately, antidepressants are not the only choice for treating depression and may offer a safe “third choice” for treating depression during pregnancy. Physicians and other health care providers may not consider these non-drug treatments, assuming that they cannot address more severe depression.

But recent research paints a very different picture. There are a number of non-drug treatments that are effective for even major depression. Non-drug treatments include Omega-3s, exercise, bright light therapy, psychotherapy, and St. John’s wort. Many of these can be combined with each other, and are sometimes used in addition to antidepressants (only St. John’s wort cannot be combined with medications). What all these treatments have in common is that they are all specifically anti-inflammatory. In the next few installments, I’ll explain that in more detail. But it’s important to know that there are alternatives, and these are especially important to consider during vulnerable times, like pregnancy.