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The exercise effect. When Jennifer Carter, Ph. D, counsels patients, she often suggests they walk as they talk.
But that's not the only benefit. As immediate past president of APA's Div. Exercise and Sport Psychology), she's well aware of the mental health benefits of moving your muscles. There is much less awareness of mental health outcomes .
Physical exercise has established efficacy as an antidepressant in individuals with depression and current medical evidence supports the use of exercise as both a preventive measure against and an adjunct therapy with.
But as evidence piles up, the exercise- mental health connection is becoming impossible to ignore. Mood enhancement. If you've ever gone for a run after a stressful day, chances are you felt better afterward. Research shows that exercise can also help alleviate long- term depression.
Some of the evidence for that comes from broad, population- based correlation studies. And people who were active and stopped tend to be more depressed than those who maintain or initiate an exercise program. Blumenthal has explored the mood- exercise connection through a series of randomized controlled trials. In one such study, he and his colleagues assigned sedentary adults with major depressive disorder to one of four groups: supervised exercise, home- based exercise, antidepressant therapy or a placebo pill.
After four months of treatment, Blumenthal found, patients in the exercise and antidepressant groups had higher rates of remission than did the patients on the placebo. Exercise, he concluded, was generally comparable to antidepressants for patients with major depressive disorder (Psychosomatic Medicine, 2. Blumenthal followed up with the patients one year later. The type of treatment they received during the four- month trial didn't predict remission a year later, he found. However, subjects who reported regular exercise at the one- year follow- up had lower depression scores than did their less active counterparts (Psychosomatic Medicine, 2. Despite these challenges, a compelling body of evidence has emerged. In 2. 00. 6, Otto and colleagues reviewed 1.
They determined that exercise could be a powerful intervention for clinical depression (Clinical Psychology: Science and Practice, 2. Based on those findings, they concluded, clinicians should consider adding exercise to the treatment plans for their depressed patients. Mary de Groot, Ph. D, a psychologist in the department of medicine at Indiana University, is taking the research one step further, investigating the role exercise can play in a particular subset of depressed patients: those with diabetes. It's a significant problem, she says.
Fitness & Exercise Overview. Fitness means being able to perform physical activity. It also means having the energy and strength to feel as good as possible. Getting more fit, even a little bit, can improve your health.
And among diabetics, she adds, depression is often harder to treat and more likely to recur. The association runs both ways. People with diabetes are more likely to develop depression, and people with depression are also more likely to develop diabetes. When she reviewed the literature, she was surprised to find the topic hadn't been researched. So, she launched a pilot project in which adults with diabetes and depression undertook a 1. CBT) intervention program (Diabetes, 2.
Immediately following the program, the participants who exercised showed improvements both in depression and in levels of A1. C, a blood marker that reflects blood- sugar control, compared with those in a control group. She's now undertaking a larger study to further explore exercise and CBT, both alone and in combination, for treating diabetes- related depression. Fight- or- flight. Researchers have also explored exercise as a tool for treating . When we're spooked or threatened, our nervous systems jump into action, setting off a cascade of reactions such as sweating, dizziness, and a racing heart. People with heightened sensitivity to anxiety respond to those sensations with fear.
They're also more likely to develop panic disorder down the road, says Jasper Smits, Ph. D, Co- Director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas and co- author, with Otto, of the 2.
After all, the body produces many of the same physical reactions . They tested their theory among 6. Subjects who participated in a two- week exercise program showed significant improvements in anxiety sensitivity compared with a control group (Depression and Anxiety, 2. The test often triggers the same symptoms one might experience during a panic attack: increased heart and respiratory rates, dry mouth and dizziness. Unsurprisingly, people with high anxiety sensitivity were more likely to panic in response to the test. But Smits discovered that people with high anxiety sensitivity who also reported high activity levels were less likely to panic than subjects who exercised infrequently (Psychosomatic Medicine, 2.
The findings suggest that physical exercise could help to ward off panic attacks. The work builds on previous research by Bess Marcus, Ph. D, a psychology researcher now at the University of California San Diego, who found that vigorous exercise helped women quit smoking when it was combined with cognitive- behavioral therapy (Archives of Internal Medicine, 1.
However, a more recent study by Marcus found that the effect on smoking cessation was more limited when women engaged in only moderate exercise (Nicotine & Tobacco Research, 2. Therein lies the problem with prescribing exercise for mental health. Researchers don't yet have a handle on which types of exercise are most effective, how much is necessary, or even whether exercise works best in conjunction with other therapies. Recently, Madhukar Trivedi, MD, a psychiatrist at the University of Texas Southwestern Medical College, and colleagues studied exercise as a secondary treatment for patients with major depressive disorder who hadn't achieved remission through drugs alone. They evaluated two exercise doses: One group of patients burned four kilocalories per kilogram each week, while another burned 1. They found both exercise protocols led to significant improvements, though the higher- dose exercise program was more effective for most patients (Journal of Clinical Psychiatry, 2.
The study also raised some intriguing questions, however. In men and women without family history of mental illness, as well as men with family history of mental illness, the higher- dose exercise treatment proved more effective. But among women with a family history of mental illness, the lower exercise dose actually appeared more beneficial.
Family history and gender are moderating factors that need to be further explored, the researchers concluded. Questions also remain about which type of exercise is most helpful. Most studies have focused on aerobic exercise, though some research suggests weight training might also be effective, Smits says. Then there's the realm of mind- body exercises like yoga, which have been practiced for centuries but have yet to be thoroughly studied.
There are so many good, open questions about which mechanisms contribute the most to changes in depression. Another theory suggests exercise helps by normalizing sleep, which is known to have protective effects on the brain. There are psychological explanations, too.
Exercise may boost a depressed person's outlook by helping him return to meaningful activity and providing a sense of accomplishment. Then there's the fact that a person's responsiveness to stress is moderated by activity. Michael Lehmann, Ph. D, a research fellow at the National Institute of Mental Health, is taking a stab at the problem by studying mice .
The alpha mice regularly tried to intimidate the submissive rodents through the clear partition that separated them. And when the partition was removed for a few minutes each day, the bully mice had to be restrained from harming the submissive mice. After two weeks of regular social defeat, the smaller mice explored less, hid in the shadows, and otherwise exhibited symptoms of depression and anxiety. One group of mice, however, proved resilient to the stress. For three weeks before the social defeat treatment, all of the mice were subjected to two dramatically different living conditions. Some were confined to spartan cages, while others were treated to enriched environments with running wheels and tubes to explore. Unlike the mice in the bare- bones cages, bullied mice that had been housed in enriched environments showed no signs of rodent depression or anxiety after social defeat (Journal of Neuroscience, 2.
But the mice ran a lot . And other experiments hint that running may be the most integral part of the enriched environment, he says. Looking deeper, Lehmann and his colleagues examined the mice's brains. In the stimulated mice, they found evidence of increased activity in a region called the infralimbic cortex, part of the brain's emotional processing circuit. Bullied mice that had been housed in spartan conditions had much less activity in that region.
The infralimbic cortex appears to be a crucial component of the exercise effect. When Lehmann surgically cut off the region from the rest of the brain, the protective effects of exercise disappeared. Without a functioning infralimbic cortex, the environmentally enriched mice showed brain patterns and behavior similar to those of the mice who had been living in barebones cages. Humans don't have an infralimbic cortex, but we do have a homologous region, known as cingulate area 2.
Brodmann area 2. 5. And in fact, this region has been previously implicated in depression. Helen Mayberg, MD, a neurologist at Emory University, and colleagues successfully alleviated depression in several treatment- resistant patients by using deep- brain stimulation to send steady, low- voltage current into their area 2.
Neuron, 2. 00. 5). Lehmann's studies hint that exercise may ease depression by acting on this same bit of brain. Getting the payoff. Of all the questions that remain to be answered, perhaps the most perplexing is this: If exercise makes us feel so good, why is it so hard to do it?
According to the Centers for Disease Control and Prevention, in 2. U. S. When people exercise above their respiratory threshold . For novices, that delay could turn them off of the treadmill for good.