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Depression -can sport help?

-By: Tomas Swift-Metcalfe

Last modified: May 3, 2014

depression and the miss use of antidepressants. Can sport help?

This article in the Guardian got me thinking: http://www.theguardian.com/commentisfree/2014/apr/30/psychiatric-drugs-harm-than-good-ssri-antidepressants-benzodiazepines. The article highlights the miss use and over-prescription of antidepressants.

Drug abuse itself doesn’t shock me as much as the abuse of people. In the case of antidepressants, it seems profits are put ahead of the well being of the people they are supposed to help. However, the aforementioned Guardian article didn’t affect me as much as the comments that follow it: People stating the ill effects these drugs have had on them in the first person. Now that’s chilling.

I know relatively little about depression and addiction, I know about sport and have some grounding in sports psychology. This is not an academic piece, but does draw on some academic resources.

what is depression?

The first problem I’ve come across exploring this problem, is that depression isn’t well defined. From my understanding of depression: Everyone has their ups and down, but clinical depression is different. It’s a long term state of under performance accompanied by indifference. These broad symptoms take various shapes and forms and also display a variety of physical and mental symptoms, which can differ from person to person and case to case. And herein lies the problem: The breadth of symptoms of depression, like sleeping too much, to sleeping to little, to anxiety (which is a separate problem often entangled with depression) mean that it’s too often diagnosed: It’s simply too easy to palm off some ‘quick fix’ antidepressants on someone.

what causes depression?

Again, I’m not an expert. From my understanding, there are a broad range of environmental factors and well as personal factors that can contribute to a bout of depression. It would seem sensible to tackle the cause, rather than treating the symptoms, however these causes can, at best be thought of as ‘multi-dimensional’: Lifestyle, diet, pre-disposition, drug use, life events(?). Psychiatry would point to chemical imbalances in the brain, in some cases this must be the direct, primary cause of depression; in lieu of some other extraneous variable causing the imbalance.

drugs, counselling apparently help. Might sport help too?

In all the sources mentioned bellow, sport refers to running, walking or cycling. I.e. the ‘endurance’ sports. It seems exercise has an effect on improving the symptoms of depression and the modality and intensity don’t seem to be important, although Weinberg and Gould (2011) suggest moderate intensity aerobic exercise as the most important.

A meta-analysis (that’s basically an analysis based on a collection of lots of research) by Lawlor and Hopker (2001), states weaknesses in various studies they analysed. Despite this exercise was found to be better than no therapy and as good as cogitative therapy.

The aforementioned meta-analysis is from the early part of this century, but a recent meta-analysis, confirm the findings of the earlier studies mentioned: Endurance exercise reduces the symptoms of depression. In fact a recent meta-analysis by Cooney, G. M. et al. (2013) found exercise to be no more effective than psychological and pharmacological therapies; or put another way it matches these therapies in the small number of well constructed experiments. In the words of the authors:

“Exercise is moderately more effective than a control intervention for reducing symptoms of depression, but analysis of methodologically robust trials only shows a smaller effect in favour of exercise. When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials.” Cooney, G. M. et al. (2013)

why most studies on this topic are flawed (in layman)?

The key flaw in these studies is that exercise as a treatment for depression is very hard to isolate as the single factor affecting change in depression. Hence a researcher can stick his hand up and say ‘exercise lowers depression!’. At best exercise is said to correlate with lower rates of depression.

if your not exercising yet, here are some useful points regarding depression:

  • Which sport you do, isn’t as important as simply doing exercise. Do the exercise you feel happiest doing.
  • The largest antidepressant effects of exercise are found in training programs that are at least 9 weeks long (Weinberg and Gould 2011).
  • Intensity isn’t important. If you’re new to exercise, exercise at the intensity that feels best for you.
  • The most acute antidepressant effects of exercise can last up to 24h; regular training is important.
  • It doesn’t matter who you are, how old you are, whether you are fit or unfit, exercise, suffering from depression or not, exercise will help reduce anxiety.

my perspective

Personally, when I was cycling professional I don’t think exercise contributed to a healthier mind. But now I work just on studying, training and this project (SMS) and I find exercise necessary to bring balance to my life.

final note

Whether you are depressed or not, exercise really is as close to a miracle drug as there is. This is so much so I often wonder if it can be true, however time and again exercise stands up to the scrutiny. There are no short cuts: get exercising, it’s worth many time the effort you put in.

has sported helped you? What do you think of using sport in helping depression?

bibliography

Gøtzsche, P. (2014) ‘Psychiatric drugs are doing us more harm than good’ The Guardian. [Online] 30 April 2014. [Accessed on 30th April 2014] URL: http://www.theguardian.com/commentisfree/2014/apr/30/psychiatric-drugs-harm-than-good-ssri-antidepressants-benzodiazepines?commentpage=1

Weinberg, R. S. and Gould, D (2011) Foundations of Sport and Exercise Psychology, 5th ed. Champaign: Human Kinetics. pp. 397-402.

Cooney, G. M. Dwan, K. Greig, C. A. Lawlor, D. A. Rimer, J. Waugh, F. R. McMurdo and M. Mead, G. E. (2013) ‘Exercise for depression’, Cochrane Database of Systematic Reviews, Issue 9, John Wiley & Sons, Ltd. [no page number]

Lawlor, D. A. Hopker, S. W. (2001) ‘The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials’, British Medical Journal, 322(7289), pp. 763.



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