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General Information Regarding Depression Disorder
Depression is one of the leading health and mental impairments in the world. This disease could affect anyone at any time, but it is more prevalent in the adult population (National Institute of Mental Health 2018). There are many ways to treat depression, such as anti-depressants or therapy, however; certain treatments are not suitable for everyone. Due to the commonality of depression, obtaining proper care tailored to the individual may be difficult. Financial status may also play a role in the quality of care, making it a challenge to provide proper treatment to everyone affected by depression.
Depression is not simply a “bad mood”. Depression overrules the mental stability of anyone struggling, and that is hard enough; finding proper treatment is just another battle (National Institute of Mental Health 2018). This paper is focused on the effectiveness of exercise as an alternative treatment for depression disorder.
According to Harvard Health (5), when it comes to exercise, chemicals are released into the body called endorphins. These chemicals contribute to that uplifting feeling upon completing a workout. Endorphins not only make an individual feel better, but they incite a release of proteins known as growth factors. This activity allows for growth in the hippocampus which begins the increasing connections of nerve cells in this section of the brain. As the hippocampus gets stronger, the depressive symptoms get weaker (Harvard Health Publishing 2013).
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Using Exercise as an Alternative Treatment for Depression
In the study performed by Aguiñaga et al. (1), the usefulness of home-based physical activity programs was examined regarding its effects on depression and anxiety in older adults. The participants were randomized and separated into two different conditions. There were 307 participants that were used over a six-month period. The first group was given DVDs to exercise that included flexibility, toning, and balance. The second group was given DVDs that included healthy aging control. They did this in their own home and were checked up on via telephone calls every 2 weeks. The hospital anxiety and depression scale (HADS) was used to evaluate the severity of the participants’ anxiety and depression.
The Godin leisure-time exercise questionnaire was used to determine the amount of physical activity each participant was completing. This questionnaire assessed how many days of the week the participants logged at least 15 minutes of mild, moderate, and strenuous activity. The amount of time the participants engaged in physical activity was multiplied by their metabolic equivalents, then summed up to generate their weekly leisure-time score which was on a scale that ranged from 0-119. Results conclusively displayed a significant reduction in the participants’ anxiety and depression symptoms after the six-month period. These results imply that home-based physical activity can hinder the effects of depression and anxiety symptoms (Aguiñaga et al. 2018).
Dunn et al. (3) conducted a study that included 60 participants divided up into two random groups. There were four conditions that contributed to the study. The first group participated in a weekly workout regimen in which they were required to burn seven kcal per their personal weight (in kg) per week. This condition was categorized as a low dose exercise (LD). The next group was to burn 17.5 kcal per their personal weight (in kg) per week. This was referred to as a public health dose (PHD). These groups were then required to exercise three days per week or five days per week. Lastly, a placebo group was in place and they exercised 3 days per week with stretching exercises for roughly 15 to 20 minutes. Before and after the exercises, participants were to take the 17-item Hamilton Rating Scale for Depression (HRSD17). A reduction in scores from the HRSD17 was the goal for a positive study.
In conclusion, the results showed that overall, there was a 30% decrease in scores for the groups after the exercise regimen (Dunn et al. 2005). General Practitioner View on Exercise and Depression Stanton et al. (6) investigated the opinions of general practitioners (GP) regarding exercise and its effects on depression. A group of 20 GPs’ were selected to complete a 25-question survey. Their answers implicated their view point on how exercise contributes to hindering depressive symptoms. The survey consisted of multiple choice questions and open ended responses. Results claimed 60% of GPs’ obtained knowledge of using exercise as a treatment for depression, while 30% were unaware. Out of those aware, 90% agreed that exercise is a beneficial element to eliminating depression in those struggling.
Those who agree of these benefits recommended exercises that utilize the cardiovascular system, such as running. Other GPs’ also recommended using relaxation exercises to combat depression, such as yoga. Exercise specialists were also recommended by 70% of these general practitioners. Professionals such as exercise physiologists, gym instructors, strength and conditioning trainers, or personal trainers were among the list of recommendations. These results show that from a medical professional’s viewpoint, exercise is crucial in combatting depression and its symptoms (Stanton et al. 2015).
Using Exercise in Conjunction with Medication to Treat Depression
Blumenthal et al. (2) examined the use of exercise in treating major depression disorder. This study was a randomized 16-week trial, utilizing four different groups. The first group in the trial was to perform aerobic exercises while under supervision while the second group performed aerobic exercises at home. The third group was administered anti-depressant drugs while the fourth group was administered a placebo. Before the 16-week trial began, the participants were screened using the 21-item Beck depression inventory. A score of 12 or above placed potential candidate in the eligible category. Eligible candidates also had to live a sedentary life style and have no history with another psychiatric diagnosis. The age requirement was 40 years or older. The participants were medically screened for blood pressure, liver function, and thyroid stimulating hormones.
If any of the results concluded abnormal levels, the candidate was excluded from the study. When the study began, the participants were evaluated using the 17-item Hamilton depression rating scale. This was done to evaluate the severity of the major depression disorder among participants. The test was used as a baseline before the study began for comparison to end results. To assess the participants’ physical fitness, there was a graded treadmill exercise. This exercise was conducted before the treatment began and at the end of the 16-week period. In the supervised aerobic exercise group, the participants were trained based on their max heart rate. The intensity was set to place them at 70% to 80% of their heart rate and the exercise would last 30 minutes.
The participants that were placed in the home-based exercise program received the same exercise prescription. They conducted the exercise program on their own with minimal contact from the study staff. The participants that received a pill were either given a placebo or an anti-depressant. These pills were given once a day. The pills dosage usually started off with a 50mg dosage and increased periodically. The psychiatrist was blinded to which pill was given to each of the participant and had the ability to adjust the dosage at any time if they thought it was needed. When analyzing the results of the study, exercise was just as effective for curing major depression disorder when compared to taking an antidepressant drug. The point of this study was to have the participants enter remission of major depressive disorder and score a rating of less than eight on the Hamilton depression rating scale.
The remission rates included supervised exercise at 45%, home based exercise at 40%, medication at 47%, and placebo at 31%. This study indicates that exercise can be just as effective as an antidepressant drug. Exercise could be used as well as medication to decrease the effects of depression and increase the quality of life (Blumenthal et al. 2007).
Research Limitations
While the research conducted in all studies was beneficial and established, there were a few limitations that could have been adjusted for superior accuracy. Age is one factor that was quite consistent throughout the studies’ by Aguiñaga et al. (1) and Blumenthal et al. (2). There was little to no variation among the populations selected for investigation.
Participants were all above the age of 40 years old. By adding a larger age divergence, the results may have been more accurate regarding the effects of exercise on depression. Younger participants will most likely have more energy, allowing for higher intensity workouts, which could potentially adjust the results. The older an individual is, the more diseases, stress, and other outside factors may contribute to their depression. Adding a younger population would out-rule that outlier and balance out the average results. Another factor that could contribute to bettering results would be utilizing psychological examinations face to face. Giving participants a non-verbal test leaves room for user error and it standardizes responses. A psychological examination would also push honest answers and lessen the possibility of a rushed survey containing inaccurate information. During the studies, aerobic exercises were used and they were mainly mild to moderate intensity. Adding anaerobic exercises such as strength training or sprints, would contribute a variation to the results.
Necessary Further Research
There was an ample amount of research conducted regarding this topic, however; consulting a neurologist may benefit results. The professional may provide insight to brain activity before and after the studies are conducted with participants. Depression is known to affect the prefrontal cortex of the brain, and the changes that occur through these studies may appear in these scans. Another professional to consult would be a psychiatrist who could share their knowledge on physical activity and its effects on mental illness. While general practitioners were consulted, adding these two other medical professionals may enhance result accuracy.
Conclusion
In conclusion, exercise was an incredibly significant component regarding the decrease in depressive symptoms. When in conjunction with prescription anti-depressants, exercise could help defeat an individual’s depression all together. This homeopathic method allows for natural cures to this disorder. Exercise can help maintain a chemical balance in the brain, as well as provide an overall healthy lifestyle. This method also avoids potential addiction to prescription drugs, as well as side effects that come along with anti-depressants. Not only does exercise benefit individuals struggling with depression, it may also aid in the healing of individuals with subset disorders such as anxiety or obsessive compulsive disorder.
Exercise is also a method available to anyone. There is no financial burden. A simple run outside or yoga in the living room will aid in combating depression. This makes fighting this disorder available to anyone, regardless of their financial standing. Many individuals affected by depression will avoid seeking help due to their income, however; utilizing exercise is a simple way to better their quality of life, without a cost. These studies produced a heightened awareness of depression and the effects it has on its victims. With depression being one of the leading causes of suicide, these discoveries may help future individuals struggling and dealing with the everyday battle of this disorder. Overall, exercise has the power to change not only a person’s physical health, but it has the power to put their mind at ease.
