01/15/01 • Aerobic exercises may help fight depression in the long run

By Marilyn Elias / Gannett News Service


Aerobic exercise may be just as effective as medication at relieving
depression and prove easier to stick with, suggests a new study. The findings
add to growing evidence that exercise can significantly improve mental health
at modest or no cost.

That doesn't mean antidepressants or psychotherapy isn't needed, says
psychologist James Blumenthal of Duke University Medical Center in Durham,
N.C.  "We just don't know if a doctor 'prescribed' exercise, if you'd get
the same results," says study leader Blumenthal.

The study of 156 volunteers, each at least 50 years old, is believed to be
the first to randomize patients with clinical depression into three groups,
testing the effectiveness of exercise and other strategies:

After 16 weeks, patients in all three groups were equally likely to have
recovered: about two-thirds no longer were depressed. Those on pills were
more likely to get better within a month. The patients were free to treat
their depression as they saw fit after the 16-week study. In a follow-up six
months later, exercisers held a surprising edge. Of those who had recovered
after 16 weeks, only 8 percent relapsed to depression, compared with 38
percent who took pills only and 31 percent in the combination group.

Overall, 30 percent in the exercise group were still clinically depressed,
compared with 52 percent on medication and 55 percent taking antidepressants
and exercising. Exercisers who took no pills may feel that they alone were
responsible for their recovery, and this sense of mastery could improve
their long-term prospects for mental health, Blumenthal speculates. The
majority on pills had stopped them six months later, "so this isn't an
indictment of anti-depressants or a claim that they don't work, but it shows
the value of exercise," he says.

Doing only 50 minutes of exercise a week halved a person's chances of being
depressed, he says. Exercise can produce "feel good" brain chemicals, such
as serotonin and endorphins, and this could account for its benefit, says
depression expert M.F. (Pete) Elias of Boston University Medical School.
"It's worth doing a bigger trial to see if you'd get the same effect with
larger numbers."

Exercise also may help "because depressed people tend to become isolated,
and exercise can be social," says psychologist Stephen Schlesinger of
Northwestern University Medical School in Chicago. Medication is helpful in
some cases, he says, but there is too much emphasis on it. "Many studies
show cognitive behavioral therapy can be as effective as drugs, but there's
a push from managed care to prescribe these pills."