Exercise
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What is it?
There are two main types of exercise: exercise which builds up the heart and lungs (such as running) and exercise which strengthens arms and legs (such as weight training).
How does it work?
There are many views as to how exercise works. Exercise may block negative thoughts, or distract people from daily worries. If a person exercises with others, exercise may increase social contact. Compared to people without depression, depressed people generally have lower fitness levels. Increased fitness may lift mood. Exercise may increase levels of neurotransmitters (chemical messengers) that have been found to be in short supply in depression. Exercise may increase endorphins, which are chemicals in the brain that have 'mood-lifting' qualities.
Is it effective?
A recent systematic review of 28 randomised controlled studies found that exercise helps depression. Jogging, weightlifting, walking, stationary bicycling and resistance training (pushing or pulling weights with arms and legs) have all been found to be effective. Exercise has been found to be more helpful than relaxation therapy and light therapy. In older people, exercise has been found to be as helpful as antidepressant medication or social contact. Unfortunately, the number of good studies in this area is small, and further work needs to be done.
Are there any disadvantages?
People can injure themselves doing exercise. People over 35 years of age should seek a medical check up before starting strenuous exercise. People with bone or heart problems may not be able to do all forms of exercise.
Where do you get it?
Strenuous exercise such as jogging, running and walking can be done outside in parks or bicycle tracks. Stationary bicycles can be purchased or hired from sports or bicycle stores. Resistance training is available at gyms and health clubs.
Recommendation
There is evidence that physical exercise helps depression. Further research is required to confirm its effectiveness in younger people.
Key references
Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA. Exercise for depression. Cochrane Database of Systematic Reviews 2008, Issue4. Art. No.: CD004366. DOI: 10.1002/14651858.CD004366.pub3.
Singh NA, Clements KM, Fiatarone MA. A randomised controlled trial of progressive resistance training in depressed elders. Journal of Gerontology 1997; 52A: M27-M35.
Blumenthal JA, Babyak MA, Moore KA et al. Effects of exercise training on older patients with major depression. Archives of Internal Medicine, 1999; 159: 2349-2356.
McNeil JK, LeBlanc EM, Joyner M. The effect of exercise on depressive symptoms in the moderately depressed elderly. Psychology and Aging 1991; 6: 487-488.