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Depression

Kick Depression to the Curb

Aerobic exercise such as brisk walking, running, and kick-boxing may reduce the need for medications in some individuals diagnosed with depression.


Your Local Health | Written by BJ Towe

Everyone knows that exercising produces a long list of benefits, from improving how you look and feel to reducing the risk of countless health conditions and diseases. Now, it appears regular exercise may also help some people with depression reduce or eliminate the need for antidepressants.

That's the conclusion drawn after researchers at Karolinska Institutet in Sweden recently identified how “well-trained muscle produces an enzyme that purges the body of harmful substances” that build up during stress, harm the brain, and contribute to stress-induced depression.

“Anytime you can use non-pharmacologic treatments, there are benefits,” says Michael Nicholson, D.O., a Family Medicine physician with The Iowa Clinic.

“Exercise can improve mood, boost self-esteem, reduce stress and improve sleep — and it doesn't have the side effects often present with medications,” he says.

Depression: A Complex Problem

There are several forms of depression, ranging from mild to severe. Because it can be caused by a combination of genetic, biological, environmental, and psychological factors, treating it can be extremely complex.

The American Psychiatric Association protocols indicate that treatment plans should be customized to patients based on their individual symptom severity, duration, health history, and patient preference.

“If a patient with mild to moderate depression is willing to try regular exercise as a treatment, they may find enough improvement to avoid, reduce, or get off their medication,” says Dr. Nicholson.

As an example, Nicholson cites a patient whose symptoms warranted antidepressant medication: “An unrelated health issue prompted him to proactively start exercising. He got himself a trainer and gym membership and began exercising regularly. He's now on a lower dose of antidepressants and feeling very positive and great.”

For patients with major depression, which interferes their ability to work, sleep, eat, and enjoy life, Nicholson says, “Exercise may not be appropriate as a solo therapy, but it definitely has a role as an adjunct therapy.”

The Down Side

There are drawbacks to relying on exercise alone to treat depression. It typically takes eight or more weeks of moderate exercise (for at least 30 minutes most days of the week) before results kick in. The same is true with psychotherapy.

“We generally expect faster results with medication, typically within two to six weeks,” says Nicholson.

Additionally, many patients prefer the convenience of taking daily medication rather than going to psychotherapy or committing to regular aerobic exercise.

Will More Doctors Prescribe Exercise?

It's too soon to tell, says Nicholson.

“More studies probably need to be done and more literature needs to be reviewed. But my hope would be that America becomes more active and reaps all of the benefits of exercise, which include reduction in stress, improvement in mood and, as such, treatment for depression,” he says.

WARNING: NEVER ABRUPTLY STOP TAKING YOUR MEDS

If you take antidepressants, start exercising and find you're feeling better, Nicholson cautions you against abruptly stopping your medication. Doing so can lead to returning symptoms of depression, increased risk of suicide, and a variety of unpleasant withdrawal symptoms.

Instead, talk with your healthcare provider, who can help you safely lower the dose over time.

While exercise alone may help, it's important to be accurately diagnosed and to have a treatment plan customized to your specific situation. Establishing a relationship with a primary care provider is an important first step in managing your overall health and wellbeing.

If you would like to set up an appointment with one of our Primary Care Providers, please call 515-875-9000.

About Depression

Depression is a complex illness involving more than occasionally feeling sad or blue — it interferes with daily life and affects others. In this country alone:

  • An estimated 1 in 10 adults reports depression.1
  • Every year, 6.7 percent of the population is affected by major depression.2
  • 16.5 percent of Americans experience major depression during their lifetimes.2
  • Women are more likely than men to report major depression, 4 percent to 2.7 percent.1

S.A.D.? Exercise will help.

During the winter months, when the amount of daylight is at its shortest, as many as 10 to 20 percent of Americans are impacted by Seasonal Affective Disorder (S.A.D.), or “winter depression”, reports the American Academy of Family Physicians.

If you think you have S.A.D. and your symptoms are minor, a good workout will increase your body's production of feel-good endorphins, which help restore your energy, mood, and outlook on life.

Other tips for combating S.A.D.:

  • Get plenty of sleep. Go to bed and get up at the same time every day, including weekends.
  • Be in the light. Expose yourself to as much light as possible. Open the curtains. Turn on bright lights around your house and at work. Get outside every day.
  • Curb the carbs. Eat a well-balanced diet low in carbohydrates, which may provide an immediate energy boost but can leave you feeling drained later in the day.
  • Manage stress. Make a point to take time out to relax each day.

If your S.A.D. symptoms interfere with your ability to enjoy the season, ask your healthcare provider if you might also benefit from therapeutic light therapy, medication and/or psychotherapy.


1. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, October 1, 2010.

2. National Co-morbidity Survey Replication

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