Exercise or, Medication: The Depression Battle? Expert Views

Understanding Depression: Causes, Treatment, and More

Recent research suggests that when it comes to addressing depression or anxiety, running can be just as effective as antidepressants. However, experts caution that the ideal solution may not be the same for every individual.

In light of the widespread prevalence of depression and anxiety and their impact on health, scientists from Amsterdam have explored the most effective means of mitigating these conditions. They sought to determine whether antidepressants or lifestyle interventions could have varying effects on mental health and certain aspects of physical well-being.

This groundbreaking study is the first to directly compare the effects of antidepressants with running exercises in the context of anxiety, depression, and overall health. The findings were presented on October 6 at the annual conference of the European College of Neuropsychopharmacology and were previously published in the Journal of Affective Disorders.

Brenda Penninx, a professor of psychiatric epidemiology at Vrije University in Amsterdam and coauthor of the study, noted, “Antidepressants are generally considered safe and effective, working for most individuals. We recognize that failing to treat depression can lead to unfavorable outcomes, making antidepressants a good choice for many. However, we must expand our treatment options since not all patients respond to antidepressants or are willing to take them.”

The researchers examined the effects of running therapy versus the use of an antidepressant medication, specifically escitalopram, on the well-being of 141 patients with depression, anxiety disorders, or both. Over a 16-week trial period, individuals in the antidepressant group adhered to their medication regimen, while those in the running group participated in two to three supervised 45-minute group running sessions per week.

Following the trial, approximately 44% of participants in both groups experienced improvements in symptoms of depression or anxiety, indicating that running and medication were equally effective. The running group also demonstrated enhancements in weight, waist size, blood pressure, and heart health, while the medication group exhibited slight deteriorations in these measures.

Karmel Choi, a clinical psychologist and assistant professor of psychology at Harvard Medical School in Boston, who was not involved in the research, remarked, “We have long considered exercise as a complementary support to more formal treatments like psychotherapy or medication. Here, we see that in some cases, exercise may prove as helpful as an antidepressant, with fewer side effects and more physical health benefits.”

Nonetheless, the question of whether general exercise or medication is the superior approach for treating depression or anxiety remains unanswered and depends on various individual factors, Choi added.

What the Research Indicates?

The effectiveness of treatment options hinges in part on personal perspectives and preferences, such as an individual’s motivation to engage in exercise or concerns regarding potential medication side effects, according to experts.

In general, there’s no need to force patients to choose between these interventions when there’s no conflict between them, as suggested by Felipe Barreto Schuch, an adjunct professor of psychiatry and mental health at the Federal University of Santa Maria in Brazil. “There are no additional risks associated with taking medication and exercising. They are not mutually exclusive,” Schuch emphasized. “Naturally, someone with depression can engage in both without any harm.”

Research-based challenges further complicate the determination of the best treatment option. For instance, the severity of depression can vary, but most studies tend to focus on milder forms of depression due to their greater prevalence and the safety of studying them. As a result, the treatment of severe depression with exercise remains a relatively uncharted territory.

For individuals with severe depression, exercise alone is often insufficient. “Severe depression typically involves intense symptoms, such as profound sadness, persistent hopelessness, suicidal thoughts, or an inability to carry out daily tasks,” noted Ben Singh, a research fellow in allied health at the University of South Australia. “Severe depression often requires a combination of treatments and close medical supervision.”

Schuch and his team of researchers discovered in a 2015 study that for severely depressed individuals who were hospitalized, exercise in addition to medication proved to be a viable approach. However, the hospital environment provides more resources and support for patients, making acceptance and adherence to exercise easier. In the community, severely depressed patients may find it more challenging to adhere to exercise.

One common limitation in studies comparing exercise and medication interventions for depression is the uncertainty about whether the prescribed doses of exercise and antidepressants are biologically equivalent and whether participants met, fell short of, or exceeded the prescribed dose of medicine or the amount of exercise.

Some experts also question which type of exercise is best for patients who benefit most from physical activity. Nonetheless, certain evidence suggests that there are no significant differences between aerobic and anaerobic exercises. While recent research highlighted the benefits of running, others may prefer weightlifting.

Furthermore, it’s important to note that the recent research was not a randomized trial. Participants were allowed to choose their treatment, with most opting for the exercise program. This means there is uncertainty about whether the observed effects were due to the treatment itself (medication or exercise) or other factors, such as individuals’ health-related interests and motivation.

The study indicated that those who chose antidepressants for the 16-week trial were more severely depressed than those who selected running.

In summary, exercise and medication are both viable options, but it’s crucial to recognize that neither is universally effective. Response rates for both antidepressants and exercise hover around 50%.

What’s Optimal for You?

The consensus in the scientific community underscores the significance of personalized treatment strategies, according to experts.

“The crucial step is to engage in an open dialogue with a healthcare provider who can evaluate your unique circumstances and assist you in making an informed decision tailored to your specific requirements,” explained Singh in an email.

If you’re considering using exercise to alleviate depression, it’s important to be aware that “the timeframe for experiencing relief from depression through exercise can vary significantly,” noted Choi. “Certain individuals may begin to observe improvements within a few weeks of consistent engagement in regular exercise. However, others may need several months of sustained dedication.”

Therefore, maintaining consistency is essential, as Choi emphasized that “adhering to a routine over time is more likely to produce positive results.”

By: M Z Hossain, Editor Sky Buzz Feed