Hi readers,
How are you doing at sticking to any New Year’s resolutions you made? One of mine was to get off my tube train one stop early whenever I work in the office, to build more exercise into my day.
Sadly, I haven’t been keeping to this goal lately, but a study out this week in The BMJ has given me an extra incentive by adding to the growing evidence that exercise can improve our mental health, as well as our physical health.
The study was an analysis of 218 previous trials that looked at a range of treatments for depression. They included SSRI antidepressants, talking therapies and a variety of exercise programmes, such as walking, aerobic activities and strength training. All these strategies were effective, suggesting that doctors should consider exercise programmes alongside counselling or medication as three valid options to offer for depression, the authors say.
The analysis also came up with estimates for how effective each approach is, and generally some form of exercise or talking therapy seemed to give better results than taking medication, something that got wide media coverage this week.
I think we should be cautious about that part of the analysis, because few of the 218 trials compared the different approaches head to head, which would have been the best way to find out which is most effective. Most trialsjust compared the effectiveness of each strategy to a control group. But it does at least suggest that exercise programmes and talking therapies shouldn’t be seen as inferior to antidepressants.
Having this third strategy could be really helpful because some people don’t like the idea of taking medication. While effective for some, antidepressants can have side effects, such as agitation or making people feel as if their emotions are numbed, although some feel the latter is actually a benefit. The drugs can also be hard to stop taking, as I explore here. Last year, I wrote this feature-length article on how antidepressants work and what the prospects are for new treatments.
It is already recommended that talking therapy is given equal consideration to antidepressants, but there can be barriers to access, such as cost or long waiting lists. Exercise programmes have the advantage that most people could begin them immediately and at no or very little cost.
There is one big caveat, though. One of the most common symptoms of depression is “anhedonia”, when people find it hard to motivate themselves to do anything. If someone has severe anhedonia, such that they have difficulty even getting out of bed some days, they will undoubtedly also struggle to go for a run.
That aside, an important question is what kind of exercise programmes work best for depression. The BMJ analysis attempts to answer this question by ranking the different interventions by their effect size. Perhaps surprisingly, yoga was one of the most effective, a close second to walking or jogging.
