Another reason why exercise can rescue you from depression

Whilst anti-depressants are still the number one choice for treating depression they have many limitations.   Exercise on the other hand has very few limitations and many benefits. Lets compare these two treatment options.

Anti-depressant drugs

The first major limitation that may surprise you is that Anti-depressant medication is only effective in less than 50% of  patients (1).  Anti-depressants have numerous side effects including loss of libido, increased sleep, weight gain, dry mouth, and many of these side effects seem to plague older adults (2).  Anxiety and diarrhea are often experienced on onset of treatment and there are well documented withdrawal side effects that can be mistaken for the return of depression / anxiety (3).

Independent reviews  of anti-depressant clinical trails have found that  the drugs are no better than placebo (4) and the original “monoamine hypothesis ” which taught us that depression is caused by a serotonin (5-HT) deficiency (a chemical imbalance in the brain) is flawed (5).  If it had been true  than wouldn’t you expect the drugs to work for 100% of people correctly diagnosed with MDD? Today scientists are still trying to explain how SSRIs/SRNIs alter the brain , but they can’t precisely  explain this because it turns out our brain chemistry is immensely complicated. The validity of the original drug trials remain controversial , but despite our new understanding of the human nervous system and its interdependency with the whole body , these out-dated ineffective drugs are still prescribed.

 

Exercise for depression

There are numerous studies proving regular exercise significantly relieves depression quickly and long term. These studies have proven exercise is just as effective at relieving MDD as anti-depressants drugs and keeps you in remission (6). Exercise wont cure everyone, but it’s consistently more effective than the anti-depressant drugs, it has no side effects, except perhaps  sore muscles and it will give you more energy, help you sleep better , strengthen your immune system  and it’s free!

A recent study on exercise and depression measured the effects of exercise on particular brain chemical called brain-derived-neurotropic factor or BDNF. BDNF has been implicated in the pathogenesis of major depressive disorder (MDD) (7). Many preclinical and clinical studies provide direct evidence suggesting that modulation in expression of BDNF could be involved in behavioral phenomenon associated with depression (4). Studies in humans have shown decreased plasma levels of BDNF in bipolar disorder, manic and depressed patients (8).

 

Study Abstract (4)

Exercise increases serum brain-derived neurotrophic factor in patients with major depressive disorder

Background

Brain derived neurotrophic factor (BDNF) has been implicated in the pathogenesis of major depressive disorder (MDD). Existing data on exercise treatment in people with MDD are inconsistent concerning the effect of exercise on BDNF pointing either to increased or unaltered BDNF concentrations. However, studies in non-depressed persons demonstrated a significant effect on resting peripheral BDNF concentrations in aerobic training interventions. Given the lack of clarity mentioned above, the current study aimed at examining the effect of adjunctive exercise on serum BDNF levels in guideline based treated patients with MDD.

depressed inpatients were included, and randomized either to a 6 week structured and supervised exercise intervention plus treatment as usual (EXERCISE, n=22), or to treatment as usual (TAU, n=20). BDNF serum concentrations were assessed before and after the intervention in both study groups with established immunoassays.

Results

Serum BDNF slightly decreased in the TAU group, whilst there was an increase in BDNF levels in the exercise group. There was a significant time x group effect concerning sBDNF (p=0.030) with repeated ANOVA measures with age and BMI as covariates, suggesting an increase in BDNF concentrations in the EXERCISE group compared to TAU.

Limitations

Though there was no statistic difference in the antidepressant medication between EXERCISE and TAU potential interactions between exercise and medication on the effects of exercise in BDNF cannot be excluded. Gender was not considered as a covariate in ANOVA due to the small number of objects.

Conclusions

Exercise training given as adjunct to standard guideline based treatment appears to have additional effects on BDNF serum concentrations in people with MDD. Our results add further evidence to the beneficial effects of exercise in the treatment of MDD.

 

Blog Post References

  1. Yu H, Chen Z. The role of BDNF in depression on the basis of its location in the neural circuitry. Acta Pharmacologica Sinica. 2011;32(1):3-11. doi:10.1038/aps.2010.184.
  2. Garfield LD, Dixon D, Nowotny P, et al. Common SSRI side-effects in older adults associated with genetic polymorphisms in the serotonin transporter and receptors: Data from a randomized controlled trial. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2014;22(10):971-979. doi:10.1016/j.jagp.2013.07.003.
  3. http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressant-withdrawal/faq-20058133
  4. Irving Kirsch , The Emperor’s New Drugs
  5. Nestler, Eric J. et al. Neurobiology of Depression Neuron , Volume 34 , Issue 1 , 13 – 25
  6. Blumenthal JA, Babyak MA, Murali Doraiswamy P, et al. Exercise and Pharmacotherapy in the Treatment of Major Depressive Disorder. Psychosomatic medicine. 2007;69(7):587-596. doi:10.1097/PSY.0b013e318148c19a.
  7. Kerling, M. Kück, U. Tegtbur, L. Grams, S. Weber-Spickschen, A. Hanke, B. Stubbs, K.G. Kahl, Exercise increases serum brain-derived neurotrophic factor in patients with major depressive disorder, Journal of Affective Disorders, Volume 215, June 2017, Pages 152-155, ISSN 0165-0327, http://doi.org/10.1016/j.jad.2017.03.034
  8. Yu H, Chen Z. The role of BDNF in depression on the basis of its location in the neural circuitry. Acta Pharmacologica Sinica. 2011;32(1):3-11. doi:10.1038/aps.2010.184.

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