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Regular Physical Exercise
By Neil Nedley, M.D.,

            It should not be surprising that exercise can help manage depression. Since it helps improve so many body functions, why shouldn't we expect it to improve the function of the mind as well?

            Even if you are not depressed, physical exercise is good for the mind. A very large study from the National Institutes of Health looked at 1,900 healthy subjects. It showed that women who exercise only occasionally or not at all have twice the risk of developing major depression within eight years compared with those that exercised moderately at least several times a week.

            Physical activity not only prevents depression, but it is also good treatment for those who are depressed. Further, it is useful in treating other mental illnesses including episodes of anxiety, ongoing anxiety, and panic disorder. New evidence indicates that regular workouts may help soothe as effectively as antidepressant medications?

           What kind of exercise and how much is needed? Figure 2 describes it.
            Researchers at Duke University tested people with major depression and found that a moderate exercise program (30 minutes three times per week) reduced depression as well as antidepressant medication. The medications produced results more quickly, but after 16 weeks the exercise effect caught up according to the study. At least a partial explanation of the mental benefits is that exercise causes the brain to produce more serotonin and norepinephrine, which are neurotransmitters in the brain that can reduce depression.

            After reviewing all the studies published since 1981 on exercise and mental health, Canadian researchers found that exercise— whether it is strength training, running, walking, or other forms of aerobic exercise—helps to alleviate mild to mod­erate depression. It also helps in the treat­ment of other mental disorders including anxiety, substance abuse disorders, body image disorders, and even attention deficit hyperactivity disorder (ADHD). The amount of exercise varied in these studies from 20 minute sessions to up to 60 minute sessions at least three times a week.

            Physical exercise brings about better results than most counseling approaches and is certainly much more cost effective. Another study showed that as little as eight minutes of daily vigorous exercise on an inclined treadmill to the point of exhaustion reduced symptoms of depression as well as tension, anger, and fatigued A summary of the benefits of regular aerobic exercise in combating mental disorders is shown in Figure 3.

            It is important for the depressed patient to realize that they likely will not feel any better after their first few exercise sessions. This is in contrast to those who are suffering from tension, anxiety, anger, or fatigue. Exercise will tend to improve their symp­toms even after the first session. Not so with people suffering from major depression. Thus, a depressed person will often stop their recently started exercise routine, thinking that it is not doing them any good. In my experience, it takes at least a week of daily exercise before depressive symptoms begin to improve in most individuals. There is more good news. Once the symptoms begin to improve they usually continue to gradually improve over the course of four to six months, during which the maximum effect is finally achieved.

            There are additional mental benefits associated with exercise. Researchers who discovered that exercise counteracted de­pression also found that after four months of regular aerobic exercise, memory and other mental abilities were improved.

            All these benefits are not limited to the young. A study followed more than 900 older adults (average age of 70) for 11 years, and found that those who exercised regularly at the start of the study but later quit were more likely to develop depression compared with those who stayed active. The quitters and those who never exercised during the study had the highest scores on a depression test at the end of the study. Specifically, mood benefits were seen in those whose regular exercise caused them to break a sweat. Even those who did any kind of exercise just three times a week were less likely to have depressed moods. Interestingly, the oldest participants who took up exercising during the study got a mood boost similar to those who had exercised throughout the study. In other words, no matter how old you are, you will benefit by starting a good exercise program.

             I tell my depressed patients that they need to commit themselves to a regularly scheduled (not haphazard) exercise program for life. They can vary the type of exercise so that it does not become monotonous. For instance, one of my patients does brisk walking on Tuesdays, Thursdays, and Saturdays; runs on Mondays and Fridays; swims on Wednesdays; and lifts weights on Sundays.

             If you want to bring a friend along and socialize during exercise sessions, do so. But do not depend on a friend in order to exercise; otherwise, you will eventually stop exercising. Choosing pleasant surroundings to exercise helps maintain a program.

             Fortunately, the benefits of physical exercise do not stop with improved mental health. Figure 4 lists additional benefits of endurance training.

Additional benefits of endurance training
More complete information on these and other benefits of physical exercise is found in the book Proof Positive

DepressionFrom the book
Depression, the Way Out,
Nedley  Publishing, Ardmore, OK, 2001

Neil Nedley, M.D.,
Nedley Health Solutions
P. O. Box 1565
Ardmore, OK 73402

Toll-free: 1-888-778-4445
Phone: 1-580-226-8007
Fax: 1-580-223-2645