Depression and Exercise

Tired topic, right? We've all heard that exercise might help fight depression. Most of us probably believe it, whether or not we practice it.

I came across this article published yesterday in the Washington Post - Exercise seems to help alleviate depression, but not for everybody. I like a big but and this has one. Exercise might not be for everyone.

It kicks off with findings from a study published in 2007 - Exercise and pharmacotherapy in the treatment of major depressive disorder. It found that 45% those who participated in supervised and monitored exercise programs for four months reported higher "remission rates." Compare that to  home-based exercise = 40%, medication = 47%, and placebo = 31% and there's something to talk about.

Back to the Washington Post article. The reporter talked to experts and cited a few anecdotes about the benefits of exercise. I won't get into it; you can read the article yourself. The conclusion is like those adds for cold cereal that claim their product may be part of a healthy breakfast. For best results, exercise could be a part of a mental-healthy diet of lifestyle, medication, and/or therapy.

Try it, you may like it.

I've tried it. Here's what my research has shown.

First, I hate exercising. There are active things I enjoy - biking, for example - but I generally hate the idea of a regular workout routine. I tend to do the things I like the least first so when I'm trying to exercise it's generally the first thing on my schedule. This makes getting out of my snug, depressive bed all the more difficult. Hating it also makes it so easy to skip. So, the thought that there's one more thing I've failed to do for the day inhabits my brain. This is not a good mood buddy for a depressive.

However, if I can stay with it for a while it does tend to improve disposition. I've never stuck to it long enough to say whether or not it helps with major depression, but the feeling of accomplishment and incrementally improving health does help stave off or lighten the load of the depressing episodes of life. Here's the rub though. I have to keep at it because giving in to the temptation of skipping one, two, three, and then all the days can toss me right back into the pit.

If you look at the numbers from the study, medication actually wins. It beats supervised exercise by two points and self-motivated exercise by seven. But that only looks at depression - pure, straight up, diagnosable depression.The point I'm trying to get to is that this is a narrow view and only over a short period of time. What about those studied after a year? Five years? I've ranted here before about the side effects of meds. One of the biggest ones for me was sexual. The few times I've tried the typical prescription depression meds I had a significant drop in my sex drive. There's no balance to strike there. Perhaps in time I could report "remission" in the major symptoms of depression, but that's a pyrrhic victory if the price is the loss of sex.

There are other downsides to meds. There's cost which is rarely brought up in studies like these, but it's a very real aspect. I don't have any polls at my fingertips, but I'd hazard a guess that for most people money is one of the top five causes of anxiety. Meds costs will always go up. Then there's the cascading effect of meds. Take the sex thing, for example. Sure, I could go back to my doctor and ask for a viagra script which is can lead to more cost and more side effects to worry about. Or I could grab my walking/running shoes and find the outside.

This is supposed to be about exercise, right? Is it the answer? Maybe. Maybe for you. I think it's probably more effective if your depression is life-episode based like a breakup or family death. For depressives like me it can be a little trickier. It's probably not my silver bullet, but it can't hurt.

It's a nice day. I should check the air in my bicycle's tires and maybe take a ride later on. We'll see...

Reprinting a Comment

My last entry (Could I have BEEN more pitiful?) generated a really great comment from Trishwash. Blog comments can sometimes get missed so I wanted to reprint it.

I hear you, brother.

I am currently going back on Wellbutrin after six months off. It's making me a bit manic at the moment. I went off because I didn't want to have to take drugs. I was feeling better and thought I could do without (ha!).

A couple things to keep in mind. 1. When you start a drug, herbal or pharmaceutical, you body will go through an adjustment period. The crazymeds guy some great things to say about this http://www.crazymeds.org/SideEffects.htm. I especially like the paragraph that begins, "These are powerful, alien substances..." While he's referring to prescription drugs, this may apply to SJW. Given that your body and mind need time to adjust, you may need choose a better time to start taking SJW. Sometimes it takes longer than a few days. Maybe getting better will require a good week where you can afford to just be deliriously happy. Or just be. Does your work have an annual slow period or can you create one by working ahead for a while?

2. Maybe next time, start with a lower dose and work your way up to the recommended amount. Maybe half is all you need to get the affect you want.

3. You sound ambivalent about happiness. That might warrant some further reflection. Did it feel good? Maybe too good? Why shouldn't you feel really good? Growing up, did you get the message that good stuff must be experienced in small, stingy amounts? If not, what other beliefs do you hold about good things? That they are limited, rare, untrustworthy, fleeting, bait for the seven deadly sins?

One of the ideas I've been playing with is that everything we do, think and feel is just a habit. It's not always easy, but all habits can be changed. You work best depressed because you are in the habit of working best depressed. http://www.fallingawake.com/falling-awake-book-toc.html is an online book with a good chapter on habits (#9). It's all a bit new agey, but there are some good nuggets in there.

Above all, don't look at this as failure. This experience has given you valuable information that you can use in other attempts to feel better.

Thanks TW. Nobody's alone, right? Cheers!