Exercise helps with depression

Complementary and Alternative Treatments
Exercise


Can a few laps around the block actually solve your emotional problems? Probably not, but a regular exercise program might help. A review of studies stretching back to 1981 concluded that regular exercise can improve mood in people with mild to moderate depression. It also may play a supporting role in treating severe depression.

Another study, published in the Archives of Internal Medicine in 1999, divided 156 men and women with depression into three groups. One group took part in an aerobic exercise program, another took the SSRI sertraline (Zoloft), and a third did both. At the 16-week mark, depression had eased in all three groups. About 60%–70% of the people in all three groups could no longer be classed as having major depression. In fact, group scores on two rating scales of depression were essentially the same. This suggests that for those who need or wish to avoid drugs, exercise might be an acceptable substitute for antidepressants. Keep in mind, though, that the swiftest response occurred in the group taking antidepressants, and that it can be difficult to stay motivated to exercise when you’re depressed.

A follow-up to that study found that exercise’s effects lasted longer than those of antidepressants. Researchers checked in with 133 of the original patients six months after the first study ended. They found that the people who exercised regularly after completing the study, regardless of which treatment they were on originally, were less likely to relapse into depression.

A study published in 2005 found that walking fast for about 35 minutes a day five times a week or 60 minutes a day three times a week had a significant influence on mild to moderate depression symptoms. Walking fast for only 15 minutes a day five times a week or doing stretching exercises three times a week did not help as much. (These exercise lengths were calculated for someone who weighs about 150 pounds. If you weigh more, longer exercise times apply, while the opposite is true if you weigh less than 150 pounds.)

How does exercise relieve depression? For many years, experts have known that exercise enhances the action of endorphins, chemicals that circulate throughout the body. Endorphins improve natural immunity and reduce the perception of pain. They may also serve to improve mood. Another theory is that exercise stimulates the neurotransmitter norepinephrine, which may directly improve mood.

Besides lifting your mood, regular exercise offers other health benefits, such as lowering blood pressure, protecting against heart disease and cancer, and boosting self-esteem. How often or intensely you need to exercise to alleviate depression is not clear, but for general health, experts advise getting half an hour to an hour of moderate exercise, such as brisk walking, on all or most days of the week.

The Ingredients of Good Therapy

Treatment for Depression: Getting Help




There are many different approaches to psychotherapy, but all good therapy shares some common elements. To start with, make sure that your therapist has a state license. While psychotherapy isn’t always comfortable, you should feel reasonably at ease with your therapist. In the best case, the two of you will be, or will become, a good match. Of course, both of you must respect ethical and professional boundaries.

It’s important that therapy provide some relief. Your therapist should not only offer reassurance and support, but also suggest a clear plan for how the therapy will proceed. You and your therapist should agree upon realistic goals for the therapy early on. While well-defined problems might be addressed relatively quickly, you may need to approach more difficult problems from many angles, which will take longer.

Since mood disorders can have a broad influence on relationships, work, school, and leisure activities, therapy should address these areas when — or if possible before — they become a problem. Therapy isn’t just for uncovering painful thoughts, although that’s part of the work. Good therapy also addresses how you can adjust, adapt, or function better. And it helps you understand the nature of your distress. You should feel that your therapist approaches the important issues in your life in a way that’s unique to your needs, not from a one-size-fits-all perspective. Pertinent issues springing from your culture, sex, and age, as well as individual differences, should shape the direction therapy takes.

If a doctor other than your therapist prescribes antidepressants for you, the two should communicate. If they don’t do so on their own, you may want to encourage collaboration by asking your therapist and doctor to speak regularly. Your therapist ought to understand the medication portion of your treatment, encourage you to take medications as prescribed, and help monitor your response.

Although it’s not uncommon to feel stuck at times, don’t persist for months with that feeling. Some difficult problems take a long time to unravel, but you should sense progress. If you don’t, it’s a sign that the match between you and either the technique or the therapist isn’t right. If four to six months have gone by and you don’t feel better, it’s a good idea to consult another therapist.

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Treatments for Depression

Types of Psychotherapy
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Depression can bring everything in your life — work, relationships, school, and even the most minor tasks — to a grinding halt, or, at the very least, gum up the works. The aim of psychotherapy is to relieve you of symptoms and to help you manage your problems better and live the healthiest, most satisfying life you can.

Some evidence suggests that by encouraging more constructive ways of thinking and acting, psychotherapy makes future bouts of depression less likely. Three schools of psychotherapy — cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy — play a primary role in combating depression.

Which type of psychotherapy works best? There’s no simple answer. Just as people respond differently to different drugs, you might do better with one type of therapy than with another. Many people find that a blended approach — one that draws on elements of different schools of psychotherapy — suits them best.

Cognitive behavioral therapy

Cognitive behavioral therapy aims to correct ingrained patterns of negative thoughts and behaviors. To accomplish this, you are taught to recognize distorted, self-critical thoughts, such as "I always screw up"; "People don’t like me"; "It’s all my fault." During cognitive behavioral therapy, your therapist may ask you to judge the truth behind these statements, to work to transform such automatic thoughts, and to recognize events that are beyond your control.

Along with cutting down on the number of negative thoughts, cognitive behavioral therapy also focuses on breaking jobs into smaller, more manageable pieces that set you up for success. You rehearse new ways of coping with problems and practice social skills that can help wean you from actions that provide a fertile breeding ground for depression, such as isolating yourself. Your therapist may assign you tasks to reinforce your learning. For example, you might keep a log of thoughts that occur as you try out your new skills. As negative patterns become clearer, you can learn to redirect them.

Interpersonal psychotherapy

Interpersonal psychotherapy concentrates on the thornier aspects of your current relationships, both at work and at home. Weekly sessions over three or four months will help you identify and practice ways to cope with recurring conflicts. Typically, therapy centers on one of four specific problems:

grief over a recent loss
conflicts about roles and social expectations
the effect of a major change, such as divorce or a new job
social isolation.
Psychodynamic therapy

Psychodynamic therapy focuses on how life events, desires, and past and current relationships affect your feelings and the choices you make. In this type of therapy, you and your therapist identify the compromises you’ve made to defend yourself against painful thoughts or emotions, sometimes without even knowing it. For example, someone with an overbearing parent may unconsciously find it difficult to risk developing intimate relationships, out of fear that all close relationships will involve a domineering partner. By becoming aware of links like this, you may find it easier to overcome such obstacles.

You and your therapist may talk about disruptions in your early life — perhaps the death of a parent, your parents’ divorce, or other disappointments — to determine their effect on you. While the duration of psychodynamic therapy can be open-ended, a variation called brief dynamic therapy is limited to a specific amount of time (generally 12–20 weeks). It applies a similar lens to a specific emotional problem.

Not just for individuals

Group, family, or couples therapy may also be part of a plan for treating depression or bipolar disorder. Group therapy draws on support generated from people in the group and uses the dynamics among them, along with the leader’s help, to explore shared problems. Family therapy and couples therapy also delve into human interactions. Like group therapy, the aim is to define destructive patterns — such as scapegoating one family member or enabling a spouse’s alcohol abuse — and replace them with healthier ones. These therapies can uncover hidden issues and establish lines of communication. Family therapy is especially useful when one person is struggling with emotions that spill over into the family.