Will Exercising Improve Depression?

Depression not only is a common serious illness but also has a significant impact on work and academic performance as well as family and social relationships. Depressive disorders are third among the leading causes of global years lived with disability.

Therapy and medication are the most common treatments for depression; however, novel treatment strategies including transcranial magnetic stimulation, ketamine, and aerobic exercise are receiving attention. A number of studies have shown that exercise reduces depression symptoms—and exercise seems to work both as monotherapy and when used in combination with antidepressant medications.

Unfortunately, whether an individual is depressed or not, consistency in continuing an exercise regimen can be challenging. Because of the associated lack of motivation and fatigue, individuals with depression have even greater difficulty maintaining an exercise regimen. Education about depression and the benefits of exercise, ongoing monitoring, supportive advice, and personalized behavioral modification techniques are very important to increase the patient’s commitment to and follow-through with an exercise treatment.

But, an important question remains: Which individuals with depression will benefit from exercise as a treatment for their depression? We still are not sure who will respond to which particular treatment for any individual patient with depression. Many researchers are working tirelessly to find blood tests or other biological characteristics that will lead to the right treatment for the right person, but, for now, that type of testing is still in the future. Until then, we have to find other ways to quickly determine who will respond to treatments so that we can reduce the amount of time that patients spend with treatments that are ineffective for them. Colleagues and I conducted a 12-week study of exercise for depression in adults with residual symptoms after 2 to 6 months of antidepressant treatment. We found that patients who experienced a very positive mood effect (feeling enthusiastic, active, and alert) immediately after the first exercise session had a greater reduction in depression symptoms and a higher rate of remission after 12 weeks. This finding is very exciting because, while we are still unable to discern which depression treatment to use for a specific individual, having a greater certainty of future improvement after only 1 treatment session is a huge improvement over the typical 8- to 12-week therapy or medication trial.

Financial disclosure:Dr Trivedi in the past year has been an advisor/consultant to Alkermes, Allergan, Acadia, AstraZeneca, Bristol-Myers Squibb, Cerecor, Global Medical Education, Health Research Associates, Lundbeck, Medscape, Methylation Sciences, Merck, Naurex, Nestle Health Science–Pamlab, One Carbon Therapeutics, Otsuka, Pfizer, Roche, Shire, and Takeda; has received research support from NIMH, NIDA, Johnson & Johnson, and Janssen; and has received royalties from Janssen.