Bateman 1 Amy Bateman English 1010 Kim Strickland 24 November 2014 Exercise as a treatment for depression Depression is a serious mental illness, it is also one of the most common. It affects about 25 percent of all Americans. The selection of this subject for my paper is due to the number of people I know that this effects including myself. Of the different types of treatment for depression many psychiatrists have turned to physical exercise to help patients relieve symptoms brought on by depression. Exercise has also been proven to help in the treatment of anxiety, selfesteem issues and addictions. Many studies and clinical trials have been performed to show the effects of an exercise program to treat depression rather than medication. Some studies have also combined exercise with medication to see improved results as well. Having participated in treatment that has involved medications and now moving to using exercise as a sole treatment I wanted to know more in depth of what kind of effects that each of them have. The science behind the benefits of exercise for depression are that certain chemicals are released by the brain when exercising. These chemicals give the same effects of some medications that are prescribed for depression. One of the powerful chemicals released naturally by the brain are called endorphins. Endorphins are released during exercise and interact with receptors in the brain which trigger a positive feeling and also give the body the feeling of a natural analgesic which reduces the feeling of pain. The difference between endorphins interacting with these receptors or a medication is that the endorphins do not lead to addiction or Bateman 2 dependence. Another chemical naturally created by the body is called Serotonin. This chemical works as a neurotransmitter and takes responsibility for maintaining mood balance, the lack of this chemical is what leads to depression. It is still not know if the lack of serotonin is what leads to depression or if depression leads to the decrease of serotonin in the body. Serotonin levels can be measured in the bloodstream but it is not known if there is a connection between deficiencies in the bloodstream and deficiencies within the brain. This is where the medications most commonly prescribed for depression are known as SSRI’s come into play with this disorder. The science supporting it is that in normal function of the neurotransmitters once they have transmitted the neural impulse that it is re-absorbed into the body. The job of the SSRI medication is to prevent the re-absorption which in turn increases serotonin levels. Increasing the serotonin levels help brain cells send and receive messages which in turn boost your mood. The introduction of SSRI’s gave patients with depression hope that they could have relief in a little small pill with very little effort. Psychiatrists all over believe in using exercise as an alternative treatment for depression. There are several factors that go into determining whether a patient will be receptive to this kind of treatment vs medication only. Some patients are attracted to an exercise therapy because it does not carry the stigma of an antidepressant medication. Professor of psychiatry at University of Texas Southwestern Medical Center in Dallas, Madhukar H. Trivedi is one of forefathers in treating depression disorders with physical exertion. He talks with the patient about treatment options that include exercise, therapy and pills. He approaches the idea gently with the patient as an option knowing that some patients don’t know to ask. He talks of the studies and how much exercise would be required, then if agreed upon they together map out a schedule of weekly workouts. He encourages them to use exercise trackers to help with motivation and to give them Bateman 3 a sense of accomplishment as they are moving forward. He is very up front with his patients in telling them about how vigilant they need to be with the exercise as well as how intense it needs to be to see results. He is also honest with them about the fact that it does not work for everyone and that they need to communicate with him about the effectiveness in the relief of symptoms and that if it’s not working that something else may need to happen. Sometimes that means adding medication to the mix also if the exercise therapy alone is not working. He does that knowing that patients will take the exercise treatment lightly if they know that a pill is on its way. The other catch to the exercise therapy is one involving insurance companies. Psychiatrists that don’t accept insurance are more likely to try the exercise therapy over medication. Psychiatrists that are reimbursed by insurance companies for appointments know that it take less time to write a prescription than to map out a plan of alternative methods. This allows them to see more patients in a day, a psychiatrist on average can do four medication visits in an hour whereas a traditional therapy visit can last up to 50 minutes. In addition there is a shortage of psychiatrists with the need for mental health care only rising. This is forcing people to see their primary care doctor, ob-gyns, and pediatricians who are writing 62 percent of all antidepressant prescriptions. These doctors are not always as equip as a psychiatrist to make a diagnosis and treatment plan. “In 2007, 73 percent of patients that were prescribed an antidepressant were not given a psychiatric diagnoses.” (Khazan, Olga) There have been hundreds of studies done showing that exercise alone will not bring a cure to depression, but those that use a combination of medication and exercise seem to have the best results. There is a greater challenge posed with keeping patients in an exercise routine than having them take a pill every day. A common symptom of a depressed patient is that they are more likely to have less Bateman 4 motivation or anxiety that might prevent them from using exercise as a treatment. In these cases they may need to be paired with medication to give them an extra boost to begin this treatment as well. Exercise is good for both mental and physical health, patients that can stick to a regimented exercise program will see more improvement in their depression treatment than those who do not. The mood enhancing effects of exercise are immediately felt, in addition those with a regimented exercise schedule show improvement in self-esteem and physical appearance as well. The research I have done in these articles has shown that for those that may be motivated to try to find an alternative to medication that exercise might be the answer. Depending on the level of depression the results can vary but in all cases there was improvement. My experience with this has been mixed. Starting out with a medication only treatment hoping for quick and fast results. After not getting the results I was hoping for and plagued with side effects going back to the roots seemed like the best choice. Already knowing the effects that exercise has had on my mood in the past, I felt like being on a regimented exercise program gave me the relief I needed from the depressive symptoms. But after falling in a slump of not being able to exercise due to life getting busy and justifying not exercising to fit something else in the situation has come about where I am not mentally healthy. This affecting my relationships with all around me set me in motion to find the road back to where I started. In my research for this paper I have been able to relate to the studies that have been performed for exercise only and exercise with medication support. I have also been able relate to the psychiatrists that said they have a hard time motivating a depressed patient to exercise. In trying the medication treatment first to help boost my mood and motivation and with a doctor that fully supported an exercise treatment knowing that was my end goal, I have been able to reduce the medication to almost Bateman 5 nothing with the end result being the use of exercise as the sole treatment for my depressive symptoms. In those I come in contact with that are fighting a similar battle telling the story of how I have used exercise to my advantage, as my medication and being able to accomplish goals of running half marathons and relay races and incorporating yoga for relaxation and relief of anxiety and stress. I want them to know that there are options for those that are willing to explore them, using it as an example to my family of how exercise can help to improve mood and selfesteem, they are seeing the results in me every day. I have made it a goal to establish exercise routines in my children at a young age in hopes to help them so that they don’t have to experience depression the way I have had to experience it. In conclusion my goal was to inform of the scientific side to the treatment of depression and how different approaches can work, some solely, others in combination. I have a greater appreciation for those that are trying to help patients like me fight a battle, but to do it in the most effective way for the patient. Depression is something to be taken seriously and because of alternative options that have been explored they have brought relief to me. Bateman 6 Works Cited Blue, Laura. "Exercise Lifts Mood, but Does It Work Against Depression? -- Printout -." Time. Time Inc., 19 June 2010. Web. 17 Nov. 2014. Psychologist, Jasper Smits has performed studies that show those who exercise are less likely to be depressed. Some patients being treated for depression are attracted to the thoughts of exercise because there is not a stigma around it as there is with medication therapy. "Depression (major Depressive Disorder)." Depression and Anxiety: Exercise Eases Symptoms. Mayo Clinic Staff, 10 Oct. 2014. Web. 27 Oct. 2014. Exercise is such a strength when it comes to lifting moods. It has such great effects when fighting depression and anxiety. This article gives great tips for beginning an exercise program as well as tips on how to stay motivated. This article will be beneficial in outlining small things that you can do to get started and stay motivated. Article is deemed credible as the Mayo Clinic is a reputable source for medical care and advice. "Exercise and Depression: Endorphins, Reducing Stress, and More." WebMD. WebMD, 19 Feb. 2014. Web. 17 Nov. 2014. Self-esteem improvement is a key psychological benefit of regular exercise. The release of a chemical called endorphins interacts with the brain to reduce the perception of pain. After a workout follows a euphoric feeling that brings on a positive and energetic view on life. Starting an exercise program can be hard. Choosing one that is fun and can fit into your schedule will give the best benefit of all. Khazan, Olga. "For Depression, Prescribing Exercise Before Medication." The Atlantic. Atlantic Media Company, 24 Mar. 2014. Web. 17 Nov. 2014. For those physicians that do want to try exercise as a first resort therapy find they have to be creative and attentive. This approach to therapy takes dedication to the patient. Some physicians fall into the Bateman 7 medicating the patients category because of time constraints. They can process more patients if they are just writing scripts rather than talking with the patients and getting to the root of the issue. For those that want to work with patients to help them with a lifestyle change they see better results than those that just want medication. There is a fine line to watch for because some people actually need the meds as well. Interestingly this article also points out the shortage in mental health workers and that primary care doctors are doing more prescribing of these types of meds and are not equip to handle the mental side of the issue. Norton, Amy. "Exercise on Par with Drugs for Aiding Depression." Reuters. Thomson Reuters, 19 Sept. 2007. Web. 17 Nov. 2014. Studies showing that structured exercise groups are just as effective in fighting depression as medication Seiss, Danielle. "When Drugs and Therapy Didn't Cure Depression, Woman Finds That Running Did." Washington Post. The Washington Post, 15 Sept. 2009. Web. 17 Nov. 2014. The author tells personal story of how suffering from depression as child, turning to therapy and medication to try to experience some relief only to find disappointment. The author turns to exercise, dog walks that turn into short bursts of running. She then turns to full on running. Facts that support her experience are listed in this article that are very eye opening. Taylor, C. B., J. F. Sallis, and R. Needle. Public Health Report. Rep. 2nd ed. Vol. 100. N.p.: n.p., n.d. National Center for Biotechnology Information. U.S. National Library of Medicine, Mar.-Apr. 1985. Web. 27 Oct. 2014. As much as the positive effects of exercise can be there also can be negative effects if an addiction to it occurs. There are instances where an addiction forms to and exercise such as running where obligations Bateman 8 becomes neglected in order to do the exercise. This article points out some of the negative effects as well as positive. Collaborative article written by experts in the field of Psychology. Weir, Kirsten. "The Exercise Effect." American Psychological Association 42.11 (2011): 48. Http://www.apa.org. Dec. 2011. Web. 26 Oct. 2014. Exercise has long been a thought of as a help for mood enhancement. Getting up and moving has been shown to lift the spirits and help fight depression. This article discusses the fact that more Psychologists should integrate and exercise program into their treatment plans for their patients and discusses statistics from studies showing the positive effects that exercise has had on patients treated for depression. I chose this article because it was interesting to me that it is not always something that is "prescribed" for patients fighting depression or depression symptoms. Author did extensive research with many different Psychologists to gain different views on the effects of exercise and depression. Young, Simon N. "How to Increase Serotonin in the Human Brain without Drugs." Journal of Psychiatry & Neuroscience 326 (November 2007): 394-99. U.S. National Library of Medicine National Institutes of Health. Web. 17 Nov. 2014. Technical article describing the types of things that are needed to increase serotonin to the brain. The low presence of serotonin is what antidepressant medications aim to correct.