Exercise for patients with major depression: What kind, how intense, how often?
Source: Medical Xpress
Exercise has been shown to be an effective treatment for major depressive disorder (MDD), both when used alone and in combination with other treatments. There's now sufficient research data to provide specific guidance on how to prescribe exercise for depressed patients, according to a report in the May Journal of Psychiatric Practice.
"Despite the substantial evidence supporting the use of exercise in the treatment of MDD, previous studies have not provided a clear indication of the proper dose of exercise needed to elicit an antidepressant effect," write Chad Rethorst, PhD, and Madhukar Trivedi, MD, of the Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas. To fill this gap, the authors reviewed available data from randomized controlled trials, with the goal of developing specific and detailed recommendations for clinicians on how to prescribe exercise for their patients with MDD.
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Data suggest that patients may experience improvement in depressive symptoms as little as four weeks after starting exercise. However, Drs Rethorst and Trivedi emphasize that the exercise program should be continued for at least ten to twelve weeks to achieve the greatest antidepressant effect.
Some people have questioned whether patients with MDD will be willing to participate in an exercise program. But Drs Rethorst and Trivedi note that, in the studies they reviewed, only about fifteen percent of patients dropped out of exercise programscomparable to dropout rates in studies of medications and psychotherapy.
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Read more: http://medicalxpress.com/news/2013-05-patients-major-depression-kind-intense.html
Brickbat
(19,339 posts)I did cardio and yoga regularly in an effort to manage my depression. I ended up heart-healthy and relaxed and depressed.
caraher
(6,279 posts)And of course, "It didn't work for me, although I know it works for many" is pretty much the same thing one can say of every drug and talk therapy intervention...
Hope you did eventually find something that helped!
Yo_Mama
(8,303 posts)For many, exercise along with therapy and/or a drug regimen does work much better than just drugs. While there is a downside to the drugs, exercise can only help.
AngryOldDem
(14,061 posts)...but I hate to think where I'd be if I didn't do it, mainly weight-wise.
ErikJ
(6,335 posts)"Climb the mountains and get their good tidings. Nature's peace will flow into you as sunshine flows into trees. The winds will blow their own freshness into you, and the storms their energy, while cares will drop away from you like the leaves of Autumn."
-John Muir, Our National Parks, 1901
US (Scottish-born) conservationist & naturalist (1838 - 1914)
lovemydog
(11,833 posts)for sharing it.
Love the Thomas Jefferson quote too.
bemildred
(90,061 posts)Hassin Bin Sober
(26,335 posts)Same concept. Not as eloquent.
bananas
(27,509 posts)Journal of Psychiatric Practice:
May 2013 - Volume 19 - Issue 3 - p 204-212
doi: 10.1097/01.pra.0000430504.16952.3e
Evidence-Based Recommendations for the Prescription of Exercise for Major Depressive Disorder
Rethorst, Chad D. PhD; Trivedi, Madhukar H. MD
Abstract
Major depressive disorder (MDD) is a source of great disease burden, due in part to the limited accessibility and effectiveness of current treatments. Although current treatments are efficacious in a segment of the population with MDD, there is a clear need for alternative and augmentation treatment strategies. Exercise is one such alternative treatment option. Research has shown exercise to be efficacious as both a stand-alone and an augmentation therapy. As a result, exercise is now included in the American Psychiatric Associations treatment recommendations. The purpose of this article is to provide clinicians with a knowledge base to prescribe exercise to their patients. The authors describe the evidence supporting the use of exercise in the treatment of MDD, provide evidence-based recommendations for prescribing exercise, and address practical considerations related to prescribing exercise in real-world treatment settings. (Journal of Psychiatric Practice 2013;19:204212)
bananas
(27,509 posts)How Much Exercise Is Needed To Fight Symptoms Of Depression?
A new study suggests the appropriate amount of exercise and form of workout for treating depression.
BY JUSTIN CABA | MAY 10, 2013 04:30 PM EDT
Past studies have shown that exercise can be effective in treating symptoms of depression on its own or combined with other treatments such as antidepressant drugs or psychotherapy. However, none of these studies have determined what variety or how much exercise is sufficient. Until now.
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During randomized trials, authors Chad Rethorst, Ph.D. and Madhukar Trivedi, M.D. analyzed markers for type of exercise, intensity of workout, and the length of workout.
The research team's findings shed light on useful tips for using exercise as a treatment for depression:
-Aerobic exercise: Achieve a heart rate that is 50 to 85 percent higher than the participant's maximum heart rate.
-Resistance training: Work on upper and lower body workouts in each session with three sets of eight repetitions at 80 percent of the maximum weight that the person can lift.
-Time: Do three to five exercise sessions weekly, with 45 to 60 minutes for each session.
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FreeState
(10,575 posts)"Achieve a heart rate that is 50 to 85 percent higher than the participant's maximum heart rate"
Ummm what? I think it was mean to say minimum? Or maybe "percentage of" rather than "higher than"?
progree
(10,911 posts)what was intended. 50 to 85% higher would be a death sentence.
Throd
(7,208 posts)enough
(13,262 posts)Katashi_itto
(10,175 posts)murielm99
(30,755 posts)I still have some depression and anxiety, but the exercise helps quite a bit. I know it would be much worse without it. I look better, and feel better about myself, too.
FreeState
(10,575 posts)I have panic disorder. I have not hand an attack now in 12 years (therapy helped a lot, so does working out). I have felt some anxiety off an on, but when I'm regularly exercising I never seem to feel anxiety on a level that bothers me.
tblue
(16,350 posts)for me, that is. I work out regularly but still have to take my meds. I am not messing with this formula--I am grateful to be able to get through a day like an almost normal person.
neffernin
(275 posts)I lost 50 lbs and started to get successful in my career and the horrible depression I used to deal with has been minimized extremely. It comes back to some extent when I'm underwhelmed and don't keep myself busy, but I used to sleep 10-12 hours a day and pretty much hate life 24/7. I look back and still wonder why.
zazen
(2,978 posts)Well, for folks with chronic fatigue and/or ehlers-danlos type III, (a congenital connective tissue disease that some researchers are starting to wonder is at the heart of a lot of these multisystemic diseases), post-exertional malaise is very, very real (and it's been measured in controlled experiments).
The tough thing about these conditions, which are often comingled with major depression (some because of circumstances, others because at least in EDS, there may be a brain-related disorder as well), is that it's hard to know precisely at what point a threshold is reached past which point malaise will set in and make everything worse.
The whole "just exercise six days a week and de-stress" thing, when told to patients with these conditions, is insensitive of doctors to the realities of their patients.
I know they mean well, but yoga to hypermobile people with EDS makes it worse, as does strenuous exercise. Mild exercise is good.
And strenuous exercise sucks for chronic fatigue patients too. Conditioning and mild exercise is good--the average exercise program, not so much.
Historic NY
(37,452 posts)I'll do 4-5 miles a day. I found in winter it helped with my seasonal disorder.
The Green Manalishi
(1,054 posts)At least that is what works for me.
If you aren't up to running then alternate jogging and walking, say 30 seconds of each. half hour to an hour a day.
Basically, the more you breath the better. It's all about consuming oxygen, not being fast, not looking cool, not setting records; just do whatever gets you breathing hard, but not so hard you can't talk, for as long as possible.
Marie Marie
(9,999 posts)Red blood cells carry oxygen to all the cells of the body and oxygen is key to repairing and/or maintaining healthy organs, muscles, tissues etc. Also, exercise is a great mental filter and stress buster.
tblue
(16,350 posts)Hadn't thought of that. Cool!
Ron Obvious
(6,261 posts)I personally detest working out in a gym, but I love cycling and walking in the outdoors. It feels especially satisfying to combine major errands with cycling or walking huge distances.
I've often suspected the high rate of depression in our society is partly explained by our lack of outdoor activity and exposure to greenery. I bet park rangers suffer low rates of depression, though I have no studies to back that up.
duhneece
(4,116 posts)But I get relief from my depression with a combo of both now-walking/running outside in the early morning (which I've done for years) but I added or substituted Zumba several times a week and my energy/mood has become even better.
We have the oldest zoo west of the Mississippi and I've chosen to walk/run behind it when I can. You'd think the smell of bears, mountain lions, etc. would make me feel anxious, but I feel especially exhilarated on those days.
byeya
(2,842 posts)feel bad and it may follow that if a epressed person maintains or adds to muscle mass, or tone at least, that's one less issue to deal with.
Good luck.
ThomThom
(1,486 posts)better off. Walking leads to more walking and other exercises also because it just fells good. Start with what you can do ... 5 or 10 mins then work up from there. Consult your doctor please.
Lydia Leftcoast
(48,217 posts)and the fact that it's hard to brood about your problems when you're at 80% of your maximum heart rate.
That's why I take classes at the gym. It's more social.
Sunlei
(22,651 posts)do an exercise for the whole body- what ever you can do as intensely fast as you can for one min. rest one min. and repete once.
During your week try not to sit for long periods, and walk when ever you can.
As the article says people quit exercise programs all the time. Though it is good for depressed people to get out of the house and do something they enjoy. Even a favorite hobby could help.
Do try the burst exercise, it really deplete the muscles of their glycogen and helps adjusts metabolism, lower cholesterol. Run in place like a crazy person with flailing arms (do something that uses your entire body), be very, very intense for that short min.
ErikJ
(6,335 posts)By the time I reach the top I'm breathing pretty hard. I might start doing it twice. Since I've been doing it almost feels like I've got bionic legs.
I start every odd-morning with 35 knee-pushups and 15 horizontal body pull ups which is pretty burst intensive too. On even-date mornings I do 50 situps.
Nikia
(11,411 posts)What is ideal is probably variable based on a variety of individual factors.