Exercise ‘Therapy’ For Depression

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D.

Exercise Therapy For Depression A new study has an old answer for mental health issues: Physical exercise is an underutilized method to reduce depression and anxiety.

According to researchers who analyzed the results of numerous published studies, exercise is a magic drug for many people with depression and anxiety disorders, and it should be more widely prescribed by mental health care providers.

“Exercise has been shown to have tremendous benefits for mental health,” says Jasper Smits, director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas.

“The more therapists who are trained in exercise therapy, the better off patients will be.”

Smits and Michael Otto, psychology professor at Boston University, based their finding on an analysis of dozens of population-based studies, clinical studies and meta-analytic reviews related to exercise and mental health, including the authors’ meta-analysis of exercise interventions for mental health and studies on reducing anxiety sensitivity with exercise.

The researchers’ review demonstrated the efficacy of exercise programs in reducing depression and anxiety.

The traditional treatments of cognitive behavioral therapy and pharmacotherapy don’t reach everyone who needs them, says Smits, an associate professor of psychology.

“Exercise can fill the gap for people who can’t receive traditional therapies because of cost or lack of access, or who don’t want to because of the perceived social stigma associated with these treatments,” he says.

“Exercise also can supplement traditional treatments, helping patients become more focused and engaged.”

The researchers presented their findings at the annual conference of the Anxiety Disorder Association of America.

Their workshop was based on their therapist guide “Exercise for Mood and Anxiety Disorders,” with accompanying patient workbook (Oxford University Press, September 2009).

“Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger,” Smits says.

“Exercise appears to affect, like an antidepressant, particular neurotransmitter systems in the brain, and it helps patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing.”

After patients have passed a health assessment, Smits says, they should work up to the public health dose, which is 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity activity.

At a time when 40 percent of Americans are sedentary, he says, mental health care providers can serve as their patients’ exercise guides and motivators.

“Rather than emphasize the long-term health benefits of an exercise program – which can be difficult to sustain – we urge providers to focus with their patients on the immediate benefits,” he says.

“After just 25 minutes, your mood improves, you are less stressed, you have more energy – and you’ll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise; it is the very reason to exercise.”

Smits says health care providers who prescribe exercise also must give their patients the tools they need to succeed, such as the daily schedules, problem-solving strategies and goal-setting featured in his guide for therapists.

“Therapists can help their patients take specific, achievable steps,” he says.

“This isn’t about working out five times a week for the next year. It’s about exercising for 20 or 30 minutes and feeling better today.”

Source: Southern Methodist University

New Grant To Study Depression Treatments

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D.

Depression affects more than 20 million people in the United States. The federal government recognizes the pervasive nature of the disease and has awarded the University of Illinois at Chicago a five-year, $4.8 million grant to develop new therapies to treat depression.

Currently, the most common treatment approach is a combination of antidepressant medication and psychotherapy.

Symptoms can include sadness, loss of interest in activities that were once enjoyed, weight change, difficulty in sleeping (or oversleeping), loss of energy, feelings of worthlessness and thoughts of death or suicide.

The illness can run in families, and it occurs more often in women than men.

What’s needed are antidepressants that work faster, have fewer side effects and that act pharmacologically in new ways, says Alan Kozikowski, UIC professor of medicinal chemistry and pharmacognosy (the study of medicines derived from natural sources) and the grant’s principal investigator.

Kozikowski and his research team had been designing and synthesizing novel nicotine-like compounds that target certain receptors in the brain, in hopes that they would improve cognition in Alzheimer’s disease. Studies in animal models revealed that some of these compounds had antidepressant activity.

“We thus chose to focus our program on depression, as this offered a very different target that might lead to something better, with a faster onset of action,” Kozikowski said.

While the main focus of the research now is to develop medications for depression, Kozikowski said it’s likely some candidate compounds may have other clinical applications, including the treatment of schizophrenia, pain and nicotine dependence.

In fact, the UIC drug discovery group — which also includes investigators from the Barrow Neurological Institute in Phoenix and from PsychoGenics Inc. in Tarrytown, N.Y. — has already found that some of these novel agents do work for pain in animal models.

Prior research has also shown that many smokers smoke to improve their mood, supporting the notion that nicotine itself has antidepressant properties. This would explain, Kozikowski said, why cigarette smoking is much more common among depressed individuals. A recent study found that smokers are 41 percent more likely than nonsmokers to suffer from depression.

Such studies suggest that nicotinic compounds that have been modified to reduce their addictive potential while retaining the ability to balance mood could provide a new family of antidepressant drugs, he said.

This new drug class could have greater efficacy and fewer side effects than antidepressant medications currently on the market that work by inhibiting monoamine reuptake, Kozikowski said. Side effects of current antidepressants include headache, nausea, insomnia, dry mouth, constipation and agitation.

In spite of the intensive efforts that have gone into the design and study of nicotinic drugs, very few of the compounds have reached clinical trials, Kozikowski said.

The new grant is part of the National Cooperative for Drug Discovery and Development Groups and is funded by the National Institute of Mental Health, one of the National Institutes of Health.

Source: University of Illinois at Chicago