Depression

There is no escaping it - Britain is fast becoming a Prozac nation!

That's the cold hard fact from The Independent newspaper today (Sunday 16th April). The article titled 'Prozac Nation' (Drugs crises: 3.5 million are on anti-depressants. Now ministers want to put Britain on the couch) reveals how GPs are stuck in the middle and forced to prescribe drugs as a 'second best' treatment. With a recent survey finding 9 out of 10 GPs prescribing anti-depressants because of long waits to other mental health services like counselling. (1)

That is a very sad predicament but an obvious question comes to mind (naturally of course since it is my field): but what about exercise as an alternative to treatment?

In the following article I wish to put the case for exercise as one of the safest and most effective treatments for depression by addressing the following:

1. Current state of our mental health 2. Research behind exercise as an effective treatment 3. How exercise can benefit depressed people 4. Supporters of the exercise alternative 5. Who's dropping the ball when it comes to passing on the message 6. Questions to consider before undertaking an exercise routine: 7. Conclusion

1. Current state of our mental health

The figures are nothing short of alarming with anti-depressant prescriptions skyrocketing out of control by almost tripling in the last 12 years from 9.9 million in 1992 to 27.7 million in 2003, costing the NHS now nearly £400 million - that is a 2000 % rise from 1992. (2)

2. Research behind exercise as an effective treatment

One Harvard study confirming the effectiveness of exercise showed that the relative risk of depression over a 25 year period was 27 % lower for men who played three hours or more of sport a week. (2)

A recent study [09-13-05] carried out by Japanese researchers from Wakayama Medical University supports the use of exercise as a way to combat depression. The study was performed on 49 female volunteers between the ages of 18 and 20 who showed mild-to-moderate symptoms of depression. After eight weeks of participating in the study, the results showed a significant decrease in depressive symptoms in the group participating in the exercise regimen. Symptoms showed no change in the group receiving no exercise. (3)

3. How exercise can benefit depressed people

According to the Mental Health Foundations booklet 'Up and Running' there is a number of ways exercise can assist those depressed:

•For starters we can get a natural high through exercise from a release of endorphins (chemicals that fight depression and increase our sense of joy and wellbeing) body.

•Exercise gives us a chance to meet new people and find support.

•A healthier self image is created through the benefits of exercise and the lifestyle changes that often go with it like more supportive eating.

•Exercise fills a void and creates a sense of purpose. (4)

4. Supporters of the exercise alternative

When the Chief Medical Officer was asked whether exercise could play a role in combating the growing depression epidemic his answer was a resounding yes. He stated: 'Physical activity is effective in the treatment of clinical depression and can be as successful as psychotherapy or medication, particularly in the longer term.' (2)

Television presenter Trisha Goddard, who has a predisposition to depression, says: 'When studies revealed that exercise was a more effective way of handling depression that medicine alone, it wasn't news to me. People often react with surprise when they hear how I've built a daily cross-country run into my life. I'm labelled an exercise fanatic, but I see what I do as a tried and trusted way of living with a predisposition of depression rather than suffering from it.' (3)

5. Who's dropping the ball when it comes to passing on the message

So why isn't this filtering to GPs? With the Mental Health Foundation (MHF) finding that only 5 % of GPs recommended an exercise programme (the Independent article raises no mention of exercise as treatment only Cognitive Behaviour Therapy). Well, for many people the 'what to do?' and 'how to do it?' can be daunting experiences like joining gyms. (2)

Fortunately organisations like the Mental Health Foundation have been busy promoting the role of exercise. At the start of Mental Health Action Week 2005, the MHF launched a year-long campaign calling for patients with depression to be offered exercise on prescription. There are now many programs linked with the NHS and so as they say for more information, ask your local G.P.

6. Questions to consider before undertaking an exercise routine:

•What physical activities do I enjoy?

•Do I prefer group or individual activities?

•What programs best fit my schedule?

•Do I have physical conditions that limit my choice of exercise?

•What goals do I have in mind? (For example, weight loss, strengthening muscles, or improving flexibility or mood enhancement)

7. Conclusion

Sometimes the most simple common sense solutions are the ones hardest to implement. Today we face epidemics like depression, obesity and preventable diseases and the need for regular exercise message is now greater than ever. Having been involved in teaching and prescribing exercise for over 10 years I have no doubt that regular exercise is one of the most powerful tools in overcoming depression, and promoting health and wellbeing. So naturally it is my drug of choice!

Your 3d Coach Craig Burton

References (1) Prozac Nation, Jamie Doward, The Independent, 16th April, 2006 (2) GPs ignore 'sport not pill' advice for depression, Francis Elliot and Sophie Goodchild, The Observer, 27th March 2005 (3) Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms, Eur J Public Health, 2006 Apr;16(2):179-84 (4) Up and Running, Mental Health Foundation, www.mentalhealth.org.uk/html/content/exercisedepressionbooklet_patient.pdf

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