By Tony Vernon, HWC, NMC, AMC, MMC
Many people have described depression as a black curtain of despair coming down over their lives. Depressed people lose their ability to concentrate and have little to no energy most of the time. They become increasingly more irritable and often say to other people they are ‘feeling low or down’. People who have been feeling ‘down’ for more than two weeks are generally described as “clinically depressed”.
Global Statistics on Depression
- During 2015–2018, 13.2% of adults aged 18 and over used antidepressant medications and use was higher among women (17.7%) than men (8.4%). Globally, 1 in 4 adults do not meet the recommended minimum levels of daily physical activity. More than 80% of the world’s population are doing inadequate physical activity. 1,2
- Depression is a common illness worldwide, with an estimated 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years. 3
- Approximately 280 million people in the world have depression 3
- Depression can lead to suicide. Over 700,000 people die due to suicide every year. Suicide is the fourth leading cause of death in 15-29-year-olds. 3
- The median age of depression onset is 32.5 years old. 4
- The prevalence of adults with a major depressive episode is highest among individuals between 18 and 25. 4
- 11.3% of adults who report two or more races have experienced a major depressive episode in the past year.
- Depression represents the main cause of disability throughout the world. 5
- Globally, one in seven 10-19-year-olds experiences a mental disorder, accounting for 13% of the global burden of disease in this age group. 6
- Depression can be hereditary: People who have an immediate family member living with depression may have a two to three times greater risk of having depression, according to Stanford Medicine. 7
- Depression is more common in people who give birth: 10% of pregnant people and people who have just given birth experience depression, according to the World Health Organization (WHO). 3
- The severity of symptoms ranges from 2.8% of U.S. adults experiencing severe depression symptoms, 4.2% experiencing moderate symptoms and 11.5% experiencing mild symptoms, per 2019 statistics from the Centers for Disease Control and Prevention (CDC). 8
- Mental health conditions were exacerbated by the COVID-19 pandemic, according to the CDC. From August 2020 to February 2021, the percentage of adults with diagnosed anxiety or a depressive disorder went from 36.4% to 41.5%, with the largest increases in the 18 to 29 age category. 9
- Common antidepressant drugs could lead to osteoporosis, research from the US suggests.10
Symptoms of Depression
Forty-five to seventy-five percent of people who are diagnosed with mental depression experience physical symptoms such as stomach aches and indigestion; weight loss or weight gain; fatigue; aches and pain in the back, neck or shoulders; muscular stress and tension; sleeping too much or too little; and headaches. Being depressed can be emotionally debilitating. Symptoms such as prolonged sadness, loss of interest in life, an inability to make simple decisions, feeling overwhelmed and hopeless, are all emotional symptoms associated with depression.
What does Depression generally lead to?
Depression can lead to trouble concentrating or making life decisions and an inability to function well in everyday life. Work and interactions with family and friends can become increasingly more difficult. Prolonged depression can often lead to thoughts of suicide and the act of suicide itself.
Why Does It Happen?
Although the cause of depression is unknown, the condition is often triggered by too much mental stress from major life events. Major life events may include childhood adverse experiences, financial difficulties or work challenges as an adult, relationship difficulties, moving, divorce, or even the birth of a child.
Scientific Research on Depression & Exercise
Research in the world leading medical journal, The Lancet, indicated visceral fat has a profoundly negative effect on cognitive abilities. Being overweight or having excess body fat is a strong predictor of reduced cognitive function, according to new research published in The Lancet. The findings highlight the importance of maintaining a healthy weight to protect cognitive function. 11
According to the findings of a study conducted by Duke University Medical Center, a brisk 30 minute walk or jog around a track three times a week may be just as effective in relieving the symptoms of major depression as antidepressant medication, the standard orthodox medical treatment.
Researchers at Duke University studied a group of middle-aged and elderly individuals, but the results are likely to be congruent with individuals of any age. This is because, generally, elderly individuals can be the most difficult group on which to test an exercise hypothesis. Elderly people tend to have additional medical problems that can make regular exercise even more difficult. Therefore, the positive results in a test on elderly people seems to point to the likelihood of positive results among people of all ages, and children as well.
Duke psychologist and lead researcher, James Blumenthal, looked closely at one of the results from the study that involved 156 elderly patients with major depressive disorder (MDD). He said that exercise may be just as effective as medication and may be a better alternative for some patients with major depressive disorder.
Blumenthal also suggested that the structured and supportive atmosphere of the study could have had a positive effect on improving the symptoms of the group. However, he believes that, whilst the camaraderie in the group may have contributed to the overall effect, the majority of the lasting benefit was derived from the exercise program.
A systematic review and meta-analysis published in 2022 in JAMA Psychiatry found brisk walking for just 2.5 hours a week cut depressive symptoms by 25%. The same study also found that doing half that amount lowered the risk of depression by 18%. 12
Another large review published in February 2023 in the British Journal of Sports Medicine found that getting physical is 1.5 times more effective at reducing stress, anxiety and mild-to-moderate symptoms of depression than antidepressant medication or cognitive behavior therapy, which are considered a gold standard treatment. 13
This study, the largest of its kind to date, found that exercise “interventions” appear to reduce depression symptoms about as much as conventional treatments, like medication and therapy.
Specifically, the review showed that exercise interventions that were 12 weeks or shorter were the most effective at reducing mental health symptoms, highlighting the speed at which physical activity can make a change. “Physical activity is known to help improve mental health. Yet despite the evidence, it has not been widely adopted as a first-choice treatment,” lead researcher Dr. Ben Singh said in a statement at the time. 13
How Exercise Works to Relieve Depression
Exercise may be effective in relieving depression because when patients choose to exercise, they are taking an active role in trying to ‘get better.’ This may be better than passively choosing to take a pill, and then sitting on the sofa watching TV or doing little and ‘expecting’ to get better. In the study, it became apparent that patients who exercised felt a greater sense of mastery over their condition. They, therefore, gained self-esteem and a sense of accomplishment because they were doing it for themselves.
In another study, Dr. Michael Craig Miller, Assistant Professor of Psychiatry at Harvard Medical School in Boston, Massachusetts said that vigorous exercise produces “helpful chemicals in the brain.” These chemicals are known as endorphins, the chemicals responsible for the euphoric feelings associated with exercise. He also went on to say that improved self-esteem is also associated with regular physical activity, which can contribute to an enhanced sense of well-being. Therefore, this combination of endorphins and improved self-esteem can be helpful in the relief of depression.
Increased participation in exercise is strongly associated with lowering levels of depression. 14 Regular low-to moderate exercise can help to produce endorphins in the brain. When endorphin production improves, mood follows. 15 It could be that the most important beneficial aspect of exercise is related to its ability to improve mood. This benefit is so critical because mental attitude is a critical factor in preventing illness and disease. Regular exercise may actually be the most powerful antidepressant available.16, 17, 18,19, 20
Many scientific studies to date have clearly indicated that exercise is a profound antidepressant. They show that increased participation in exercise and physical activity decreases symptoms of anxiety and depression. They also show that people who participate in regular exercise feel better, are happier, and have higher self-esteem than those who do not. In fact, over 100 studies to date have identified the effectiveness of exercise in the treatment of depression. Even in 1980, an analysis of sixty-four scientific studies that were concluded prior to 1980, confirmed that exercise relieves depression. 21
When we do a quick burst of complex movements as exercise, we are using more of our 100 billion brain cells than is used in any other activity – changing up our brain chemistry in an avalanche of positive ways. While we have unpacked much of the science behind why exercise works in modern days, we’ve known of its strong mood-altering effects since Hippocrates wrote about it in the first medical textbook written 300 years BC. In it, Hippocrates advised depressed patients to “go for a long walk,…and if still depressed, then walk again.” 22
Neurogenesis, or the birth of new neuronal cells, could be an important factor in the treatment of depression and also in everyday mood. It is now thought that neurogenesis can indeed continue into and throughout adult life, however research suggests that it is dependent on two key factors: physical exercise and human interactions. A 1997 study conducted by Kemperman and Gage found that adult mice given enriched living conditions showed a sixty percent increase in new cell growth. Scientists are now studying how neurogenesis occurs naturally, and how it can be used to assist in various medical treatments. Neurogenesis is regulated by growth factors that can lead to the development of new cells. 23, 24, 25
Chemical signals from contracting muscles can influence the growth of brain networks, according to new research published in the Journal of Neuroscience. Their study highlights the importance of physical activity to mental health, and the findings could also help contribute to the development of more effective treatments for cognitive disorders such as Alzheimer’s disease.26
Scientists have recently discovered a whole family of proteins called neurotrophic factors. The word “neurotrophic” is derived from the Greek words “neuro” for nerve and “troph” for nourish. These proteins play a crucial role in the development and survival of nerve cells, or neurons. Neurotrophic factors are responsible for the growth and survival of neurons during development and also keep adult neurons alive and healthy throughout life.
The Division of Molecular Psychiatry at Yale School of Medicine studies demonstrated that stress and depression decrease neurotrophic factor expression and neurogenesis in the brain. In an article published on February 3rd 2006, they went on to say that neurotrophic factors and neurogenesis can decrease with age, but may not have to. The study says, “Exercise and an enriched environment increase neurotrophic support and neurogenesis, which could block the effects of stress and aging.”
The Department of Psychology, Division of Neuroscience and the Brain Research Center at UBC Hospital, University of British Columbia, Vancouver, studies revealed that “an enriched environment and voluntary exercise massively increases neurogenesis in the adult hippocampus”.
Many people today do not want to take antidepressants. Reports conclude that more and more people are concerned about the side effects of drugs. These people are looking for more ‘natural’ ways of feeling better. In any case, the findings of these studies confirm that exercise is as effective as medication or better than medication, in the treatment of depression. These findings may begin to pave the way for more research to be conducted, and could change the way depressed patients are treated in the future with lifestyle-related medicine.
The Department of Medical-Surgical Nursing, University of Illinois, Chicago says, “the beneficial effects of both exercise and multi-sensory environmental stimulation have been well-documented.”
An Enriched Environment
Dr. Marian C. Diamond is professor of anatomy at the Department of Integrative Biology, University of California. She is one of the world’s foremost neuroanatomists. Dr. Diamond’s work with rats has proved the importance of an enriched environment. This research is, without doubt, applicable to human learning. Diamond’s work shows that 5 basic factors are important to keep a brain healthy well into old age.
The Five Basic Factors for a Healthy Brain are:
- Human Love
- Good Nutrition from Food
- Daily Exercise
“The brain needs new challenges if it is to remain a healthy, functioning organ. At any age, trying more difficult tasks, especially those involving multisensory input (seeing, listening, feeling), is a good thing”.
Diamond further reports, because ‘newness’ is an important aspect of learning, we changed the toys frequently in rat experiments; otherwise, the brain at first responds to the enriched conditions but decreases its growth activity when the newness wears off. However, Diamond goes on to say that too much stimulation or newness causes stress, which has a negative impact on brain development. 27, 28, 29, 30, 31, 32
Personal Words by Tony Vernon, HWC, NMC, AMC, MMC
Regular daily exercise generates optimism to start. No drug on the market can do that. However, it is perfectly natural to have bad experiences or days and become upset when life is challenging – everyone has their moments and with the grueling pace of work or professional modern life today, we need an overcome adversity mindset or we could get down or even depressed with life. A progressive, systematic exercise program makes the body stronger, and so the mind with it. It is a powerful means to feel better, to become more resilient, and to beat depression. I know I had depression, and I beat it with daily exercise. Whilst the medical world will express the causes of depression can be complex, the most common triggers are lifestyle-related, and can therefore be negated mostly by developing more positive habits, with daily exercise maybe being the most important of the positive habits to develop, because we are built to move.
Every system in the body and organ works better from exercising daily, as long as you understand the importance and ‘how to’ recuperate and recover properly. There is absolutely no doubt that if you take regular physical exercise you will (in addition to the other health benefits) have a far more positive self-concept and sense of optimism, and find it easier to take life’s knocks in your stride. For mental health, exercise is NOT optional.
I have been lucky and fortunate enough to have helped World leaders in my line of work as a coach. I remember asking someone at the top I helped and trained. “Does anyone at your level not exercise?” The answer was “No, they would not be here”. If you want to build a great life, I would say exercise is the miracle medicine. With the right coach or trainer to get you there and persistence: a daily, systematic, progressive exercise program can make you into a champion. Champions in sport or fitness, are always champions in life.
- Debra J. Brody, M.P.H., and Qiuping Gu, M.D., Ph.D., Antidepressant Use Among Adults: United States, 2015-2018
vWHO, Physical activity https://www.who.int/news-room/fact-sheets/detail/physical-activity
- Depression: World Health Organization
- Depression Statistics Everyone Should Know
- Friedrich, M.J.. (2017). Depression Is the Leading Cause of Disability Around the World. JAMA. 317. 1517. 10.1001/jama.2017.3826.
- Adolescent mental health https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
- Douglas F. Levinson, M.D., Walter E. Nichols, M.D., Professor in the School of Medicine Department of Psychiatry and Behavioral Sciences, Major Depression and Genetics
- Symptoms of Depression Among Adults: United States, 2019. Centers for Disease Control and Prevention (CDC)
- Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic — United States, April and May 2020. CDC.
- Arthritis Research Campaign 10 July 2007 Antidepressants ‘could add to osteoporosis risk’. Available from http://www.arc.org.uk/news/article/18206829 [cited 10th July 2007]
- Adiposity impacts cognitive function in Asian populations: an epidemiological and Mendelian Randomization study, The Lancet Regional Health Western Pacific
- Pearce M, Garcia L, Abbas A, et al. Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2022;79(6):550–559. doi:10.1001/jamapsychiatry.2022.0609
- Singh B, Olds T, Curtis R, et alEffectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. British Journal of Sports Medicine Published Online First: 16 February 2023. doi: 10.1136/bjsports-2022-106195
- .S. Dept. of Health and Human Services, The Surgeon General’s Report on Nutrition and Health (Rocklin, CA: Prima, 1988).
- Daniel Carr et al., “Physical Conditioning Facilitates the Exercised-Induced- Secretion of Beta-Endorphin and Beta-Lipoprotein.
vJ.E. Martin and P.M. Dubbert, “Exercise Applications and Promotion in Behavioral Medicine,” J Consult Clin Psychol 50 (1982): 1004-17.
- C.H. Folkins and W.E. Sime, “Physical Fitness Training and Mental Health,” Am Psychologist 36 (1981):375-88.
- S.Weyerer and B. Kupfer, “Physical Exercise and Psychological Health,” Sports Med 17 (1994): 108-16.
- A. Byrne and D.G. Byrne, “The Effect of Exercise on Depression, Anxiety, and Other Mood States: A Review,” J Psychosom Res 37 (1993): 565-74.
- R.C. Casper. “Exercise and Mood,” World Rev Nutr Diet 71 (1993):115-43.
- C.H. Folkins and W.E. Sime, Physical Fitness Training and Mental Health,” Am Psychologist 36 (1981): 375-88.
- John J. Ratey, MD, Build a Better Mood Through Exercise https://www.highperformanceinstitute.com/blog/better-mood
- Gage, Fred. (2003). Brain, Repair Yourself. Scientific American, 289(3), 87-95.
- Kempermann and Gage (2003). New Nerve Cells for the Adult Brain. (2003) Retrieved 11, 03, 2003 From: http://www.dsrf.co.uk/Reading_material/ New_braincells/newbrain2.htm.
- Eriksson et al. (1998). Neurogenesis in the adult human hippocampus. Nature America Inc. Retreived 11, 03, 2003 from: http://medicine.nature.com
- Ki Yun Lee, Justin S. Rhodes, M. Taher A. Saif, Astrocyte-mediated Transduction of Muscle Fiber Contractions Synchronizes Hippocampal Neuronal Network Development, Neuroscience
- Bennett E L, Rosenzweig M R, Diamond M C 1974 “Effects of successive environments on brain measures.” Physio. and Behavior 12:621-631
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- Diamond M C, 1988 Enriching Heredity, The Free Press, New York
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