Why exercise can be better than pills for depression

AS A Zumba instructor, Karen Bedford might be expected to rave about what she teaches. But Karen has a more personal motive, for she believes exercise helped her recover from a decade-long battle with depression.

Where antidepressants failed, Zumba succeeded. ‘Since Zumba became part of my life my mental state’s been more stable and I haven’t needed the pills,’ says Karen, 49, who has two grown-up children.

‘I get the odd down day, but because I’ve regained my confidence I face my problems much better now.’

It’s a far cry from when Karen’s depression emerged in 1998. Her long-term relationship had just ended and she was fighting to keep the family home when she was made redundant from her job at a publishing house.

Karen tried to put a brave face on for her children, then 11 and eight, but was struggling — so she went to her GP who prescribed antidepressants.

She took these for nearly a year, despite initially suffering from a range of side-effects, including an upset stomach, which meant she had to be switched to different drugs.

‘The antidepressants probably helped but I don’t think they were the right solution for me. I questioned if it was worth taking them, especially because they made me feel unwell.’

Karen’s depression stabilised and she began a new relationship and found work in publishing again.

Then her boyfriend, Randy, died from pancreatic cancer in 2003, and her depression returned with a vengeance.

KAREN’S doctor again prescribed antidepressants. She took them for less than a year. ‘I was terrified I’d be stuck on them for ever and I wanted to sort out the underlying problems,’ she says.

Studies show that patients suffer at least one side-effect from taking antidepressants — such as lack of sex drive and excessive sweating — and these are a common reason why some with mild to moderate depression ask to come off the pills, says Dr Sandrine Thuret a principal investigator and lecturer in neural stem cell research.

Then a friend suggested that Karen try an exercise class, and the first one she took was Zumba (which combines lively dance music with high- energy exercises).

‘I loved it — I felt better instantly after each lesson and it gave me a real high,’ she says.

There is good evidence to show that exercise can have a huge impact on people with mental health problems, particularly depression. It helps in a variety of ways.

‘It diverts negative thoughts because you have to focus on the exercise you’re doing — which is why some experts think more intensive exercise is best because it requires more concentration,’ says Dr Thuret.

It also r aises selfesteem — something which people with depression usually have little of, she says. It also has a direct physiologi- cal effect, boosting levels of neurotrophic factor in the brain, which in turn encourages the growth of new cells in the hippocampus, the area which controls our mood.

‘People with depression often have low levels of new brain cells, so we think this is one way exercise can help,’ explains Dr Thuret. ‘Some antidepressants also increase the number of these new brain cells — but can have side-effects.’

Another possibility is that exercise boosts levels of ‘feel-good’ hormones such as serotonin.

Last year, the authoritative Cochrane Collaboration reviewed 30 trials comparing exercise with antidepressants, talking therapies (such as cognitive behavioural therapy), and placebos. It concluded that exercise appeared to improve symptoms of depression to the same degree as other treatments, especially for those with mild depression.

Dr Thuret suggests group exercise could be more beneficial because of the social aspect. But Simon Lawton-Smith, an expert in mental health policy, warns: ‘It’s crucial that you discuss coming off antidepressants with your doctor.’

However, doctors are increasingly encouraging their patients to take exercise to tackle depression. ‘Exercise would be one of the first things I’d suggest to patients,’ agrees Dr Thuret.

‘GPs could offer it alongside talking therapies, then if there’s no improvement antidepressants, which aren’t always the answer, could be introduced.’

But not all experts are convinced. A recent study of people diagnosed with depression for the first time found that those who were given advice about exercising — and who exercised more — as well as receiving antidepressants actually did no better than those who had just the standard treatment, reported the British Medical Journal.

‘The message isn’t that exercise won’t help depression but we couldn’t show it had an added effect beyond standard treatment,’ says lead researcher Professor John Campbell. ‘ For sufferers, their world is black, so it’s not always an appropriate treatment to start with.’ Karen herself needs no convincing about the benefits. ‘ I’d recommend it to anyone with depression and doctors should do too.

‘It’s definitely offered me a solution.’

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