Jog on 300x262 Breaking News: Simply telling depressed people to exercise does not help relieve symptoms of depressionExercise ‘no help for depression’, research suggests, reads todays BBC headline (despite the cited quote appearing not once in the research paper published today in the BMJ). The Guardian lead with: Exercise doesn’t help depression, study concludes. This comes as shockingly blunt advice after we have been told for years that exercise helps treat depression and a wide range of evidence has come to support this view.

So, what did the study actually find? Two groups of depressed individuals were kept on their standard treatment plan and one of those groups was mildly encouraged to do more exercise through a few short telephone calls and a couple of face to face meetings. There was no minimum amount of exercise required for inclusion in the study, nor were any facilities for exercise provided. Over half of the participants were on anti-depressant medication that may provide some of the benefits of exercise alone, thus negating the benefit of exercise on self reported happiness.

“The aspiration was for the participants to engage in moderate or vigorous activity for 150 minutes a week in bouts of at least 10 minutes, but if that seemed unrealistic then the facilitator encouraged any increase in physical activity, whatever the intensity. The intervention programme comprised an initial hour long face to face assessment session followed by two short telephone contacts, then a further face to face meeting for half an hour. Over the course of 6-8-months, the physical activity facilitator offered up to eight further telephone contacts and one more face to face half hour meeting.”

Chalder, M. Wiles, N. Campbell, J. Hollinghurst, S. Haase, A. Taylor, A. Fox, K. Costelloe, C. Searle, A. Baxter, H. Winder, R. Wright, C. Turner, K., & Calnan, M. Lawlor, D. Peters, T. Sharp, D. Montgomery, A. Lewis, G. (2012). Facilitated physical activity as a treatment for depressed adults: randomised controlled trial. BMJ, 344 DOI: 10.1136/bmj.e2758

At the four month follow up, exactly the same number of people in the treatment group had participated in physical activity as had done so in the control group (though it should be noted that there were seventeen more people in the control group than in the treatment group). Over the course of the study there was only a fifteen percent difference in the amount of exercise between the two groups! This study shows that the current exercise based treatment plan of telling people to exercise is not effective. It does not assess the outcomes of enabling people to exercise, or indeed of actually exercising.

Update: A follow up on this study in Scientific American comes to the same conclusion.

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  • Neuroskeptic

    Good point, but I suppose that in the real world, doctors are mostly going to be telling people to exercise, not actually going out and helping them do it. At least not unless they get a lot more money to spend. Telling people to exercise costs nothing, antidepressants cost pretty very little in the grand scheme of things, but actually providing people with exercise facilities would be costly.

    • Neurobonkers

      Agreed, I don’t see the NHS providing depressed people with ways to exercise as a good use of resources but I would expect that at the very least, ensuring people do actually exercise should be a requirement for a study that asks if exercise helps treat depression. The study asks an entirely different question – do depressed people exercise when advised to by their doctor?

      I just find it weird that that’s not how the research has been framed. People with depression are hardly going to bother exercising if they read that it wouldn’t help them anyway! The research completely throws the baby out with the bathwater. It’s ridiculous to suggest that people who are feeling down shouldn’t try exercising *before* making that trip to the doctor in the first place.
      In fairness to the reporters, the closing remarks of the research make little sense when you consider that the study hasn’t really examined what happens when the advice to exercise is actually followed:

      “Clinicians and policy makers should alert people with depression that advice to increase physical activity will not increase their chances of recovery from depression”

      • Cel West

        I disagree: a discounted gym membership by £10 for say three months would not be an unreasonable expense, and may well save money in crisis interventions or so on (whether this would be a sufficient intervention is another discussion, of course, but even three months membership for £90 may save money longer-term).

        Such things used to be available anyway by means of discounted memberships for those on benefits; these, at least in London, have largely been discontinued in the last couple of years.

        Considering that this entire discourse around depression and responsibility is intensely political, I’m not at all surprised by newspapers’ distortion of the research. It seems I’m just as alone in this as being alone in being angry about the gym membership withdrawal.

  • John Ellis

    Well I have to say of all the rags only the DM has the truth of it, endocannabinoids are good for mental health, how we generate them through exersise is person dependant. I dont find running good but i do find digging good for this. It has also been noted about the chemical imbalance in the ECSN and how overproduction of AEA is linked to serious mental illness.

  • John Ellis

    anyone got a full text of this please
    Effects of chronic
    treatment with citalopram on cannabinoid and opioid receptor-mediated G-protein
    coupling in discrete rat brain regions

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