Exercise and depression: When does it help (and when doesn’t it)? Why?

July 19, 2007

Last year I discovered that half an hour of nice fast walking can bring me down out of a hypomania or mixed state or whatever you want to call it when I start getting unpleasantly overenergized. (Heavy exercise can make some people hypo/manic, so be careful if you decide to try this at home.) I exercise a lot now because it does stuff for me and because I’m in good enough mental health to do so. When I’ve been depressed, no matter how many times I read that exercising was supposed to make me feel better, it never did in the short term, and (due to inability to find energy to do things like stay awake for long periods of time) I was not able to keep it up long enough to make a difference.

But it does help ease depression, on average, which means that some people are probably getting a lot of benefit from it, other people little or no benefit, and most people in between. (This doesn’t count the people who are not able to exercise due to depression, although possibly it should – if you cannot put the treatment into action due to the disease, the treatment is inappropriate for you at that time.)

Earlier today I read an article on a study showing that women on a *supervised* exercise regimen who were *also taking medication* improved more (on average) than women who were also taking medication but did not have the benefit of a supervised exercise regimen. Note “supervised” and “also taking medication”; they were not just told that if they exercised more they’d get better, but were actually provided with the support necessary to exercise. And they were not exercising-instead-of-taking-medication the way some well-meaning dumbasses tell depressed people to do. Supervised exercise was the supplement, not the treatment, and it helped.

I’m hoping there’s a follow-up comparing people with supervised exercise regimens + medication to people with supervised exercise regimens without medication. The women in the study were ones who had failed to show improvement on medication for two months – so was it that (on average) the supervised exercise made it possible for the medication to work? Or was the supervised exercise (on average) doing what the medication wasn’t?
My long-range pie-in-the-sky hope is that this takes off enough that eventually we’ll have government and insurance-company support for supervised exercise programs as an adjunct to other treatments. Helping with depression and making the rest of you healthier too…curative and preventive treatment at the same time.