# Exercise as it relates to Disease/The effects of physical activity on depression and anxiety

This is the analysis of the article "The Effect of Exercise on Depression and Anxiety: A Comparison to Transdiagnostic Cognitive Behavioral Therapy"

## What is the background to this research?

Anxiety and Depression are both a mental disorder characterised by persistently depressive mood or loss of interest in activities, anxiety or fear that can negatively impact an individual in their daily life. Only recently have we recognised that the depressive and anxiety disorders are among the most common medical conditions throughout the world. Currently anxiety is the most common mental health condition in Australia with 1 in 4 people being diagnosed with the mental health disorder – 1 in 3 women and 1 in 5 men. Nearly three million Australians live with depression and/or anxiety, which affect their wellbeing, personal relationships, career and productivity. Men are less likely to seek help than women, with only 1 in 4 men who experience anxiety or depression accessing treatment, this places considerable pressure on public health and social services as men account for 75 per cent of deaths by suicide in Australia.
To date there is no cure for depression and anxiety as no two people are affected the exact same way. The best way to treat depression is to become informed as soon as possible about treatment options. Whilst there are medications out there to relieve symptoms of depression and anxiety, it is not usually suitable for long-term use as it will be the body's sole medication to temporarily remove the symptoms of these mental disorders. Other treatments include exercise and therapy which can be just as effective as medication, and don't come with unwanted side effects.
Studies indicate that exercise is an effective strategy to prevent and treat the mental disorders of depression and anxiety and can have great potential in prevention and treatment of these disorders.. There is growing evidence that physically active people are at a reduced risk of developing depression and anxiety, and that physical activity are associated with significant benefits for individuals with mild to moderate forms of depression as well as in reducing anxiety. This had led to the idea that physical activity serves as an alternative or a supplement to traditional forms of therapy when treating depression or anxiety.

## Where is the research from?

A group of researchers from the University of Iceland with extensive knowledge in physical activity, physical education, science and engineering sought 15 participants with depression and/or anxiety symptoms and conducted a study with a validated questionnaire and an exercise program.
Researchers introduced this program to the head of the Primary Health Care of the Capital Area in Reykjavik in Iceland where when approved the participants were asked to watch a short lecture and sign a consent form. The participants had a meeting with all of the volunteers of the study at Reykjavik University in Iceland, where they were given a introductory letter. The study was approved by the National Bioethics Committee of the Government of Iceland.

## What kind of research was this?

Research was conducted over an 8-week period with an exercise program that consisted of three 60 minute sessions each week. A Beck Depression Inventory (BDI-II) which is a 21 item questionnaire that measures depression and Beck Anxiety Inventory (BAI) which is a 21 item questionnaire that measures anxiety were also carried out over 5 weeks just after the first couple weeks of training.

## What did the research involve?

The research involved 15 sedentary Caucasian adults (12 females and three males, age 19–58 years, M age  = 34.7, SD = 10.34) from the town of Reykjavik, Iceland. Researchers created a program that included aerobic training 3 times a week, at 80% maximum heart rate. The intensity of training was supervised and their body was measured by heart rate monitors.
Additionally, strength training was incorporated into the routine twice a week. Strength training included free weights and body weight exercises, as it has been shown to have some advantages over machine-based exercises, and will increase intensity of the exercise program. Each week, a new strength training exercise was introduced to the participants as research has shown that learning a new skill during exercise may potentially increase their effectiveness and this may be one possible explanation to why exercise works as an anti-depressant

## What were the basic results?

From the research there was an improvement in both depression and anxiety symptoms as measured with the BDI-II and BAI, with a significant change in depression scores. These results compare to previous findings of exercise for people with depression and anxiety that have found exercise to decrease depression scores Although anxiety did not change significantly in the study, there was a trend towards lower anxiety scores towards the end of the intervention.

## What conclusions can we take from this research?

Based on the findings of the current study, exercise can have significant effects on the individuals with depression and anxiety that is comparable, and even slightly better than TCBT. (Transdiagnostic Cognitive Behavioral Therapy) With the right supervision and the right exercise program individuals have found that exercise can have a significant change in depression scores.

## Practical advice

Regular exercise for patients suffering from depressions and/or anxiety can be an effective treatment by itself and can serve both a non-melancholic and severe melancholic depressions. Exercise alongside other treatments like therapy can be beneficial for improving sleep, providing social support and increase sense of control and self-esteem in the individual.

## Further information/resources

Further information about depression and anxiety can be found below:
* Depressions and Anxiety - What is it? http://resources.beyondblue.org.au/prism/file?token=BL/0804
* Benefits of Physical Activity: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/depression-and-exercise
* Depression and/or Anxiety - Support services: https://www.beyondblue.org.au/get-support/national-help-lines-and-websites

## References

* 1 2 3 4 5 6 Ólafsdóttir K, Kristjánsdóttir H, Saavedra J. Effects of Exercise on Depression and Anxiety. A Comparison to Transdiagnostic Cognitive Behavioral Therapy. Community Mental Health Journal. 2017;54(6):855-859.
* ↑ Stockman J. Evidence Based Physical Activity for School-Age Youth. Yearbook of Pediatrics. 2007;2007:424-425
* 1 2 3 Australian Bureau of Statistics. (2008). National Survey of Mental Health and Wellbeing: Summary of Results, 2007. Cat. no. (4326.0). Canberra: ABS.
* 1 2 Saisan J. Depression Treatment: Therapy, Medication, and Lifestyle Changes That Can Treat Depression [Internet]. Helpguide.org. 2018 [cited 19 September 2018]. Available from: https://www.helpguide.org/articles/depression/depression-treatment.htm
* 1 2 3 Martinsen E. Physical activity in the prevention and treatment of anxiety and depression. Nordic Journal of Psychiatry. 2008;62(sup47):25-29.
* ↑ Larun L, Nordheim L, Ekeland E, Hagen K, Heian F. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database of Systematic Reviews. 2006;.
* ↑ Ólafsdóttir K, Kristjánsdóttir H, Saavedra J. Effects of Exercise on Depression and Anxiety. A Comparison to Transdiagnostic Cognitive Behavioral Therapy. Community Mental Health Journal. 2017;54(6):855-859.
* ↑ Craft, L. L. (2005). Exercise and clinical depression: Examining two psychological mechanisms. Psychology of Sport and Exercise, 6(2), 151–171.
* 1 2 Bridle, C., Spanjers, K., Patel, S., Atherton, N. M., & Lamb, S. E. (2012). Effect of exercise on depression severity in older people: Systematic review and meta-analysis of randomized controlled trials. The British Journal of Psychiatry : The Journal of Mental Science, 201(3), 180–185.