# Exercise as it relates to Disease/Exercise and depression, reducing symptom severity

There are strong links between exercise and improved mental health. With the stigma around mental illness still strong, many people refuse to seek help. Exercise has the potential to become a viable treatment for depression, that is affordable and stigma free.

## What is depression?

Depression is an illness that significantly impacts a persons mood state. Depression is often characterised by a combination of the following physical, emotional and behavioural symptoms:
* significant weight fluctuations
* difficulty sleeping
* fatigue and energy loss
* thoughts and feelings of worthlessness
* irritability and restlessness
* change of appetite
* recurring suicidal thoughts
* withdrawal from family and friends
The change in mood state can refer to either a clinically diagnosed, chronic mood state, such as major depressive disorder, or a temporary mood state, that may be recurring. Depression is a severe condition, whether clinically diagnosed or not, as it can cause individuals suffering with the disorder difficulties coping with everyday situations, as the symptoms can cause ongoing distress$_{[1]}$$_{[2]}$

## Who is at risk of depression?

Depression has the potential to affect anyone, with research showing that one in five Australians will experience depression at some stage of their lives. While depression is not a selective disorder, people who are experiencing the situations listed below, may be at a higher risk of depression $_{[3]}$.
* Onset of puberty – those going through puberty are a high risk group due to the rapid changes to emotional and cognitive aspects of life, as well as changes in physical appearance. The rate of physical maturation may also increase a person’s risk of depression$_{[3]}$
* Social disadvantage – such as poverty or unemployment increase risk by increasing anxiety levels, and feelings of worthlessness
* Biological factors – A family history of depression has been shown as a risk factor
* Personality traits - including anxiety, pessimism and neuroticism
* Medical Conditions - depression is often related to other physical and mental conditions that limit a person’s life quality

## Treatment of symptoms

Cognitive Behavioural Therapy: A treatment aimed at identifying, and eliminating thought and behavioural patterns that may be attributing to depression. This form of therapy is often utilised as an online resource, such as Mood Gym.
Pharmacotherapy: A treatment aimed at using pharmaceuticals to restore chemical balances in the brain back to normal. With several different anti depressant drugs available in Australia, finding an effective type and dosage is often a long and tiring process that may incur side effects.
Exercise: A less common prescription for the treatment of depression however has been shown to be at least as effective as anti depressant medications in some cases.
| Benefits of exercise as a treatment | Constraints on effects of exercise as a treatment |
| Clinically significant reductions in syptoms: * Elevated mood * Increase in energy * Improved sleeping patterns * Feelings of worthiness and self- efficacy (certain exercise activities will require mastery of new skills, which leads to said improvements) Reduction in negative thoughts Increased interactions with others (if undertaken in a group setting) Cheap and available resource Adaptable to individuals needs and abilities Superior relapse prevention than other forms of treatment, if exercise is continued $_{[8]}$ Decreased risk of co morbid conditions (such as Cardiovascular disease) No associated stigma to exercise | Outcomes dependant on participant adherence Less rapid outcomes than pharmacotherapy treatments Pre existing medical conditions, or current pharmacotherapy treatments may prohibit involvement in exercise programs |
    Prescription of exercise - Although like any other treatment, the prescription required for each individual will be different, recommendations are currently suggesting that following the exercise guidelines for your age group is sufficient is reducing symptom severity with alterations then being made based on individual responses.Australia is currently moving forward by implementing an Act, Belong, Commit initiative to aid in the improvement of mental health. The lack of knowledge on dose, however, suggests that there is a lot more research needed in this area.

## Further information and support

Although there are strong links between exercise and an improvement in mental health, it is important to find a solution that works best for your situation. If you or someone you know is suffering from depression, the following links may provide additional information and support.
Lifeline:13 11 14 - Crisis support and suicide prevention
Headspace - Australia's National Youth Mental Health Foundation
Sane Australia: 1800 18 SANE - A non-profit organisation that strives to provide accurate information about, and reduce the stigma associated with mental illness
Carers NSW: 1800 242 636 - A contact and support source for relatives or friends of those living with a mental illness
Anxiety and depression checklist - A tool designed to show how depression and anxiety may have affected you in the past four weeks

## References

* ↑ "Mental Health Council of Australia". {{cite web}}: |access-date= requires |url= (help); Check date values in: |accessdate= (help); Missing or empty |url= (help); Unknown parameter |http://www.mhca.org.au/index.php/component/rsfiles/download?path= ignored (help)
* ↑ "Depression".
* ↑ "Depression".
* ↑ Hoffman,, B., (2012). "Is Exercise a Viable Treatment for Depression?". 16(4): 14–21. {{cite journal}}: Cite journal requires |journal= (help); |access-date= requires |url= (help); Check date values in: |accessdate= (help)CS1 maint: extra punctuation (link)
* ↑ Park,, N., (2003). "Building Wellness to Prevent Depression". 6(16). {{cite journal}}: Cite journal requires |journal= (help); |access-date= requires |url= (help); Check date values in: |accessdate= (help)CS1 maint: extra punctuation (link)
* ↑ "FACTS AND FIGURES ABOUT MENTAL HEALTH AND MOOD DISORDERS" (PDF).
* ↑ Nazareth,, I., (2011). "The pattern of physical co-morbidity and psychological determinants of depression: a prospective cohort study on a representative sample of family practice attendees in Slovenia". Mental Health in Family Medicine. 8: 147–155.{{cite journal}}: CS1 maint: extra punctuation (link)
* ↑ "Medical treatments for depression". Retrieved 18/09/2013. {{cite web}}: Check date values in: |accessdate= (help)
* ↑ Krishnan,, R., (2000). "Exercise Treatment for Major Depression: Maintenance of Theraputic Benefit at 10 Months". Psychosomatic Medicine. 62: 633–688. {{cite journal}}: |access-date= requires |url= (help); Check date values in: |accessdate= (help)CS1 maint: extra punctuation (link)
* ↑ Baune,, B., (2013). "Treating depression and depression-like behaviour physical activity: and immune perspective". Frontiers in Psychiatry. 4 (3): 1–27. {{cite journal}}: |access-date= requires |url= (help); Check date values in: |accessdate= (help); Unknown parameter |month= ignored (help)CS1 maint: extra punctuation (link)
* ↑ Chambliss,, H., (2005). "Exercise Treatment for Depression Efficacy Dose Response". American Journal of Preventive Medicine. 28 (1): 1–8. {{cite journal}}: Text "lastKampert," ignored (help)CS1 maint: extra punctuation (link)
* ↑ "Mental Health Council of Australia". {{cite web}}: |access-date= requires |url= (help); Check date values in: |accessdate= (help); Missing or empty |url= (help); Unknown parameter |http://www.mhca.org.au/index.php/component/rsfiles/download?path= ignored (help)
* ↑ "Act Belong Commit". {{cite web}}: |access-date= requires |url= (help); Check date values in: |accessdate= (help); Missing or empty |url= (help); Text "http://www.actbelongcommit.org.au/" ignored (help)