Resistance Exercise Reduces Depressive Symptoms in Adults

Adapted from an article by Christopher Moulton, PhD

Depression is one of the most common mood disorders in the US and worldwide. In 2016 an estimated 16.2 million adults, or 6.7% of US adults, suffered at least one major depressive episode, while globally more than 300 million are afflicted. Further, depression is comorbid with numerous chronic disease states including cardiovascular disease, type 2 diabetes, inflammatory bowel disease, and cognitive decline.
Current frontline therapies such as psychotherapy and antidepressant medications present challenges related to treatment cost, compliance, and adverse effects; therefore, it is of interest to identify additional effective interventions that may be used as alternative or complementary treatments.

One such promising alternative is physical exercise, which may potentially increase the production or availability of neurotransmitters such as dopamine and serotonin, which are known to be diminished in patients with depression. A recent review of 8 clinical studies concluded that regular, deliberate physical activity should be included as a routine component in the management of depression in older adults. However, this finding did not distinguish between aerobic exercise (intended to improve cardiorespiratory fitness) and resistance exercise (intended to improve muscular strength and function).

For this reason, another analysis of 33 clinical trials involving 1,877 participants was done.10 The investigators included studies that reported validated measures of depressive symptoms. The typical resistance exercise program was 16 weeks in duration, and training sessions occurred on average 3x/week. The majority of the interventions were categorized as low- or moderate intensity, and the overall program adherence rate was 78%. The results indicated a moderate reduction in depressive symptoms that favored resistance exercise. Total exercise volume, mental health status, and strength increase were not related to the effect size, which measures the magnitude of a phenomenon. Other analyses revealed that the effect size was greater among adults with symptoms at baseline that were indicative of mild-to-moderate depression, which suggests that resistance exercise may be particularly effective in individuals with a greater degree of depressive symptoms.
Clinicians wishing to implement effective complementary therapies for depression may consider prescribing resistance exercise, with appropriate attention given to program monitoring for compliance enhancement and behavioural skill training to facilitate long-term implementation into a patient’s lifestyle.
Why is this Clinically Relevant?

Depression and depressive symptoms are pervasive mental health burdens that are associated with numerous forms of chronic disease (such as diabetes, heart disease, and other organ system diseases). Practitioners and patients need effective complementary strategies to address the challenges of depression that do not include therapy and drugs, and patients themselves often wish to peruse therapy that does not include psychoactive pharmaceutical medications. Prescription of controlled and well-monitored resistance training programs such as weight lifting, circuit training, and body weight exercise may be an effective alternative or adjuvant therapy for reducing the severity of depression and depressive symptoms.
Citations
  1. NIMH. Major Depression. https://www.nimh.nih.gov/health/statistics/major-depression.shtml. Accessed July 26, 2018.
  2. WHO. Depression. http://www.who.int/news-room/fact-sheets/detail/depression. Accessed July 30, 2018.
  3. Halaris A. Co-morbidity between cardiovascular pathology and depression: role of inflammation. Mod Trends Pharmacopsychiatry. 2013;28:144-161.
  4. Mendenhall E, Norris SA, Shidhaye R, Prabhakaran D. Depression and type 2 diabetes in low- and middle-income countries: a systematic review. Diabetes Res Clin Pract. 2014;103(2):276-285.
  5. Martin-Subero M, Anderson G, Kanchanatawan B, Berk M, Maes M. Comorbidity between depression and inflammatory bowel disease explained by immune-inflammatory, oxidative, and nitrosative stress; tryptophan catabolite; and gut-brain pathways. CNS Spectr. 2016;21(2):184-198.
  6. Wang S, Blazer DG. Depression and cognition in the elderly. Annu Rev Clin Psychol. 2015;11:331-360.
  7. Psychiatry.org. Clinical Practice Guidelines.https://www.psychiatry.org/psychiatrists/practice/clinical-practice-guidelines. Accessed July 30, 2018.
  8. Craft LL, Perna FM. The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry. 2004;6(3):104-111.
  9. Schuch FB, Vancampfort D, Rosenbaum S, et al. Exercise for depression in older adults: a meta-analysis of randomized controlled trials adjusting for publication bias.Rev Bras Psiquiatr. 2016;38(3):247-254.
  10. Gordon BR, McDowell CP, Hallgren M, Meyer JD, Lyons M, Herring MP. Association of efficacy of resistance exercise training with depressive symptoms: meta-analysis and meta-regression analysis of randomized clinical trials. JAMA Psychiatry. 2018;75(6):566-576.
  11. Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.
  12. Gerber M, Holsboer-Trachsler E, Pühse U, Brand S. Exercise is medicine for patients with major depressive disorders: but only if the “pill” is taken! Neuropsychiatr Dis Treat. 2016;12:1977-1981.

For more information or to make an appointment, please call us at (949) 600-5100