Emotional Health · Health

Dr. Ford on Emotional Health: Yes, Exercising May Protect Against Depression!

fordCecilia Ford, who has been a psychologist in private practice in New York City since 1987, has addressed emotional issues for Women’s Voices in many articles over the years.

 

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Last week, Gretchen Reynolds reported in The New York Times on an exciting Swedish study that underscores the strong link between the body and the mind. While mental health professionals have long known that physical exercise helps militate against and relieve depression, the mechanisms involved were not completely understood. Much of the effect, it was assumed, came from the release of endorphins—chemicals that are associated with pleasurable feelings—that occurs after vigorous exercise. The Stockholm scientists, however, have found another complex but intriguing process that is also involved.

Using that old standby, the lab mouse, the researchers first induced depression by exposing them to stressful situations—a time-honored scientific procedure well-shown to cause the “symptoms” of depression in mice. The group of mice that had been “pre-bred” to produce large amounts of an enzyme called “PGC-1alpha1” seemed to be protected against developing depressive behaviors. Especially interesting is that this enzyme does not act on the brain—the action is on a cellular level instead. The researchers found that it breaks down another chemical, called kynurenine, which can cross the blood/brain barrier and lead to depression. By breaking down this chemical, PGC-1alpha1 renders it inactive. Would the experiment’s results apply to human subjects?

…. to ensure that these findings are relevant to people, the researchers had a group of adult volunteers complete three weeks of frequent endurance training, consisting of 40 to 50 minutes of moderate cycling or jogging. The scientists conducted muscle biopsies before and after the program and found that by the end of the three weeks, the volunteers’ muscle cells contained substantially more PGC-1alpha1 and the substance that breaks down kynurenine than at the study’s start.

So this study was able to demonstrate that there is a direct relationship between a certain level of exercise and “resilience” against depression. Further studies will be able to pinpoint this process even further, the researchers hope.

This latest research underscores the intimate relationship between mental health and physical well-being. Not only does the body have the ability to protect us against symptoms of depression, but the reverse is also true. Depression often makes its presence known in physical symptoms. Patients have very many complaints that are brought to their doctor’s attention for which no physical cause can be found.

But just because the symptoms may be linked to depression, it does not mean they are not real. It is important to understand that pain caused by “psychogenic” (i.e., psychological) issues is just as real as any other; just as the protective effects of exercise are due to “real” chemical changes on a cellular level, depression can cause physical changes that are very tangible. It may start “in the head,” but it doesn’t stay there.

Physical symptoms of depression include—
Headaches
Indigestion
Lack of energy
Appetite and weight changes
Pain
Sleep loss
Nausea

It’s easy to see how these complaints can get interpreted as problems caused by an underlying physical illness. Doctors should always be careful to rule this out, but if a patient presents with these symptoms, the physician should look for accompanying emotional signs.

Emotional symptoms of depression include—
Anxiety
Brooding and obsessive rumination
Excess worry over physical health
Tearfulness

This list is far from exhaustive, but it represents the most common complaints. Many people are ashamed about voicing emotional complaints, worried about the stigma of “mental illness.” Some patients may not even realize that they are feeling “down.” It is incumbent upon the physician in such cases to be alert to the fact that physical symptoms may be caused by depression and to help the patient find appropriate treatment. If you or someone you care about is suffering in this way, try to be alert to this connection.

When both physical and emotional symptoms occur at once, full-blown depression can occur with symptoms ranging from lack of pleasure in normal activities to overall sadness and even to suicidal feelings and thoughts.

Once depression takes hold, it can be difficult to shake off, especially if it is causing physical symptoms. As I have written here earlier, it can also cause long-term physical damage to the brain if left untreated. While psychotherapy alone has been shown to bring about the reversal of these physical manifestations of depression, a combination of therapy may be indicated in such cases. It is NOT appropriate to prescribe medication alone, though unfortunately, that is more and more often the case. The very rare instances of serious or atypical side effects have been linked to this practice. Adequate supervision of drug treatment, as well as ongoing therapy to help the patient understand his symptoms and re-engage with life, is crucial.

In the meantime—by all means, exercise!

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  • ellen sue spier-jacobson October 9, 2014 at 4:41 pm

    I agree completely with your report. The problem that I see is that once someone is depressed, exercise is not a priority, so I think that your article indicates that preventing depression in the first place can be avoided by regular exercise.
    Since depression seems to run in my family, so I now can add avoiding depression as a benefit of exercising. Thanx!

    Reply