Depression: Could running be as effective as antidepressants?

  • Researchers from Amsterdam conducted a study to see whether running therapy could be as helpful as antidepressants for treating depression and anxiety symptoms.
  • The researchers found that both groups experienced similar improvements in their depression symptoms.
  • However, the running group also saw improvements in physical health, while the antidepressant participants experienced slightly worse physical health.

Many people experience depression, and sometimes it is situational or mild, which may not require treatment. However, other people experience depression to a more severe degree.

In the case of people with clinical depression, treatments that include psychological therapy and/or specific medications may be appropriate.

According to the National Alliance on Mental Illness, 8.3% of adults in the United States experience a major depressive episode every year. Additionally, the Centers for Disease Control and Prevention (CDC) report that 13.2% of adults take an antidepressant.

Since depression is so prevalent, scientists are interested in improving treatments. Researchers in Amsterdam wondered whether running could be as beneficial as taking an antidepressant.

To do this, the researchers recruited more than 100 people to participate in a study that compared the effects of running and antidepressants on improving depression and anxiety symptoms. Each group followed 16-week regimens of either participating in running therapy or taking an antidepressant.

After 16 weeks, the researchers found that both groups had similar improvements in their symptoms.

These findings were presented at the ECNP Congress in Barcelona, Spain, and appear in the Journal of Affective Disorders.

Boosting endorphins with physical activity

Depression and anxiety are both common mental health issues in the U.S. In addition to the impact these issues have on someone’s mental well-being, they can affect physical health.

Some of the physical health problems tied to depression include:

  • chronic joint pain
  • sleep disturbance
  • gastrointestinal problems
  • psychomotor activity changes.

Additionally, the American Heart Association reports that over time, chronic depression can lead to heart disease because of higher levels of cortisol.

The impacts on both mental and physical health make treating ongoing depression of utmost importance. Many doctors prescribe medications from antidepressant classes such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants.

Treating depression with medications is not the only option, though. Increasing physical activity can be beneficial by increasing endorphins, a chemical the body produces that boosts the mood.

With both the pharmacological treatment of depression and the fact that physical activity boosts endorphins in mind, the researchers in the current study wonder whether running therapy could be as beneficial as using an antidepressant.

Most participants chose running over antidepressants

The researchers recruited 141 participants with either depression or anxiety disorder. They gave the participants the option to take either an antidepressant — the SSRIs escitalopram or sertraline — or participate in a running group two to three times per week.

The participants had to agree to provide blood samples, undergo a psychiatric evaluation, and complete self-evaluations to assess their mental states. The mean age of the participants was 38.2 years, and 58.2% of the group were females.

Most participants chose running, and if a participant did not have a preference, the researchers assigned them to a group. Overall, the running therapy group had 96 participants, and the antidepressant group had 45 participants.

The running group participants had to attend two or three running sessions that lasted 45 minutes each week. The researchers expected them to complete at least 70% of the sessions, and participants wore heart rate monitors during running sessions so researchers could track their participation level and other data.

The researchers prescribed escitalopram (Lexapro) to the antidepressant group, but if they found it ineffective or participants did not tolerate it well, they switched to sertraline (Zoloft).

Both groups show improvement in depression symptoms

While most participants opted for running therapy, this group’s adherence to the treatment plan was lower overall. Of the participants, 82.2% of the people in the antidepressant group adhered to the medication protocol, while only 52.1% of people in the running therapy group completed the minimum required exercise sessions.

Regardless of which treatment plan people participated in, both groups saw improvements in mental health overall.

When comparing the participants’ depression symptoms at the beginning of the study to the end, 43.3% of the running therapy group saw their depression go into remission, and 44.8% of the antidepressant group experienced remission.

Participants in the antidepressant group saw improvement in their anxiety symptoms more quickly than people in the running group, but the end result at the end of the 16-week study was almost the same.

While both treatment plans were nearly identical in terms of depression improvement, the running therapy group saw improvements in physical health that the antidepressant group did not experience.

Participants in the running group experienced weight loss, improved lung function, reduced blood pressure, and reduced heart rate. The antidepressant group experienced weight gain and increased blood pressure.

“This study showed the importance of exercise in the depressed and anxious population and caution of antidepressant use in physically unhealthy patients,” write the authors.

Why running may not be effective for everyone

Dr. David Merrill, a geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center in Santa Monica, California, who was not involved in the current research, spoke with Medical News Today about the study.

“This is an important study,” Dr. Merrill began before explaining how antidepressants and running can impact the brain.

“Both antidepressants and running increase brain-derived neurotrophic factor (BDNF) in the brain. BDNF is an important neuroplasticity-enhancing molecule important in maintaining a normal mood,” he said.

Depressive states may lead to lowered levels of BDNF, which can be corrected by medications or exercise. Dr. Merrill said ideally, patients can try a combination for “synergistic benefits.”

“Brain-derived neurotrophic factor (BDNF) is like Miracle Grow for the brain; that’s one reason why regular physical movement is so important for brain health.”
— Dr. David Merrill

When Dr. Merrill elaborated on the study findings, he said he wished more people would have stuck with the exercise protocol.

“It’s disappointing to see how many dropped out of the exercise intervention. It’d be nice to know why so future interventions could be modified to increase the odds of successfully starting and maintaining a workout regimen to improve mood,” he said.

Dr. Ryan Sultan, a board certified psychiatrist, therapist, and professor at Columbia University in New York City, who was also not involved in the study, spoke with MNT about the findings.

“The topic of depression treatment has always been at the forefront of psychiatric discussions, and this new study offers intriguing insights into the comparative effects of running and antidepressants on treating this condition,” he said.

While Dr. Sultan found the study intriguing, he did note that there is not a “one-size-fits-all approach” to treating depression.

“While both running and antidepressants seem effective in treating depression, it’s essential to understand that every individual’s needs and responses can vary. It’s always crucial to consult with a medical professional before making decisions about treatment options.”
— Dr. Ryan Sultan

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