Depression Disentanglement

The tragic death of Robin Williams kindled a global conversation about depression. TED just released yesterday a playlist of talks on depression. Depression afflicts 121 million people worldwide (Discovery’s Curiosity.com). The horrible consequences of depression include diminished vitality at a minimum as well as suffering so intense that 100 million people commit suicide annually (Medical News Today). In the organizational setting, researchers suggest that depressed leaders are less likely to feel optimistic, resilient, self-confident, as well as less likely to adopt a transformational leadership style (Byrne, Dionisi, Barling, Akers, Robertson, Lys, & Dupré , 2014). To say depression is complex is a great understatement. Stunned and saddened by Williams’ death, I felt compelled to begin understanding what role exercise may or may not have in alleviating symptoms of depression. I share now the highlights of my search and its unexpected turn to a connection between exercise and stress.

Cooney, Dwan, Greig, Lawlor, Rimer, Waugh, McMurdo, & Mead (2013) conducted a meta-analysis of 39 studies with 2,326 total participants on depressive adults age 18 and older that were published up until March, 2013, to determine if exercise is an effective treatment. They mentioned NHS guidelines that recommend exercise as a treatment, and aimed to verify the reliability of this guideline. They specifically asked the following research questions:

  • Is exercise more effective than no therapy for reducing symptoms of depression?
  • Is exercise more effective than antidepressant medication for reducing symptoms of depression?
  • Is exercise more effective than psychological therapies or other non-medical treatments for depression?
  • How acceptable to patients is exercise as a treatment for depression?

Their findings suggest that exercise is modestly more effective than no therapy, but no more effective than antidepressants or psychological therapies for reducing depressive symptoms. The caveat is that the results regarding the effect of exercise compared to the use of antidepressants or psychological therapies were based on a small number of studies. The authors noted also that conclusions were inconclusive concerning a modest effect of exercise as better than no therapy when isolating the higher-quality studies. They recommend future research to examine what types of exercise may help people suffering from depression.

Wegner, Helmich, Machado, Nardi, Arias-Carrion, & Budde, (2014) also conducted a meta-analysis of 37 studies of 48,207 participants, and found the overall effects of exercise on anxiety were small. However, the effect of exercising on depression was significantly higher. They posit a neurobiological connection between exercise and depression.

My initial inquiry on the role of exercise to fight depression yielded inconclusive data. I was hoping to find stronger evidence in support of such a simple solution.

Although stress differs substantially from depression, it “can lead to depression in susceptible people” (Web MD). Evidence of a connection between exercise and stress reduction has been confirmed through research (Edenfield & Blumenthal, 2011). I agree with Lombardo’s view: “As a society, we do a pretty lousy job at managing stress effectively: over-eating, alcohol and drug abuse, excessive spending, hours in front of screens… these are all attempts at reducing stress to feel better. Unfortunately, they tend to add to stress rather than deter it” (Dr. Elizabeth Lombardo’s Blog). I suppose most of us are vulnerable to resorting to unhealthy behaviors, despite our knowing better. Many also understand the futility of self-destructive coping mechanisms. According to Edenfield and Blumenthal’s The Handbook of Stress Science: Biology, Psychology, and Health (2011), exercise does combat many stress-related problems, including phobias, anxiety bouts, and panic disorders, and with minimal risk of adverse consequences. Obviously, exercise is preferred over unhelpful stress-management strategies.

One participant I interviewed in my study is a manager of pharmaceutical researchers. As mentioned in my book Transformational Leadership and High-Intensity Interval Training, she uses exercise to deal effectively with stress. The following quote conveys the strength of her perceived benefits:

You know sometimes I do not want to go to the gym. I had a hard day and my brain is hurting; my body is aching. It is so much stress. But I know I have to go because I know after I’m done, I’ll feel so much better. I’ll feel this great sense of relief. I’ll feel this tension being tucked away and the only way I found to get rid of this heaviness and this excessive amount of stress that I’m under. Because what I do is very stressful, it is wonderful; it is helping mankind. It is developing wonderful medicines to cure people of diseases but there is a heavy burden with it. There are people dying out there that so you’ve got this heaviness with you, and the stress. And if you don’t get it out by exercise you’re not going to have enough energy to keep on doing what you need. So when I go and exercise, I feel this tremendous sense of wellbeing afterwards.

Her comments are consistent Edenfield and Blumenthal’s (2011) research. I wish I could advocate exercise as a simple solution for depression. I can, however, endorse the many benefits of exercise, including stress reduction. Perhaps exercise could be an effective early intervention to prevent depression among some people struggling to cope with stress. I hope the loss of Robin Williams will spur important research to advance the stock of knowledge of depression. I feel for the 121 million people who live with this debilitating condition.

References

Byrne, A., Dionisi, A. M., Barling, J., Akers, A., Robertson, J., Lys, R., … & Dupré, K. (2014). The depleted leader: The influence of leaders’ diminished psychological resources on leadership behaviors. The Leadership Quarterly, 25(2), 344-357.

Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, McMurdo M, Mead GE. Exercise for depression. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD004366. DOI: 10.1002/14651858.CD004366.pub6.

Edenfield, T. M., & Blumenthal, J. A. (2011). Exercise and stress reduction. The handbook of stress science: Biology, psychology, and health, 301-319.

Wegner, M., Helmich, I., Machado, S., Nardi, A. E., Arias-Carrion, O., & Budde, H. (2014). Effects of Exercise on Anxiety and Depression Disorders: Review of Meta-Analyses and Neurobiological Mechanisms. CNS & neurological disorders drug targets.

Copyright © 2014 Carol R. Himelhoch. All rights reserved.

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