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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GPA and the Gym

On July 10, 2014, MSU posted a press release concerning the research of James Pivarnic and Samantha Danbert, which found that MSU freshman and sophomore students who belonged to the university’s recreational sports and fitness center earned higher GPAs than non-participating students. The two-year retention rate, which measures students who persist in their studies, was higher for the athletic participants as well, by 3.5%. Put in another light, that retention rate on a population of 49,000 students suggests that 1,575 more students would progress from their sophomore to their junior year in college because they participate in exercise at the university’s athletic facility (http://msutoday.msu.edu/news/2014/want-a-higher-gpa-in-college-join-a-gym/).

The findings are consistent with higher-education research conducted over three decades by Ernest Pascarella and Patrick Terenzini (2005), who are famous for their work on how students are affected by their college experiences. Their research uncovered an association between academic success and connectedness to the college or university. In other words, the more involved students are in activities at the college or university, the greater is their academic success. The recent MSU study explores physical activity in a campus community, which is provided through the institution’s athletic center.

Two dimensions caught my attention. First is the notion that academic success is enhanced by physical exercise. The study did not explore whether or not there was a mind-body relationship. Rather, it looked at summative (end-results) data. Those who exercised persisted in college and earned higher GPAs than students who did not exercise at the athletic center. I see a possible research project here. As a layperson, I always believed that the mind is part of the body. Like any muscle, oxygen, the blood and all its helpful nutrients will circulate to the mind when the individual exercises. As all of the body’s systems and components improve with exercise, it is logical that the mind grows stronger as well. A fit mind has the stamina to focus on learning. Moreover, the discipline required to complete a workout transfers over to one’s studies. The student’s brain is better prepared for mental exercise; the student’s dedication to a disciplined study routine is trained indirectly through the physical workout regimen. At least, that is how I perceived my body to work when I exercised while attending college.

The second dimension is the role of community. Pascarella and Terenzini’s research demonstrates the power that belonging to a community has in affecting student retention. “Community” can take many forms. It can be a student club or organization, working collaboratively with other students on projects, interacting with and developing relationships with faculty, belonging to a fraternity or sorority, holding a job on campus, and so forth. The source of the community is not as important as the effect. Regardless of the source, student retention tends to improve when belonging to a community. Pivarnic and Danbert’s research shows the positive effects of belonging to a student athletic community in particular.

The community dimension is something I experienced firsthand when I started working out in a CrossFit® gym in 2005. The high-intensity workouts were (and still are) intensively grueling. The fact that I was not alone in pushing myself to my limit kept and is what keeps me going. When I’m working out in an instructor-led class with others, the instructor pushes us; the fact that others persist in the workout also pushes us to keep going. It is almost as if we are in a battle together; however, that battle is within ourselves. When working out, we are so focused on what we are doing that we tend to “zone out” everything around us. However, when we’re done, we feel proud of what we accomplished, and share a bond in knowing we shared the challenge of completing such an intense experience together. I often feel that if I can complete a HIIT workout, I can complete almost anything to which I set my mind. I feel proud of myself and happy for the accomplishments of those who “suffer” with me. I also have a better understanding of my limitations. Knowing those, I have developed confidence that I can overcome my limitations with practice and self-discipline.

My book Transformational Leadership and High-Intensity Interval Training explored this sense of accomplishment within community among a population of CrossFit® athletes who are organizational leaders. I was gratified to see certain hunches validated through my exploratory study. These leaders found mind-body connections between their high-intensity athletic training and their approaches to leadership. Achievement within a community was motivating and inspirational to them. Their love of community spills over to their leadership style. They consider their employees teammates. The leaders who participated in my study are successful in their careers. I can’t help but wonder if there is a parallel between the research of Pivarnic and Danbert among college freshmen and sophomores and organizational leaders. Both groups are athletes who belong to a community, and both are successful in their respective contexts. Perhaps this is a question I will add to the many other suggestions for future research that I proposed in my book.

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