There is a huge psychological component to exercise, especially running. “Running…is a form of natural psychotherapy. It stimulates the unconscious and is a powerful catalyst to the individual psyche”- The Joy of Running(1978) – Thaddeus Kostrubala. Running can help us calm our thoughts as we experience more balance, worry less, and sleep better. Running encourages mindfulness and flow. Given that antidepressant medications can sometimes lead to weight gain, running therapy might be a game-changer for folks dealing with depression and anxiety.
A recent study published in the Journal of Affective Disorders compared the effects of running therapy and antidepressant medications on the mental and physical health of patients with depression and anxiety disorders and found that both had similar effects on remission and response rates. Moreover, running therapy outperformed antidepressants in physical health, due to both larger improvements in the running therapy group as well as larger deterioration in the antidepressant group.
What is running therapy?
Running therapy is the (therapeutic) use of a slow endurance run under the guidance of a running therapist. It is an additional form of treatment for people with psychological problems. It is a form of therapy in which you are physically active, but the effects will be mainly felt on a psychological level. It is primarily about running, and finding the right running rhythm where talking is subordinate to running.
Moreover, breathing is important. Better blood circulation results in better breathing, which increases the exchange of oxygen and carbon dioxide in the blood. You feel better mentally because of this. Running is built up very gradually, so prior experience is not required. The distance will increase during the therapy until a level of relaxed endurance running of at least 30 minutes is reached. The most crucial factor is simply enjoying movement!
Comparing antidepressant medications and exercise therapies
Depressive and anxiety disorders cause immense suffering by compromising both mental and physical health, and the need for effective treatment strategies continues to be pressing. In addition to psychotherapy, antidepressant drugs are regarded as a conventional first-line treatment with modest effectiveness and adequate tolerability. Antidepressants frequently have negative effects and are not always helpful for everyone.
Exercise therapy is a fascinating alternative therapy. Meta-analyses revealed that the effectiveness of exercise interventions for mild to moderate depression is comparable to that of antidepressant drugs and psychotherapy, while exercise interventions appear to be an effective adjunct therapy for severe depression.
Antidepressant medication and exercise are contrasting interventions
Antidepressant medication and exercise are two distinct types of therapies on the psychosocial and behavioural levels. Patients on antidepressants must take their prescribed medications as directed, however, this typically has a little direct effect on daily behaviours. Encouraging people to get outside, set personal objectives, increase their fitness, and take part in social activities, and exercise, in contrast, directly targets the sedentary lifestyle frequently observed in individuals with depression and anxiety disorders.
Antidepressant medications and exercise therapies have been demonstrated to influence neurobiological and physiological pathways. For instance, it has been demonstrated that exercise lowers oxidative stress, inflammation, cortisol, and dysregulation of the metabolic syndrome.
Need to understand the impact of antidepressants and exercise on physical health
Determining which treatments protect physical health might help prevent or lessen such morbidity because people with depression and anxiety disorders have a greater risk of a variety of physical ailments such as cardiovascular disease, diabetes, and obesity. Additionally, it might reveal methods to spot patient subgroups with certain biochemical dysregulations who might benefit more from antidepressants or physical activity, which would ultimately aid with individualized care.
Researchers looked at 141 patients with depression and/or anxiety disorders who were randomly assigned to receive either escitalopram or sertraline antidepressants for 16 weeks or group-based running therapy for two weeks.
Among the 141 individuals, 96 got running treatment, and 45 received depressive medication.
Running Therapy intervention
For 16 weeks, running treatment involved supervised 45-minute outdoor runs. It was hoped that people would attend these fitness programs two to three times a week.
The running therapist talked about previous exercise experiences and gave advice on nutrition, moisture balance, exhaustion, injuries, sleep, and recuperation at the start of the running intervention.
A qualified staff member led the running sessions, which included a 10-minute warm-up exercise period, and 30 minutes of jogging at a pace that kept the heart rate within the designated training range (starting in the first 4 weeks at 50-70% of heart rate reserve and in the following 12 weeks at 70-85% of heart rate reserve), and a 5-minute cooling-down exercise period.
Both antidepressants and running therapy give similar results on mental health outcomes
First, the results for mental health were similar for both therapies. In the medication group, 45% of patients, compared to 43% in the running group, no longer had a DSM-IV-based depression or anxiety disorder after 16 weeks. Also, there was no difference in 50% response rates between the therapy groups.
Second, intention-to-treat analyses revealed that the running therapy group had better results than the control group in terms of changes in physical health, including weight, waist circumference, systolic and diastolic blood pressure, heart rate, and heart rate variability.
Additionally, the rates of remission and impacts on levels of self-reported depression and anxiety are comparable across antidepressant drugs and exercise.
Compliance in running therapy is essential
14 individuals (15%) did not begin the running therapy intervention, demonstrating how crucial—but difficult—it is to encourage adherence right away. It is likely that higher compliance levels could result in larger effect sizes, emphasizing the significance of increasing exercise therapy motivation, sustainability, and compliance.
Running therapy had more favourable outcomes
The study concluded that while the effects of antidepressant medication and running therapy on a sample of patients with depression and anxiety disorders were not statistically significantly different, the effects of the interventions on several physical health outcomes were significantly different and frequently contradictory, with better results for those who participated in the exercise intervention.
Together, the heart rate variability of antidepressant users decreased as their waist circumference, blood pressure, and triglyceride levels increased, suggesting a greater prevalence of metabolic syndrome and a higher risk of cardiovascular disease. The metabolic syndrome components and heart rate of the running group both decreased, indicating preventive effects against cardiovascular events.
Overall, this study demonstrated the value of exercise in the depressed and anxious population and the need for prudence when prescribing antidepressants to individuals who are physically unfit. Due to its positive effects on both mental and physical health, exercise therapy is a beneficial choice in mental health care and ought to be regarded as routine treatment for people with anxiety and/or depressive disorders.
Help is here:
Name of the Organisation: Maitri
Maitri is a Mumbai-based support group for those suffering from a mental illness, and their families. For over a decade, they’ve worked with patients living with schizophrenia and bipolar disorder and organized weekend meetings.
Contact: Ms. Samrin Shaikh: (022) 2683 8895, Harish Shetty: (022) 2683 8895 / 26840720