Exercise or Pills for Depression? Study Finds Pros and Cons to Both

New research could complicate the narrative over using exercise to help with depression and other mental health issues. A study compared depressed and/or anxious people who joined a running program to those who took a course of antidepressants, and found that both groups experienced a similar level of mental health improvement after several months. Those who exercised did experience greater physical health benefits, but those taking antidepressants were much more likely to stick with the regimen the entire time.

The research, conducted by scientists in the Netherlands, is apparently the first of its kind to attempt a head-to-head comparison between exercise and antidepressants.

The experiment involved 141 patients diagnosed with depression and/or anxiety who sought care at an outpatient clinic. The patients were divided into two groups: one where patients attended group-based running therapy twice a week, or one where they took selective serotonin reuptake inhibitors (SSRI), a common class of antidepressants, with each program lasting for 16 weeks. The volunteers were asked if they were willing to be randomly assigned into these groups, and if not, picked the one they preferred. Most went with their upfront preference, and about two-thirds chose exercise.

By the end of the study period, about 44% of the volunteers in each group experienced a clear enough improvement in their symptoms to be considered in remission. But there were important differences between the two groups.

Those who exercised also lost some weight and had improved blood pressure and general heart function on average compared to before the study, for instance, while those taking antidepressants saw a slight weight gain and an increase in blood pressure. At the same time, only 52% of the participants in the running group fully adhered to the program, compared to 82% of those on antidepressants, despite exercise being the preferred choice for most.

The team’s results were published in February in the Journal of Affective Disorders and are set to be discussed this weekend at the annual meeting of the European College of Neuropsychopharmacology (ECNP).

The findings, according to study author Brenda Penninx, a professor and epidemiologist at Vrije University in Amsterdam, show that both exercise and antidepressants can have a place in helping treat depression and anxiety, though each come with their own unique set of considerations and challenges.

“Antidepressants are generally safe and effective. They work for most people. We know that not treating depression at all leads to worse outcomes; so antidepressants are generally a good choice.” said Penninx in a statement released by the ECNP. “Nevertheless, we need to extend our treatment arsenal as not all patients respond to antidepressants or are willing to take them.”

And while exercise can be an appealing alternative for lots of patients, the lower adherence rate seen in this study suggests that many people will need support to help them maintain their routine.

“Telling patients is to go run is not enough. Changing physical activity behavior will require adequate supervision and encouragement as we did by implementing exercise therapy in a mental health care institution,” added Penninx.

Past research has found that exercise, and particularly outdoor exercise, has benefits for our mood and brain health in general. A study earlier this year even found a link between regular exercise and higher pain tolerance. While getting active is undoubtedly good for overall health, it remains to be seen whether it can truly be a depression treatment. 

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