Paper Example on Depression Affects Millions - A Costly Mental Health Crisis

Introduction

One in ten adults in the US struggles with depression, meaning that millions suffer from the condition each year. It is estimated that about 17% of the US population will suffer from a major episode of depression at some point during their life. In the US, depression has been ranked as the leading cause of disability. Consequently, over 40 billion dollars are spent each year on medical treatment and lost work productivity due to the disease (Craft & Perna, 2014). Often, these patients only receive pharmacology therapy alone when they visit their primary caregivers. While antidepressants medication is a common method of treating this disease, pills are not the only way of dealing with depression. With so many people affected, it is critical to examine the effectiveness of other therapies, specifically exercise Studies show that regular exercise is also a very effective treatment method of dealing with the symptoms of depression. New evidence suggests that the addition of cognitive-behavioral therapies in treatment, specifically exercise, can improve outcomes for many of the patients suffering from depression. This research will demonstrate the positive impact of exercise in dealing with the symptoms of depression.

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Literature Review: Link Between Exercise and Depression

In the article "exercise for depression" Cooney et al. (2013) reveal in the background that depression is a common cause of mortality and morbidity worldwide. The article outlines that despite the availability of psychological therapy and antidepressants, some people simply prefer alternative approaches such as exercise in dealing with their depression. The study utilized 39 trial experiment composed of 2326 participants, with 37 providing effective data for meta-analysis (Dwan, 2013). Psychological and pharmacological trials provided the control experiments.

The study's reports indicated that exercise is moderately more effective than a psychological intervention for reducing the symptoms of depression. The study concluded that more research was required in future research on the types of exercises that could benefit people with depression as well as the number and duration of sessions that provide the most benefit. Besides, the study urged for further larger trials.

In the second study, Bridle et al. (2012) examine the effect of exercise on depression severity in older people. In the background, the study explains that the prevalence of depression among the elderly is very high and treatment is inadequate. Due to the amounting burden to public health, the examination of the effectiveness of exercise in dealing with depression has become a top priority (Bridle et al., 2012).

The study utilized a systematic review and meta-analysis of randomized control trials of exercise for depression. The results indicated that exercise was associated with significantly lower levels of depression severity. In conclusion, the authors outline that for older people who are diagnosed with clinically meaningful symptoms of depression, the prescription of exercise tailored to the ability of the individual will reduce the severity of depression.

Analysis: Physical Exercise and Management of Depression

Various theories have been put forward to explain the relationship between depression and exercise. One of the theories that explain this link is the endorphin hypothesis. The hypothesis predicts that exercise has a positive effect on depression because following an exercise, the release of endorphins increases. Endorphins are associated with a positive mood and an overall sense of well-being which is essential in the reduction in the symptoms of depression. It is worth noting that the diminished capacity to experience positive effects is one of the important distinguishing symptoms in the diagnosis of clinical depression.

It is believed that an increase in plasma endorphins is directly linked with chronic and acute exercise. Hence, apart from starting a cascade of biological effects that result in many health benefits including diabetes, lowering blood pressure, heart disease, and improved sleep, exercises release endorphin chemical that makes one feel relaxed and happy (Craft & Perna, 2014). The feeling of happiness has often been described by joggers as "runner's high."

It may also be that exercise is essential in treating depression because it serves as a distraction from depression thoughts and worries. Physical activities are believed to work better in the management of depression because they provide a higher level of distraction than introspective and self-focused activities such as the keeping of a journal. Exercise has been compared to such distracting activities as social contact, assertiveness training, and relaxation. As a result, the combination of the distractive nature of physical exercise and the release of endorphins is critical in managing depression.

Besides, the monoamine hypothesis suggests that exercise leads to an increase in the number of brain transmitters such as dopamine and serotonin that are diminished as a result of depression. Studies involving animals have demonstrated that physical exercises increase the availability of norepinephrine and serotonin in various regions of the brain. Scientists believe that low-intensity exercise sustained over a lengthy period of time triggers the release of neurotrophic proteins that cause nerve cells to grow as well as make new connections in the brain.

The improvement in the functioning of the brain makes one feel better. Neuroscientists have noticed that among people who are depressed, the hippocampus part of the brain is smaller (Harvard Health Publishing, 2019). The hippocampus is the brain region that helps in the regulation of an individual's mood. As a result, the exercises support the growth of nerve cells in this important part of the brain, thereby improving the connections between the nerve cells, ultimately relieving depression.

Scientists believe that the involvement in exercises act as depressants because they offer the perfect platform for a patient to realize that they possess the necessary skills to successfully complete a task. Often, depressed people feel inadequate to bring about the desired positive outcomes in their lives (Craft & Perna, 2014). Consequently, they find it hard to cope with the symptoms of depression, bringing about negative self-evaluation.

It is believed that exercise acts as an effective mode of enhancing self-evaluation because the person is able to feel that they possess the meaningful skills within them to cope and manage tasks. Hence, as the feeling of coping self-efficacy increases, the feelings of depression reduce. It is highly likely that a combination of sociological, psychological, and biological factors brought about by exercise lower the symptoms of depression.

Conclusion and Recommendation

As revealed, there is a strong link indicating that exercises bring about positive effects on the management of depression. As revealed, exercises are related to positive mood and an overall enhanced sense of well-being due to the release of endorphins. Besides, exercises cause an increase in the number of brain neurotransmitters that are usually diminished with depression. Apart from enhancing self-efficacy, it has been revealed that physical activity serves as a distraction from worries and depressing thoughts. This research recommends that physical exercise should be incorporated into the management of depression alongside psychotherapy and pharmacotherapy. Exercises should be tailored to the sociological, psychological, and biological aspects of the patient for the best outcome.

References

Bridle, C., Spanjers, K., Patel, S., Atherton, N., & Lamb, S. (2012). Effect of exercise on depression severity in older people: Systematic review and meta-analysis of randomized controlled trials. British Journal of Psychiatry, 201(3), 180-185. DOI:10.1192/bjp.bp.111.095174

Craft, L. L., & Perna, F. M. (2014). The Benefits of Exercise for the Clinically Depressed. Primary care companion to the Journal of clinical psychiatry, 6(3), 104-111. https://doi.org/10.4088/pcc.v06n0301.

Dwan, K. (2013). Exercise for depression. Cochrane Database of Systematic Reviews(9), 1-129. DOI: 10.1002/14651858.CD004366.pub6

Harvard Health Publishing. (2019, March 25). Exercise is an all-natural treatment to fight depression. Harvard Health Letter. Retrieved from https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression

Abstracts

Background

Depression is a common and important cause of morbidity and mortality worldwide. Depression is commonly treated with antidepressants and/or psychological therapy, but some people may prefer alternative approaches such as exercise. There are a number of theoretical reasons why exercise may improve depression. This is an update of an earlier review first published in 2009.

Objectives

To determine the effectiveness of exercise in the treatment of depression in adults compared with no treatment or a comparator intervention.

Search methods

We searched the Cochrane Depression, Anxiety, and Neurosis Review Group's Controlled Trials Register (CCDANCTR) to 13 July 2012. This register includes relevant randomized controlled trials from the following bibliographic databases: The Cochrane Library (all years); MEDLINE (1950 to date); EMBASE (1974 to date) and PsycINFO (1967 to date). We also searched www.controlled-trials.com, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform. No date or language restrictions were applied to the search.

We conducted an additional search of the CCDANCTR up to 1st March 2013 and any potentially eligible trials not already included are listed as 'awaiting classification.'

Selection criteria

Randomized controlled trials in which exercise (defined according to American College of Sports Medicine criteria) was compared to standard treatment, no treatment or a placebo treatment, pharmacological treatment, psychological treatment or other active treatment in adults (aged 18 and over) with depression, as defined by trial authors. We included cluster trials and those that randomized individuals. We excluded trials of postnatal depression.

Data collection and analysis

Two review authors extracted data on primary and secondary outcomes at the end of the trial and end of follow-up (if available). We calculated effect sizes for each trial using Hedges' g method and a standardized mean difference (SMD) for the overall pooled effect, using a random-effects model risk ratio for dichotomous data. Where trials used a number of different tools to assess depression, we included the main outcome measure only in the meta-analysis. Where trials provided several 'doses' of exercise, we used data from the biggest 'dose' of exercise and performed sensitivity analyses using the lower 'dose'. We performed subgroup analyses to explore the influence of the method of diagnosis of depression (diagnostic interview or cut-off point on scale), the intensity of exercise, and the number of sessions of exercise on effect sizes. Two authors performed the 'Risk of bias' assessments. Our sensitivity analyses explored the influence of study quality on the outcome.

Main results

Thirty-nine trials (2326 participants) fulfilled our inclusion criteria, of which 37 provided data for meta-analyses. There were multiple sources of bias in many of the trials; randomization was adequately concealed in 14 studies, 15 used intention-to-treat analyses, and 12 used blinded outcome assessors.

For the 35 trials (1356 participants) comparing exercise with no treatment or a control interventio...