Exercise in the treatment of depression

Abstract

A large body of research supports the use of exercise as a treatment for depression across a wide range of ages and with special populations, such as pregnant women and women who suffer from postpartum depression. However, methodologic limitations have historically limited our ability to interpret and understand previous research findings, which in turn may have hindered acceptance of exercise as treatment for depressed patients. This review provides information on some of the most salient studies of exercise as a treatment for depression and highlights important methodologic issues that have limited this area of research. In addition, several ongoing studies that were designed to address these limitations are reviewed. These and future well-designed trials can better inform the field regarding the utility of exercise in the treatment of depression.

This is a preview of subscription content, access via your institution.

References and Recommended Reading

  1. 1.

    Simons A, McGowen C, Epstein L, Kupfer DJ: Exercise as a treatment for depression: an update. Clin Psychol Rev 1985, 5:553–568.

    Article  Google Scholar 

  2. 2.

    Mead GE, Morley W, Campbell P, et al.: Exercise for depression. Cochrane Database Syst Rev 2009:CD004366.

  3. 3.

    Lawlor DA, Hopker SW: The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. BMJ 2001, 322:763–767.

    Article  CAS  PubMed  Google Scholar 

  4. 4.

    Sjosten N, Kivela SL: The effects of physical exercise on depressive symptoms among the aged: a systematic review. Int J Geriatr Psychiatry 2006, 21:410–418.

    Article  PubMed  Google Scholar 

  5. 5.

    Larun L, Nordheim LV, Ekeland E, et al.: Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database Syst Rev 2006:CD004691.

  6. 6.

    Rush AJ, Trivedi MH, Wisniewski SR, et al.: A comparison of bupropion-SR, sertraline, and venlafaxine-XR following SSRI failure for depressed outpatients: a STAR*D report. N Engl J Med 2006, 354:1231–1242.

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Trivedi MH, Fava M, Wisniewski SR, et al.: Medication augmentation after the failure of SSRIs for depression. N Engl J Med 2006, 354:1243–1252.

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Dishman RK: Brain monoamines, exercise, and behavioral stress: animal models. Med Sci Sports Exerc 1997, 29:63–74.

    CAS  PubMed  Google Scholar 

  9. 9.

    Dunn AL, Reigle TG, Youngstedt SD, et al.: Brain norepinephrine and metabolites after treadmill training and wheel running in rats. Med Sci Sports Exerc 1996, 28:204–209.

    CAS  PubMed  Google Scholar 

  10. 10.

    Pagliari R, Peyrin L: Norepinephrine release in the rat frontal cortex under treadmill exercise: a study with microdialysis. J Appl Physiol 1995, 78:2121–2130.

    CAS  PubMed  Google Scholar 

  11. 11.

    Pagliari R, Peyrin L: Physical conditioning in rats influences the central and peripheral catecholamine responses to sustained exercise. Eur J Appl Physiol Occup Physiol 1995, 71:41–52.

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Chaouloff F: Effects of acute physical exercise on central serotonergic systems. Med Sci Sports Exerc 1997, 29:58–62.

    CAS  PubMed  Google Scholar 

  13. 13.

    Dunn AL, Dishman RK: Exercise and the neurobiology of depression. Exerc Sport Sci Rev 1991, 19:41–98.

    Article  CAS  PubMed  Google Scholar 

  14. 14.

    Meeusen R, De Meirleir K: Exercise and brain neurotransmission. Sports Med 1995, 20:160–188.

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    Wilson WM, Marsden CA: In vivo measurement of extracellular serotonin in the ventral hippocampus during treadmill running. Behav Pharmacol 1996, 7:101–104.

    Article  CAS  PubMed  Google Scholar 

  16. 16.

    Bailey SP, Davis JM, Ahlborn EN: Effect of increased brain serotonergic activity on endurance performance in the rat. Acta Physiol Scand 1992, 145:75–76.

    Article  CAS  PubMed  Google Scholar 

  17. 17.

    Dey S, Singh RH, Dey PK: Exercise training: significance of regional alterations in serotonin metabolism of rat brain in relation to antidepressant effect of exercise. Physiol Behav 1992, 52:1095–1099.

    Article  CAS  PubMed  Google Scholar 

  18. 18.

    Russo-Neustadt A, Beard RC, Cotman CW: Exercise, antidepressant medications, and enhanced brain derived neurotrophic factor expression. Neuropsychopharmacology 1999, 21:679–682.

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Altar CA: Neurotrophins and depression. Trends Pharmacol Sci 1999, 20:59–61.

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Siuciak JA, Lewis DR, Wiegand SJ, Lindsay RM: Antidepressant-like effect of brain-derived neurotrophic factor (BDNF). Pharmacol Biochem Behav 1997, 56:131–137.

    Article  CAS  PubMed  Google Scholar 

  21. 21.

    Greist JH, Klein MH, Eischens RR, et al.: Running as treatment for depression. Compr Psychiatry 1979, 20:41–54.

    Article  CAS  PubMed  Google Scholar 

  22. 22.

    McCann IL, Holmes DS: Influence of aerobic exercise on depression. J Pers Soc Psychol 1984, 46:1142–1147.

    Article  CAS  PubMed  Google Scholar 

  23. 23.

    Dunn AL, Trivedi MH, Kampert JB, et al.: Exercise treatment for depression: efficacy and dose response. Am J Prev Med 2005, 28:1–8.

    Article  PubMed  Google Scholar 

  24. 24.

    Blumenthal JA, Babyak MA, Doraiswamy PM, et al.: Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosom Med 2007, 69:587–596.

    Article  CAS  PubMed  Google Scholar 

  25. 25.

    Dimeo F, Bauer M, Varahram I, et al.: Benefits from aerobic exercise in patients with major depression: a pilot study. Br J Sports Med 2001, 35:114–117.

    Article  CAS  PubMed  Google Scholar 

  26. 26.

    Knubben K, Reischies FM, Adli M, et al.: A randomised, controlled study on the effects of a short-term endurance training programme in patients with major depression. Br J Sports Med 2007, 41:29–33.

    Article  CAS  PubMed  Google Scholar 

  27. 27.

    Veale D, Le Fevre K, Pantelis C, et al.: Aerobic exercise in the adjunctive treatment of depression: a randomized controlled trial. J R Soc Med 1992, 85:541–544.

    CAS  PubMed  Google Scholar 

  28. 28.

    Martinsen EW, Medhus A, Sandvik L: Effects of aerobic exercise on depression: a controlled study. Br Med J (Clin Res Ed) 1985, 291:109.

    Article  CAS  Google Scholar 

  29. 29.

    Trivedi MH, Greer TL, Grannemann BD, et al.: Exercise as an augmentation strategy for treatment of major depression. J Psychiatr Pract 2006, 12:205–213.

    Article  PubMed  Google Scholar 

  30. 30.

    Trivedi MH, Greer TL, Grannemann BD, et al.: TREAD: TReatment with Exercise Augmentation for Depression: study rationale and design. Clin Trials 2006, 3:291–305.

    Article  PubMed  Google Scholar 

  31. 31.

    Blumenthal JA, Babyak MA, Moore KA, et al.: Effects of exercise training on older patients with major depression. Arch Intern Med 1999, 159:2349–2356.

    Article  CAS  PubMed  Google Scholar 

  32. 32.

    Babyak M, Blumenthal JA, Herman S, et al.: Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months. Psychosom Med 2000, 62:633–638.

    CAS  PubMed  Google Scholar 

  33. 33.

    Mather AS, Rodriguez C, Guthrie MF, et al.: Effects of exercise on depressive symptoms in older adults with poorly responsive depressive disorder: randomised controlled trial. Br J Psychiatry 2002, 180:411–415.

    Article  PubMed  Google Scholar 

  34. 34.

    Kerse N, Falloon K, Moyes SA, et al.: DeLLITE depression in late life: an intervention trial of exercise. Design and recruitment of a randomised controlled trial. BMC Geriatr 2008, 8:12.

    Article  PubMed  Google Scholar 

  35. 35.

    Sanders CE, Field TM, Diego M, Kaplan M: Moderate involvement in sports is related to lower depression levels among adolescents. Adolescence 2000, 35:793–797.

    CAS  PubMed  Google Scholar 

  36. 36.

    Baumert PW Jr, Henderson JM, Thompson NJ: Health risk behaviors of adolescent participants in organized sports. J Adolesc Health 1998, 22:460–465.

    Article  PubMed  Google Scholar 

  37. 37.

    Johnson CC, Murray DM, Elder JP, et al.: Depressive symptoms and physical activity in adolescent girls. Med Sci Sports Exerc 2008, 40:818–826.

    Article  CAS  PubMed  Google Scholar 

  38. 38.

    Brown SW, Welsh MC, Labbe EE, et al.: Aerobic exercise in the psychological treatment of adolescents. Percept Mot Skills 1992, 74:555–560.

    Article  CAS  PubMed  Google Scholar 

  39. 39.

    Nabkasorn C, Miyai N, Sootmongkol A, et al.: Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms. Eur J Public Health 2006, 16:179–184.

    Article  PubMed  Google Scholar 

  40. 40.

    Kramer MS, McDonald SW: Aerobic exercise for women during pregnancy. Cochrane Database Syst Rev 2006: CD000180.

  41. 41.

    Polman R, Kaiseler M, Borkoles E: Effect of a single bout of exercise on the mood of pregnant women. J Sports Med Phys Fitness 2007, 47:103–111.

    CAS  PubMed  Google Scholar 

  42. 42.

    Koltyn KF, Schultes SS: Psychological effects of an aerobic exercise session and a rest session following pregnancy. J Sports Med Phys Fitness 1997, 37:287–291.

    CAS  PubMed  Google Scholar 

  43. 43.

    Armstrong K, Edwards H: The effectiveness of a pramwalking exercise programme in reducing depressive symptomatology for postnatal women. Int J Nurs Pract 2004, 10:177–194.

    Article  PubMed  Google Scholar 

  44. 44.

    Heh SS, Huang LH, Ho SM, et al.: Effectiveness of an exercise support program in reducing the severity of postnatal depression in Taiwanese women. Birth 2008, 35:60–65.

    Article  PubMed  Google Scholar 

  45. 45.

    Doyne EJ, Ossip-Klein DJ, Bowman ED, et al.: Running versus weight lifting in the treatment of depression. J Consult Clin Psychol 1987, 55:748–754.

    Article  CAS  PubMed  Google Scholar 

  46. 46.

    Sims J, Hill K, Davidson S, et al.: Exploring the feasibility of a community-based strength training program for older people with depressive symptoms and its impact on depressive symptoms. BMC Geriatr 2006, 6:18.

    Article  PubMed  Google Scholar 

  47. 47.

    Prochaska JO, DiClemente CC: Stages and processes of selfchange of smoking: toward an integrative model of change. J Consult Clin Psychol 1983, 51:390–395.

    Article  CAS  PubMed  Google Scholar 

  48. 48.

    Plotnikoff RC, Hotz SB, Birkett NJ, Courneya KS: Exercise and the transtheoretical model: a longitudinal test of a population sample. Prev Med 2001, 33:441–452.

    Article  CAS  PubMed  Google Scholar 

  49. 49.

    Marcus BH, Dubbert PM, Forsyth LH, et al.: Physical activity behavior change: issues in adoption and maintenance. Health Psychol 2000, 19:32–41.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Madhukar H. Trivedi.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Greer, T.L., Trivedi, M.H. Exercise in the treatment of depression. Curr Psychiatry Rep 11, 466 (2009). https://doi.org/10.1007/s11920-009-0071-4

Download citation

Keywords

  • Depressive Symptom
  • Major Depressive Disorder
  • Aerobic Exercise
  • Edinburgh Postnatal Depression Scale
  • Postpartum Depression