Article written by Audrey Bélanger and Jessica Lecourt, interns at NeuroMotrix
Between 12 and 15% of Quebecers over the age of 15 have experienced a depressive episode during their lifetime. According to the World Health Organization (WHO), depression is defined as a common mental health disorder, which can be characterized by sadness and feelings of guilt.
The depressive state can result in a loss of interest or pleasure in daily activities and even in the leisure activities of the sick individual, the latter can also experience a decrease in his self-esteem, sleep and / or appetite disturbances or even a feeling of fatigue and lack of concentration. This non-exhaustive list of symptoms associated with depression provides insight into the impact of the disorder.
Depending on the number of symptoms and their severity, three degrees of severity are possible: mild, moderate and severe depression. People with depression find themselves in a state of mind that interferes with their work or leisure activities, their studies and their social relationships. Carrying out their activities of daily living becomes difficult; even the simplest tasks can become impossible to perform.
During an episode of depression, those affected experience such a loss of interest and pleasure in their usual activities that they also lose motivation to participate in physical activity. They often become more sedentary, which has deleterious effects on both their mental health and their physical condition. While these people are even less inclined to move than usual, they are among those who could benefit the most from it.
Indeed, it has been shown in numerous scientific studies that physical activity is an effective treatment for depressive disorders.
There are several beneficial effects of physical activity on depression, here are just a few:
Professor Paquito Bernard of the University du Québec à Montréal, a researcher specializing in the effects of activity on mental health, says that being active improves the health of people living with depression [i]. He reports a meta-analysis published in 2018 which shows that physical activity has a protective effect among different age groups, both in adolescents, adults and the elderly [ii]. In fact, the protective effect is also effective on people with genetic predispositions that make them more vulnerable to depression [iii]. Several studies find a high correlation between the level of physical activity and the reduction in the intensity of symptoms induced by depressive disorders, a phenomenon which is observed in all degrees of severity of the disease.
Despite knowledge about it, physical activity is not commonly prescribed as an intervention for people who are experiencing a depressive episode. Indeed, the current medical approach does not necessarily prioritize the practice of physical activities, since pharmacological treatment and psychotherapy are almost always offered as first solutions. Also, it is common to observe a certain reluctance towards its practice among the most vulnerable people. However, physical activity, when practiced properly, can be easily adapted to everyone’s health condition, and thus provide significant benefits.
Physical activity is an affordable and inexpensive treatment. It can take different forms and be practiced at different levels of intensity. Thus, it individualizes very well to individual preferences. Indeed, physical activity takes many forms, including physical exercise, sport, recreation, household chores, active transportation, etc. It is wrong to think that only structured exercises, practiced in a fitness center for example, or sports themselves, such as skiing, badminton or basketball, provide benefits. You should see physical activity as any movement that increases energy expenditure. Simply walking out for shopping or parking your car farther away to walk a little more is considered a physical activity. Gardening, cleaning, walking with the dog, are also active times of the day. It is important to identify activities that provide some pleasure, this is the most important! Each active period counts, you just need to increase the frequency and duration gradually to reap the benefits.
The recommendations proposed in the scientific literature differ according to the severity of the depressive disorder [iv] – [v], but, in general, the duration of the intervention program should be between 10 and 16 weeks. The program can include aerobic exercise, which calls for cardiovascular capacity, or strengthening. Examples are walking, yoga, dancing or weight training. The emphasis should be on activities that are enjoyable for the person concerned. For moderate depressive disorder, two sessions of 30 to 45 minutes per week are recommended, with an intensity varying between 50 and 75% of the maximum heart rate or 80% of the maximum repetition. For severe depressive disorder, three sessions of 45 to 60 minutes per week are recommended, with an intensity left free. However, this should gradually increase. These recommendations are for management as a treatment for depression. Keep in mind that physical activity should be considered a long-term commitment, and ending a 10-16 week program alone is not enough to prevent future episodes of depression. To maintain the long-term benefits, it is essential to continue the practice.
According to the Canadian Network for Mood and Anxiety Treatments (CANMAT), physical activity should be the first treatment to be recommended in the management of mild to moderate depression. In cases of severe depression, physical activity is rather recommended as a complementary treatment to other interventions, whether pharmacological or psychological. Since its practice is scientifically proven to be a beneficial treatment for reducing symptoms of depression, and in addition to offering many other benefits for overall health, physical activity should be at the heart of interventions.
[i] Bernard, Paquito. (25 février 2021). Mouvemental – Journal étudiant de kinésiologie et des sciences de l’éducation physique. L’activité physique dans le traitement des troubles dépressifs. [Vidéoconférence].
[ii] Schuch, F. B., Vancampfort, D., Firth, J., Rosenbaum, S., Ward, P. B., Silva, E. S., … & Stubbs, B. (2018). Physical activity and incident depression: a meta-analysis of prospective cohort studies. American Journal of Psychiatry, 175(7), 631-648.
[iii] Choi, K. W., Zheutlin, A. B., Karlson, R. A., Wang, M. J., Dunn, E. C., Stein, M. B., … & Smoller, J. W. (2020). Physical activity offsets genetic risk for incident depression assessed via electronic health records in a biobank cohort study. Depression and anxiety, 37(2), 106-114.
[iv] Rethorst, C. D., Wipfli, B. M., & Landers, D. M. (2009). The antidepressive effects of exercise. Sports medicine, 39(6), 491-511.
[v] Perraton, L. G., Kumar, S., & Machotka, Z. (2010). Exercise parameters in the treatment of clinical depression: a systematic review of randomized controlled trials. Journal of evaluation in clinical practice, 16(3), 597-604.