PHYSICAL ACTIVITY AND DEPRESSION

Background

Depression is a condition that is likely to affect every human being at some point in life. It manifests itself in various forms, which range from mild effects to those that impair mental performance. The latter form is the most noticed form and often chronic type of non-endogenous depression. Experts consider depression as a disease that could create a significant global burden than tuberculosis, cerebrovascular disease, or ischaemic heart disease. Cases of depression occur due to different causes among individuals of different age groups and gender. In childhood, depression can be a result of torture or bullying, while among older adults, depression can be caused by being neglected and alienation from friends and relatives, which often leads to loneliness. 

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Conversely, common causes of depression among adolescents and younger adults include depressive episodes, increased neuroticism, poor performance at work or in school, unemployment, or early parenthood. Even though the condition is treatable, when it affects an emotionally unstable person, it can cause suicidal feelings to the individual. Preventive methods are thus highly advised to the potential victims to limit the risk of developing into a more severe condition. Physical activity is commonly recommended for physiological and psychological health. Individuals who engage in physical activity regularly and less likely to fall into depression. Besides, most people relieve stress by engaging in vigorous activity to help them forget the stressing factors in their surroundings.

Hypothesis: physical activity helps in treating depression.

Literature Review

Data from the World Health Organization indicates that depression affects approximately 340 million people across the world. In the United States, data from the Center for Disease Control estimates that approximately 16% of the population will experience a major depressive disorder in their lifetime. Some research has shown that women are more prone to depression, while others differ, stating that both men and women have an equal likeness of becoming depressed, only that men will not show it as much as women do. However, most of the research document that the rate of engagement in physical activity is inversely proportional to the levels of depression among individuals. Physical activity and prevalence of depression have a negative relationship. Similarly, physical inactivity is associated with high prevalence rates of depression among individuals.

According to a study in 2003 by Goodwin using a sample of 8098 individuals in the United States, it was noted that regular physical activity, regardless of whether it occurred in the form of recreation or work, led to a significant reduction in cases depression. The relationship remained constant even after factoring in variations in sociodemographic characteristics and self-reported illnesses, among other factors. Another study conducted in 2006 by Galper and colleagues using a sample of 6728 Americans from across the country reported a negative relationship between physical activity and depressive symptoms. The team further noted the existence of a close relationship between depressive symptoms and sufficient activity as compared to insufficient activity. In addition, Palmore (1979), in his study of factors associated with successful aging, stated physical activity as one of the explanatory predictors.

Researchers seem convinced by the existence of a relationship between mental fitness and physical activity, which can be harnessed to provide an evidence-based solution to depression. However, efforts to determine the relationship between physical exercise and the severity of depression have not been successful yet. The relation may, however, be possible since depression seems to influence the morale to exercise, and thus depressed people rarely consider doing physical exercise. Similarly, exercise determines the prevalence of depression, such that individuals who engage in regular physical activity are less likely to become depressed. More studies are needed to confirm the relationship.

Analysis

The article on “Physical activity and depression in men: Increased activity duration and intensity associated with a lower likelihood of current depression” by Currier and colleagues shows that men who engage in more exercise had reduced likelihood of reporting moderate to severe depression as compared to men who participated in the insignificant exercise. The study associated a low prevalence of depression symptoms with increased physical activity (Currier et al., 2020). The study noted that significant limitations with the cross-sectional study designs, which made it difficult to establish the relationship between depression and motivation to exercise. Reports indicate that individuals with critical depression levels rarely take physical exercises, whereas healthy individuals are highly motivated to engage in physical activities. Even though the team investigated depression as a syndrome that contributed to the feeling, the nature of the study hindered further study to determine causality. Furthermore, although there is adequate data to prove the negative relationship between physical exercise and depression, there is little consensus regarding the intensity of the activity and the optimal duration that is considered beneficial (Currier et al., 2020).  

Conversely, in the literature “The association between physical activity and depression among individuals residing in Brazil,” it was noted that physical exercise might act as a mental health approach of controlling depression cases among members of a population (de Oliveira et al., 2018). Moreover, the study determined that there is no correlation between physical activity for leisure and depression among Brazilian males. The study aimed to evaluate the prevalence of depression levels and its association with physical exercise for leisure among individuals of different age groups in the population. It was noted that depression cases were highest among middle-aged female adults followed by female older adults and female, young adults, respectively (de Oliveira et al., 2018). In males, older adults had the highest rates, followed by middle-aged and young adults, respectively. 

Generally, older adults had the highest prevalence rates, which is consistent with previous studies to determine the association between age and depression. In the report, de Oliveira and colleagues found that physical exercise had a role in protecting individuals against depression and thus concluded that encouraging physical activity among individuals could serve as a mental health approach in controlling the prevalence of depression in a population. A second objective of the study was to determine the connection between physical activity for leisure and depression. The study established that leisure influenced depression levels among males only. The lack of a relationship between physical activity for leisure and depression among females could be caused by the fact that females in Brazil are busy most of their time since they participate in both the labour market and domestic activities, leaving them with little time for leisure. The events, however, expose them to indirect physical activity.

Conclusion and Recommendations

Exercise helps depression in two main ways. First, it releases endogenous cannabinoids and other natural brain chemicals that facilitate an individual’s sense of well-being. Secondly, physical activity takes people’s minds off their worries, keeping them away from the surrounding negative thoughts that enhance depression. Other ways in which exercise prevents depression is by providing confidence to individuals when they achieve the goals. Besides, getting in good shape also makes people confident in their appearance. Another benefit is that exercise gives an individual a chance to socialize, which promotes the individual’s mood.  

Individuals experiencing depression rarely think of physical activity as a remedy for the condition. However, exercise can be used as a preventive measure rather than a treatment measure. Exercise improves various health problems in the body of human beings, including high blood pressure, arthritis, and diabetes, all of which may cause suffering to a patient and force them into depression. Studies on depression, anxiety, and exercise have proven that physical activity also improves an individual mood. The motivation creates a vicious cycle since when individuals are in good moods, they get motivated, and motivation leads to more exercise.   

People should learn that structured exercise programs are not the only option of exercising. Engaging in simple activities like regular walking is an example of physical activity, and it helps to improve an individual’s moods. However, running, lifting weights, playing ball games, and other vigorous activities that require intensive use of energy is highly recommended when performed occasionally. To get started, individuals are advised to identify an activity that they enjoy doing and do it regularly. One can also talk to a professional, and together they can set reasonable goals. The next step involves analyzing one’s barriers and preparing for setbacks that may affect the process.

There exists inadequate information on the amount of exercise that is considered enough to control depression. But with the strong evidence indicating the strong of the intervention in preventing and managing depression, clinicians should recommend physical exercise to not only their patients but the society too. However, when recommending the intervention to patients, physicians should help the patients plan the exercising activity since depressed patients are less motivated to engage in physical activity. They should advise patients to choose activities that they are comfortable with at the start and graduate slowly to more vigorous activities. Lastly, clinicians should address the frequency of physical activity with their patients to ensure that the intervention is effective.

References

Currier, D., Lindner, R., Spittal, M. J., Cvetkovski, S., Pirkis, J., & English, D. R. (2020). Physical activity and depression in men: Increased activity duration and intensity associated with lower likelihood of current depression. Journal of affective disorders, 260, 426-431.

de Oliveira, G. D., Oancea, S. C., Nucci, L. B., & Vogeltanz-Holm, N. (2018). The association between physical activity and depression among individuals residing in Brazil. Social Psychiatry & Psychiatric Epidemiology, 53(4), 373–383.

Physical activity and depression in men: Increased activity duration and intensity associated with lower likelihood of current depression

Objectives

Depression is a significant public health issue for men, however men are less likely to use mental health services. Alternative interventions, such as physical activity, may be of value for this population. This study sought to determine what levels and intensity of physical activity are associated with lower depression prevalence in Australian men.

Methods

Using baseline data from 13,884 participants in the Australian Longitudinal Study on Male Health we compared current depression in men who completed the recommended 150 min of physical activity in the past week with men who did not. Duration of activity was examined using logistic regression with restricted cubic splines. Intensity of physical activity was examined by isotemporal substitution of hours of moderate activity with hours of vigorous activity.

Results

Men who completed at least 150 min/week of activity had lower odds of moderate/severe depression symptoms. Duration of activity was inversely associated with moderate/severe depression symptoms. Among physically active men, each additional hour of moderate activity replaced with vigorous activity was associated with lower odds of depression.

Limitations

This is a cross-sectional study and so cannot determine causal direction in the relationship between physical activity and depression symptoms observed. Self-report measures of physical activity are widely used but are not as accurate as biometric measurement.

Conclusions

In adult men, meeting minimum recommendations is associated with lower current depression. Increased duration and greater intensity of activity were both associated with further reduction in prevalence. Promoting higher levels of physical activity is potentially an intervention for improving men’s mental wellbeing.

The association between physical activity and depression among individuals residing in Brazil 

Purpose

 There is very limited literature investigating the association between physical activity (PA) and depression in South American countries such as Brazil. The purpose of the current study was to evaluate the prevalence of depression and its association with PA in a very large, representative sample of young adults (ages 18-39 years) (YA), middle-aged adults (ages 40-59 years) (MAA) and older adults (ages ≥ 60 years) (OA) residing in Brazil.

Methods

The sample for this cross-sectional study was based on the Brazilian National Health Survey conducted in 2013. The Personal Health Questionnaire depression scale (PHQ-8) was applied to measure current (past 2 weeks) depression as the outcome of interest, and the exposure was self-reported PA for leisure. Multivariable weighted logistic regression models were conducted to investigate the association between PA and depression while adjusting for socio-demographic characteristics and number of health comorbidities among YA, MAA and OA.

Results

 The final study sample size was 59,399 (33,480 females; 25,919 males). After adjusting for the covariates of interest, the lack of PA for leisure was associated with a significant increase in depression only among males (YA: OR 1.45, 95% CI 1.02-2.06; MAA: OR 2.38, 95% CI 1.40-4.03; OA: OR 5.35, 95% CI 2.14-13.37). There was no significant association between PA for leisure and depression among females of all age groups.

Conclusions

Although PA for leisure is not associated with depression among Brazilian females, the obtained results suggest that this association is significant among Brazilian males, who may be able to benefit from PA for leisure to reduce their symptoms of depression.

Key words

Brazil; Physical activity; Depression; PNS; National Health Survey

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