Depression and the Benefits of Pressing RESET
Feb 15, 2021
And now, a guest article by OS Clinician, Dr. Kurt Brooks...
Let’s start with what we know… Depression sucks!
Depressive disorders are found in most cultures, affecting between 15-20% of the population. Workdays lost due to depression is estimated at $1.15 trillion US dollars globally ($40 billion annually in the US alone!) and is expected to double in the next 10 years. Symptoms of depression include low mood, decreased interest or pleasure in most or all activities, decreased motivation, increase or decrease in appetite, insomnia or hypersomnia, agitation, fatigue, cognitive impairments such as memory deficits, and suicidal thoughts.
Most commonly, treatment focuses on psychotherapies and antidepressants. The effectiveness of psychological therapies is unclear, though, and antidepressants only help roughly 50% of patients Then there’s the issue of drop-out rates of people taking antidepressants due to side effects, which ranges from 15-35%! Side effects of antidepressants can include weight gain, diabetes, and sexual dysfunction.
There is a growing body of evidence that people with depressive disorder present with substantially poorer health, including increased prevalence of metabolic disorders, diabetes, cardiovascular disease, and premature mortality (by 10 years, compared to the general population). In the same growing body of evidence though, is the recognition that physical activity and exercise can contribute to preventing or treating depressive symptoms and improving quality of life. Physical activities include any activity that works your muscles and requires energy (including housework, gardening, washing your car, etc.). Exercise, on the other hand, is a planned and structured movement session to improve or maintain physical fitness, including gym activities and sports.
Studies in the US, Brazil, Japan (and 33 other countries!) have shown associations between lack of physical activity and depression. Those who engaged in less than 150 minutes of moderate to vigorous physical activity each week experienced higher levels of depression than those who were more active. Further analysis of the research shows a decreased risk of depression of about 22% across age, sex, and nationality for those who engage in 150+ minutes of moderate to vigorous physical activity per week. That’s “physical activity”, not just exercise!
But how much exercise do I need to do at any given session? People suffering from depressive disorders can see benefit from a single bout of exercise! A 20-minute cycling session (of ANY intensity: light, moderate or hard) has been shown to decrease depressive symptoms at 10 minutes and 30 minutes after the exercise. Sticking with an exercise routine has long-reaching benefits, too.
Research has shown that the beneficial anti-depressive effects of a 12-week exercise routine can last for up to 12 months! The type of exercise, whether aerobic or anaerobic, doesn’t seem to matter. Walking and weight lifting were both equally beneficial in reducing depressive symptoms. Exercise is not a panacea though, and should not be done in place of seeking professional help.
Since no one treatment can help everyone, is there any way to know who can benefit from exercise the most? Well, there are some factors that can help predict who would respond better to exercise. These can be summarized into four categories:
1. Biological factors include those with higher levels of BDNF, Interleukin-1B, and tumor necrosis factor-alpha. These are markers found in inflammatory and oxidative stress reactions, which are found to be higher in depressed people. These markers have led to theories that the anti-inflammatory and anti-oxidative effects of exercise are partial reasons for its benefit with depressive symptoms.
2. Clinical factors include those with higher functioning levels; those with more physical symptoms; those with higher cardiorespiratory fitness. Regular physical activities such as walking or running, strength training, and Pressing RESET, can certainly help with these factors!
3. Psychological factors include those people with higher self-esteem. Staying physically fit and mobile can certainly help with one’s self-esteem, too!
4. Social factors include those with social support. So, find a workout group or buddy to have fun with and to keep yourself accountable. Men suffering from depression symptoms (sorry ladies!) also tend to respond better to exercise than women.
How do we keep people exercising when the exercise drop-out rates for people with depression are about 18%? (The drop-out rate for psychotherapies is about 19% and antidepressants is 26-28%.)
Strategies for improving exercise adherence may include allowing people to choose their own intensity level and adapting the exercise routine to improve the client’s autonomous motivation or each person’s reason for exercising (just liking to exercise, finding it challenging, etc.). Written exercise prescriptions, supported by calls and face-to-face meetings have also been shown to improve physical activity levels in depressed people. Supervision by trained exercise professionals has been shown to be a protective factor against drop-out in depressed people.
The American College of Sports Medicine has recommended that all adults should exercise at a moderate to vigorous intensity 5-7 days per week. This may be overwhelming to a sedentary, depressed person. The research, though, shows that 20 minutes of moderate exercise, 3x per week, is sufficient to significantly decrease symptoms of depression, so this may be a better starting place for this population.
So could Original Strength help with depression?
Original Strength is first and foremost a movement system. But let’s take a look at how the movements in Original Strength might be helpful when dealing with depression.
We breathe with the diaphragm to help regulate the nervous system, to help regulate blood gasses and to help stabilize the spine. Deep diaphragmatic breathing has also been demonstrated to help relieve inflammatory conditions by decreasing cortisol and pro-inflammatory cytokines. As noted earlier, research has shown elevated levels of inflammatory markers in depressed people.
We regulate the vestibular system through head and eye movements. We engage the neuro-musculoskeletal systems through rocking, segmental rolling, crawling, and more. Research has shown a high rate of correlation between depression and anxiety with vestibular disorders. Pressing RESET on a regular basis can help keep the vestibular system functioning at its best.
We activate both hemispheres of the brain by performing motions that cross the midline. All of these are meant to Press RESET – to improve neuromotor input into the brain so the brain can feel safer, thus allowing the body to move better. As noted above, just a few minutes of moving (Pressing RESET) can give almost immediate help with depressive symptoms. And regularly moving (Pressing RESET) can have long-lasting implications for the management of depression-related symptoms and overall physical health.
So, OS may be quite helpful in helping those who deal with depression. And that is quite hopeful. But remember, moving is not a panacea. While it can be very helpful and hopeful, it may work best alongside the help of a mental health professional.
Kurt Brooks, DPT
Kurt is a physical therapist with almost 30 years experience. Working with orthopaedic and sports medicine injuries, he continues to build on his love of learning - from completing a manual therapy fellowship, earning an advanced doctorate in Physical Therapy, to teaching at the Duke University School of Medicine/ Department of Physical Therapy.
His love of movement has evolved from participating in all major sports during his childhood and playing college-level volleyball, to attaining his 2nd-degree black-belt in Tae Kwon Do and challenging himself with Spartan races in time for his 50th birthday. He continues his love of anatomy and biomechanics, of life-long learning, of caring for others, and of movement by incorporating Original Strength concepts into his clinical practice and daily life.
The Role of Exercise in Preventing and Treating Depression, by Felipe Barreto Schuch PhD and Brendon Stubbs PhD, published in Current Sports Medicine Reports (August 2019, Volume 18, Issue 8, pp 299-304).
The Benefits of Exercise for the Clinically Depressed, by Linda Craft PhD and Frank Perna PhD, published in The Primary Care Companion to the Journal of Clinical Psychiatry (2004, Volume 6, Issue 3, pp 104-111).
Deep Diaphragmatic Breathing: Neurobiological and Anti-inflammatory Effects. Giuseppe Maniaci, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone Palermo. https://clinicaltrials.gov/ct2/show/NCT04102813
Anxiety and Depression Among People with Different Types of Vestibular Peripheral Vertigo. Qing Yuan MD et al. Medicine. 2015 February. Vol 94. Issue 5. E453.