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Centre4activeliving.ca

AUGUST 2007
Mental Health: Yet Another Reason to
Promote Physical Activity
Guy Faulkner, PhD, assistant ProFessor, exercise PsycholoGy unit, Faculty oF Physical eDucation anD health, university oF toronto.
What's in This Article for You?
billion annually in treatment, medication, This article focuses on the following main topics: lost productivity and • The impact of depression, both on individuals premature death (Stephens and on society as a whole.
& Joubert, 2001). • The role of physical activity in preventing and Medication and/or talking therapies are the front-line • How much physical activity people need to treatment strategies for benefit their mental health.
depression. However, many people do not seek treatment, or wait too long to • Bridging disciplines: The need for dialogue receive treatment. between physical activity and mental health professionals. Health professionals can never fully meet the need for treatment in mental health care. It's also useful The Impact of Depression
to look at other strategies that could reach a broader Depression is one of the most common mental population who can't access therapy or prefer not health disorders in Canada. Almost 11 per cent to use medication. There's growing evidence for the of Canadians may experience a major depressive role of physical activity in preventing and treating disorder over the course of their lives (Patten et al., 2006). Worldwide, depression is the leading cause of years lived with disability. People with depression also experience significant distress and a reduced "Almost 11% of Canadians may experience quality of life (Uston et al., 2004). Depression also has an economic impact. A a major depressive disorder over the course Health Canada study suggests that depression of their lives" (Patten et al., 2006).
and distress cost Canadians at least $14.4

WellSpring
Preventing Depression
At least five studies show that physical inactivity
increases the likelihood of developing clinically
defined depression (Department of Health, 2004).
These studies involve large numbers of people and
measure physical activity levels before depression.
For example, Camacho and colleagues (1991) linked
inactivity and depression in a large population in
Alameda County, California. This study group
provided baseline data in 1965 and were followed up
in 1974 and 1983.
The study categorized people's physical activity levels
as low, medium or high. In the first follow-up (1974),
the odds ratios (OR) of developing depression were
significantly greater for both men and women who
had been low active in 1965 (OR 1.8 for men, 1.7
for women) compared to those who were high active.
Blumenthal et al. (1999) compared the effects of Low active men and women were nearly twice as exercise treatment and drug treatment in a sample of likely to develop depression in comparison to high older adults. In this study, 156 men and women with active men and women.
a major depressive disorder were randomly assigned to one of three treatment groups: How active should people be to help prevent depression? Data from a study of middle-aged • An exercise group consisting of three supervised Australian women showed that physical activity at exercise sessions (30 minutes of continuous cycle levels below the currently recommended guidelines ergometry or brisk walking/jogging at 70–85% (i.e., about 60 to 150 minutes of moderate activity heart rate reserve) per week for 16 consecutive per week) may help prevent depression (Brown et al., • Antidepressant therapy (using sertraline).
• Combination of exercise and antidepressants. After 16 weeks, all groups showed significantly The role of exercise in treating depression has perhaps reduced symptoms of depression (there were no received the most research attention. An analysis of significant differences across groups). 14 randomized controlled trials reported an effect size of 1.1 (Lawlor & Hopker, 2001) for exercise A 10-month follow-up (Babyak et al., 2000) found compared to no treatment for depression. The that improvements continued for at least six months analysis also showed that the effects for exercise were after the treatment ended. Self-reported participation similar to those found from other psychotherapeutic in exercise during the follow-up period was inversely related to the incidence of depression at 10 months. Each 50-minute increase in exercise per week was These results indicate that depression scores associated with a 50 per cent decrease in the odds of decreased by approximately one standard deviation being classified as depressed. more in the exercise groups than in comparison groups. For example, studies using the Beck A recent study on a smaller scale also found that the Depression Inventory (scores on this inventory can effects of exercise were comparable to sertraline in vary between 0 and 63) showed just over a seven-point treating minor depression (Brenes et al., 2007). difference in final depression scores in favour of the Overall, exercise is effective in treating clinical exercise group compared to a control group.
depression and might be as successful as August 2007
psychotherapy or medication (Department of Health, is nearly three times longer than recommended by 2004). specialists (Esmail & Walker, 2005). A dialogue across disciplines could start by considering a role for physical How Much Exercise Is Enough?
activity professionals during this delay in specialist Current physical activity guidelines of 30 minutes of moderate physical activity on most or all days of the week can both help prevent and treat depression. Useful Links
A recent study found that this amount of exercise • Alberta Centre for Active Living. The centre's was an effective treatment for mild to moderate "Mental Health" website section contains a wide depression (Dunn et al., 2005). It's important to variety of resources on physical activity and mental recommend a range of exercise types and intensities based on the participant's previous exercise experiences, personal preferences, and strengths and goals. O'Neal and colleagues (2001) provide an excellent set of recommendations for supervising Included in this section are the podcasts and exercise training for people with depression.
other information from a 2006 centre workshop that brought physical activity and mental health While there are some methodological concerns with professionals together in Alberta. the existing evidence, there is consistent evidence that physical activity has a role to play in preventing and treating depression. • At least five a week: Evidence on the impact of physical Because physical activity helps improve important activity and its relationship to health. A report from aspects of physical health (such as obesity, the Chief Medical Officer. This document from the cardiovascular fitness, and hypertension), promoting U.K. sets out the latest research on the benefits of physical activity as a way to tackle depression is a physical activity for health, including a chapter on "win-win" situation, with both physical health and physical activity and mental health. potentially antidepressant benefits (Faulkner & Taylor, 2005). Physical activity may not be a panacea The document is for those concerned with forming for depression, but people may find it useful either policies or programs to promote physical activity, as a self-help strategy or in addition to other forms of sport, exercise and active travel. Physical activity and mental health professionals need to develop partnerships to provide physical activity • Canadian Mental Health Association. The opportunities for people to benefit from this broad- Canadian Mental Health Association promotes based form of intervention. the mental health of all and supports the resilience and recovery of people experiencing mental illness. The total waiting time for psychiatric treatment The CMHA accomplishes this mission through in Canada can be as much as five months, which advocacy, education, research and service. http://www.cmha.ca studies sho�� • Mind guide to physical activity. Mind is a mental health charity in England and Wales. Mind has inactivity increases the likelihood of produced a series of self-help booklets, including developing clinically defined depression" one on physical activity. http://www.mind.org.uk/Information/Booklets/ (Department of Health, 2004).
Mission Statement
WellSpring • August 2007
of the Alberta Centre for
Active Living
Working with practitioners, organizations, and communities to improve the • Babyak, M., Blumenthal, J.A., Herman, S., Khatri, P., Doraiswamy, M., Moore, K., et al. health and quality of life of (2000). Exercise treatment for major depression: Maintenance of therapeutic benefit at Albertans through physical 10 months. Psychosomatic Medicine, 62, 633–638.
• Blumenthal, J.A., Babyak, M.A., Moore, K.A., Craighead, W.E., Herman, S., Khatri, P., et al. (1999). Effects of exercise training on older patients with major depression. Archives of Internal Medicine, 159, 2349–2356.
• Brenes, G.A., Williamson, J.D., Messier, S.P., Rejeski, W.J., Pahor, M., Ip, E., & Penninx, B.W. (2007). Treatment of minor depression in older adults: A pilot study comparing If you HAve ANy suggesTIoNs or sertraline and exercise. Aging & Mental Health, 11, 61–68. quesTIoNs, we'D LIke To HeAr from you.
Alberta Centre for Active Living • Brown, W., Ford, J., Burton, N., Marshall, A.L., & Dobson, A.J. (2005). Prospective Percy Page Centre study of physical activity and depressive symptoms in middle-aged women. American 3rd Floor, 11759 Groat Road Journal of Preventive Medicine, 29, 265–272 Edmonton, AB T5M 3K6 • Camacho, T.C., Roberts, R.E., Lazarus, N.B., Kaplan, G.A., & Cohen, R.D. (1991). Phone: 780.427.6949 or Physical activity and depression: Evidence from the Alameda County study. American 1.800.661.4551 (toll-free in Alberta)Fax: 780.455.2092 Journal of Epidemiology, 134, 220–231.
Web site: www.centre4activeliving.ca • Department of Health. (2004). At least five a week. A report from the Chief Medical Officer. London: HMSO.
• Dunn, A.L., Trivedi, M.H., Kampert, J.B., Clark, C.G., & Chambliss, H.O. (2005). Exercise treatment for depression: Efficacy and dose response. American Journal of Director: Judith Down Preventive Medicine, 28, 1–8. Researchers: Ron Plotnikoff, PhD, • Esmail, N., & Walker, M. (2005). Waiting your turn: Hospital waiting lists in Canada (15th ed.). Vancouver, B.C.: The Fraser Institute Foundation.
Education Coordinator: Judy Newman • Faulkner, G., & Taylor, A.H. (2005). Exercise, health and mental health: Emerging Older Adult Coordinator: Jennifer relationships. London: Routledge.
DechaineCommunications and Marketing • Lawlor, D.A., & Hopker, S.W. (2001). The effectiveness of exercise as an intervention Coordinator: Kathy Garnsworthy in the management of depression: Systematic review and meta-regression analysis of Centre Coordinator: Betty Lee randomised controlled trials. British Medical Journal, 322, 1–8.
Resource Coordinator: Rosanne • O'Neal, H.A., Dunn, A.L., & Martinsen, E.W. (2001). Depression and exercise. International Journal of Sport Psychology, 31, 110–135.
Financial Administrator: Carol Knull • Patten, S.B., Wang, J.L., Williams, J.V., Currie, S., Beck, C.A., Maxwell, C.J., & El- Administrative Assistant: Margaret Guebaly, N. (2006). Descriptive epidemiology of major depression in Canada. Canadian Journal of Psychiatry, 51, 84–90.
Centre Assistant: Lynda Matthews- • Stephens, T., & Joubert, N. (2001). The economic burden of mental health problems in Canada. Chronic Diseases in Canada, 22, 18–23.
Canadian Health Network: Pauline Poon, Maria Tan, Sally Press • Ustun, T.B., Yuso-Mateos, J.L., Chatterji, S., Mathers, C., & Murray, C.J. (2004). Health in Action Project: Karena Apps Global burden of depressive disorders in the year 2000. British Journal of Psychiatry, 184, Eccles, Gwen Farnsworth WELLSPRING EDITORIAL ADVISORY COMMITTEE WellSpring is published six times/year. Claudia Emes, University of Calgary Zakk Morrison, Be Fit for Life, Medicine Hat Dela Royan, Aspen Regional Health Authority John Valentine, Grant MacEwan College Judy Newman and Kathy Garnsworthy, Alberta Centre for Active Living The Alberta Centre for Active Living is the CHN Active Living Affiliate.

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