New research could complicate the narrative about using exercise to help with depression and other mental health problems. A study compared depressed and/or anxious people who joined a running programme with those who took antidepressants, and found that both groups experienced similar levels of improvement in mental health after several months. Those who ran experienced greater physical health benefits, but those who took antidepressants were much more likely to stick with the programme.
The study, conducted by scientists in the Netherlands, is believed to be the first of its kind to attempt a head-to-head comparison between exercise and antidepressants.
The experiment involved 141 patients diagnosed with depression and/or anxiety who were attending an outpatient clinic. The patients were divided into two groups: one in which the patients participated in group-based running therapy twice a week, or one in which they took selective serotonin reuptake inhibitors (SSRIs), a common class of antidepressants, with each programme lasting 16 weeks. The volunteers were asked if they were willing to be randomly assigned to these groups, and if not, to choose the group they preferred. Most chose their first preference, and about two-thirds chose exercise.
By the end of the study period, about 44% of people in each group had experienced enough improvement in their symptoms to be considered in remission. But there were important differences between the two groups.
Those who exercised also lost some weight and had, on average, improved blood pressure and general heart function compared to before the study, while those who took antidepressants had a slight weight gain and an increase in blood pressure. At the same time, only 52% of those in the running group fully adhered to the programme, compared with 82% of those on antidepressants, despite exercise being the preferred choice for most.
The team’s findings were published in the Journal of Affective Disorders in February and will be discussed at the annual meeting of the European College of Neuropsychopharmacology (ECNP) this weekend.
According to study author Brenda Penninx, a professor and epidemiologist at Vrije University in Amsterdam, the findings show that both exercise and antidepressants have a place in the treatment of depression and anxiety, although each comes with its own set of considerations and challenges.
“Antidepressants are generally safe and effective. They work for most people. We know that not treating depression at all leads to worse outcomes, so antidepressants are generally a good choice,” Penninx said in a statement released by the ECNP. “However, we need to expand our treatment armamentarium because not all patients respond to antidepressants or are willing to take them.”
And while exercise can be an attractive alternative for many patients, the low adherence rate seen in this study suggests that many people need support to maintain their routine.
“Telling patients to go for a run is not enough. Changing physical activity behaviour requires adequate supervision and encouragement, as we have done by implementing exercise therapy in a mental health setting,” Penninx added.
