Studies have shown that for many cases, routine exercise is just as effective as antidepressants. So why don’t doctors prescribe it?
Scott Johnson, author of Running is My Therapy, sought to find out.
He looked into several clinical studies that all concluded the same thing: when it comes to reducing the symptoms of mild to moderate depression, routine aerobic exercise will return the same results as your regular prescription.
And the science behind it makes sense. Exercise and antidepressants create the same structural changes in our brains. Both lead to new neural pathways, and an increase in the size of the hippocampus.
Most people know that exercise improves self-image, which generally making us feel better. But few doctors in the United States prescribe exercise to their patients as a way to improve their mental health. So it’s really not our fault that we don’t know its benefits… They aren’t shared with us.
Here’s How Different Countries Treat Depression
What do U.S. doctors prescribe?
Both the American Psychiatric Association and the American College of Physicians feature two first-line treatments for patients with depression: psychotherapy and antidepressants.
Exercise gets a mention in the “Beyond Treatment: Things You Can Do” section. That puts it side by side with vague statements like “continue to educate yourself about depression.
That’s not the way it is in other countries. Canada, the United Kingdom, and the Netherlands all prioritize exercise as a first-line treatment for patients suffering from depression. And in Canada, it’s recommended as the initial standalone treatment, before combining it with other treatments.
In both Australia and New Zealand, psychotherapy and prescription medication are only recommended after a sedentary patient has tried routine exercise and it fails to relieve symptoms.
Of course, countries with single-payer systems are going to prioritize cheaper options. So it makes sense that countries like Canada and Holland recommend exercise over antidepressants as a first line treatment. New Zealand and Australia go even further, suggesting that a sedentary lifestyle could be actually be the underlying basis for the depression.
Johnson notes that the American healthcare system has a reputation for recommending pills and medical procedures over more holistic alternatives. And the National Institute of Mental Health admits that antidepressants are frequently prescribed for “off-label” reasons, including eating disorders, migraines, and insomnia. It’s partially this “can’t hurt to try them” attitude that keeps antidepressants at the front of the recommendation list.
And There’s No Evidence That Doctors Exercise More Than Their Patients
As a whole, Americans are a largely sedentary nation. The Centers for Disease Control and Prevention reports that not even a quarter (21.7) of adults in the U.S. get the recommended amount of exercise: 150 minutes of cardio and two strength-training sessions per week.
We live in a society where convenience is the ultimate priority, which means that even movement is powered for us. It’s not just the hours we spend in our cars each day… Think about the moving walkways that connect airport terminals to each other.
And it isn’t just the American people who struggle with a pervasive lethargy. For all we know, our doctors are just as sedentary. Johnson tried to find a large-scale survey on how many doctors in the United States exercised regularly. He couldn’t find any.
Johnson notes that he doesn’t believe exercise is a “cure-all” for depression, and notes that along with being a dedicated runner, he also takes Wellbutrin. But in his peer-reviewed surveys, he found that when depressed people do begin exercising, they rate is as the best treatment for reducing symptoms when it comes to the ratio of effectiveness to burden.
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Data Source: slate.com