According to the last European Health Survey in Spain (2020), 5.28% of the population of our country was diagnosed with depression by a doctor in the last year. That leaves more than two million people with this problem, a number that, unfortunately, seems to be increasing. This is confirmed by the survey carried out at the end of 2022 by the Instituto de Saúde Carlos III, which maintains that 32% of the population noticed a worsening of their mental health in the last year. The data is proof that addressing the situation, from all areas, has become an important public health issue.
Thus, it is not surprising that more and more studies are appearing on the approach to depressive treatments, although not all of them cause the same impact. The last one, published in the magazine British Journal of Sports Medicinein fact, what caused it has been controversial, because according to its researchers, physical activity is as effective as usual care (medication and cognitive-behavioral therapy) to reduce mild to moderate symptoms of depression, anxiety, and psychological distress.
“A recent study has gone viral for allegedly showing that exercise is more effective than antidepressants for depression.” denouncedthrough his Twitter account, Gideon MK, epidemiologist and science popularizer. According to him, the review, despite claiming to have an extensive source of data, no quality studies among those analyzed and, still, the sources did not agree with him: “This review does not bring us new evidence about exercise and depression, beyond a review that showed that the works on the subject were bad and that the best ones showed little or no effect“, he writes.
[La España ‘colgada’ del lexatin: “He llegado a tomar ansiolíticos como si fueran gominolas”]
The expert dismantled, from his area of work, the hype that has been given to the investigation. But what do psychiatrists think about it? “My opinion, as a clinician who treats depression, is skepticism on the effectiveness of exercise in true depression, in clinical depression”, points Pablo Malo, psychiatrist and scientific popularizer, to EL ESPAÑOL.
1.5 times more effective
The professional finds “a little exaggerated” the statements of the main author of the research, Ben Singh, specialist in clinical exercise physiology, in an article by The conversationwhere he goes so far as to state that, according to his findings, physical exercise is “approximately 1.5 times more effective than medication or cognitive-behavioral therapy“for the treatment of mental health problems, without specifying whether they are mild, moderate or severe cases.
“The enthusiasm that exists for exercise in depression seems to me to be exaggerated.. It has a background (although it doesn’t say so explicitly) that psychiatrists and psychologists use medication and cognitive therapy and that we put it aside as therapy. alternativesomething better and with fewer side effects”, concludes Malo. complaint de Singh is a slogan, as also published in the press release of the University of South Australia study: “Physical activity is known to help improve mental health. However, despite the evidence, it has not been widely adopted as a first-line treatment.”
Malo’s opinion is the same as Marina Díaz Marsá, Vice President of the Spanish Society of Psychiatry and Mental Health (SEPSM). “Sounds like overkill to me,” she replies on the other end of the line. “Pharmacological treatments they are effective and cognitive-behavioral therapy as well,” he adds.
[Depresión: hallan la primera evidencia directa en décadas de su vínculo con la serotonina baja]
Both professionals do not deny that exercise is good for helping certain patients with certain psychopathologies. As Díaz Marsá explains, physical exercise has the ability to release endorphins and therefore improve the feeling of well-being. “It also regulates the concentration of serotonin and norepinephrinethat we know are altered in depression”, continues the specialist, who adds, as a last positive effect for mental health, the fact that a little activity provides a feeling of capacity and self-esteem, something important in this problem.
Helps in mild cases
Of course, all these benefits, obtained mainly with aerobic physical activities —which activate the cardiovascular system— have a but. “Exercise has been shown to help improve depression in very mild cases“, continues the vice-president of SEPSM, who gives special emphasis to the word light: “Perhaps they are not even cases in which there is a real depression, but stress, irritability or one everyday discomfort“.
“Physical exercise seems fantastic to me and I recommend it to all my patients”, replies Malo, who also directs the conversation towards milder cases: “In milder adaptive anxiety frames, it is true that people can continue more or less our indications and you can be motivated to exercise. In more severe cases, seems like an illusion“.
The psychiatrist refers to the fact that, based on his experience, a person with clinical depression is generally not receptive to proactive stimuli, such as physical exercise. “If my depressed patients were receptive to the message of running or going to the gym, that would already mean that they are not really depressed,” he argues. “I find it difficult to get them out into the street and, many of them, to get them out of bed. Just ask what they can’t do and I think it’s a mistake.”