‘Exercise doesn’t help with depression’ – have the headline writers got it wrong again?

running scared

Back from my 5-mile run around the woodland yesterday morning I sat down to catch up on the latest elf stories.

Many of the national newspapers reported on a new randomised controlled trial published in the BMJ, which studied ‘facilitated physical activity’ for people with depression.

The headlines seemed to be in agreement:

Anyhow, this all came as a bit of a surprise to me.  I’ve always thought that exercise was a good thing and certainly something that people with poor mental health should be encouraged to take up.  I always feel invigorated and ready for the day after my early morning Chariots of Fire shenanigans.

What’s more, there has been a lot of evidence published (even in the last few months) supporting the links between physical exercise and good mental health, so what’s going on?

Looking at the paper in the BMJ I see that the research was conducted in general practices in Bristol and Exeter.  361 adults with depression were randomised to one of two treatments:

  1. Usual care
  2. Usual care plus three face-to-face sessions and 10 telephone calls with a trained physical activity facilitator over eight months (the aim being to offer tailored support and encourage people to take part in more physical activity)

It’s a well conducted trial with a good sample size and excellent randomised design.

The outcomes of interest were:

  • Depression symptoms
  • Use of antidepressants
  • Physical activity

Here’s what they found:

  • At 4 months and at 12 months, the patients who had been encouraged to exercise did not have better mood than the patients who had received usual care
  • Patients who had been encouraged to exercise did not reduce their antidepressant use
  • However, at 4, 9 and 12 months, the patients in the physical activity group did report significantly more physical activity than the usual care patients

The authors concluded:

The addition of a facilitated physical activity intervention to usual care did not improve depression outcome or reduce use of antidepressants compared with usual care alone.

Now is it just me or is this a long and winding road away from ‘exercise doesn’t help with depression’?

  • The study did not assess whether exercise helps to prevent depression
  • It looked at one intervention, but there are many other exercise programmes that have been shown to work well
  • And of course we know that exercise helps prevent obesity, reduce the risk of diabetes and help with cardiovascular fitness; all potential health issues for every man, woman and child who ever got depressed.

Us elves have a lot of sympathy for health writers. Most of the articles I read yesterday were actually very balanced and well informed.  As usual it was the headline writers who got it wrong; trying to grab your attention and sell some newspapers!

Link

Chalder, M. Lewis, G. et al Facilitated physical activity as a treatment for depressed adults: randomised controlled trial. BMJ 2012; 344 doi: 10.1136/bmj.e2758 (Published 6 June 2012)

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Andre Tomlin

Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol with his wife, dog and three little elflings.

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