Exercise for patients with major depression: What kind, how intense, how often?

May 10, 2013

Exercise has been shown to be an effective treatment for major depressive disorder (MDD), both when used alone and in combination with other treatments. There's now sufficient research data to provide specific guidance on how to prescribe exercise for depressed patients, according to a report in the May Journal of Psychiatric Practice.

"Despite the substantial evidence supporting the use of exercise in the treatment of MDD, previous studies have not provided a clear indication of the proper dose of exercise needed to elicit an antidepressant effect," write Chad Rethorst, PhD, and Madhukar Trivedi, MD, of the Department of Psychiatry at the University of Texas Southwestern Medical Center, Dallas. To fill this gap, the authors reviewed available data from , with the goal of developing specific and detailed recommendations for clinicians on how to prescribe exercise for their patients with MDD.

Exercise for Major Depression—Evidence of Effectiveness

have shown that exercise is effective in reducing depressive symptoms in patients with MDD, on its own and in conjunction with other treatments, such as antidepressant medication and/or psychotherapy. Exercise may help to meet the need for cost-effective and accessible alternative therapies for depressive disorders—particularly for the substantial number of patients who don't recover with currently available treatments.

Based on the available data, aerobic exercise is the preferred form of exercise for patients with MDD—although there is also support for , Drs Rethorst and Trivedi note. In terms of session frequency and duration, they recommend that patients participate in three to five exercise sessions per week, for 45 to 60 minutes per session.

In terms of intensity, for , they recommend achieving a heart rate that is 50 to 85 percent of the individual's (HRmax). For resistance training, they recommend a variety of upper and lower body exercises―three sets of eight repetitions at 80 percent of 1-repetition maximum (RM—that is, 80 percent of the maximum weight that the person can lift one time).

Data suggest that patients may experience improvement in depressive symptoms as little as four weeks after starting exercise. However, Drs Rethorst and Trivedi emphasize that the exercise program should be continued for at least ten to twelve weeks to achieve the greatest antidepressant effect.

Some people have questioned whether patients with MDD will be willing to participate in an exercise program. But Drs Rethorst and Trivedi note that, in the studies they reviewed, only about fifteen percent of patients dropped out of exercise programs—comparable to dropout rates in studies of medications and psychotherapy.

The authors discuss strategies that may help improve adherence to exercise programs, such as consulting patients about their preferred types of exercise and providing individualized educational materials and feedback. They also provide some practical tips for clinicians on how to estimate exercise intensity using readily available information.

Even if the depressed patient can't reach the target intensity and frequency levels, exercise can still be helpful. "Taken as a whole, these findings suggest that exercise doses below the current recommendations may still be beneficial for patients with MDD," Drs Rethorst and Trivedi add. "Therefore, clinicians should encourage patients to engage in at least some exercise, even if they do not exercise enough to meet current public health recommendations."

Explore further: Exercise can substitute effectively as second 'medication' for people with depression

Related Stories

Resistance exercise offers more prolonged glycemic control

December 5, 2012

(HealthDay)—For patients with type 1 diabetes, resistance exercise is associated with a smaller initial decline in blood glucose compared with aerobic exercise, but offers a more prolonged reduction in post-exercise glycemia, ...

Exercise improves quality of life in type 2 diabetes

March 19, 2013

(HealthDay)—For people with type 2 diabetes mellitus (T2DM), a nine-month aerobic and resistance training program significantly improves quality of life (QOL) compared with no exercise, according to research published online ...

Is it safe to exercise while undergoing cancer treatment?

April 5, 2013

Exercise can improve the quality of life for cancer survivors as well as for patients still undergoing treatment, based on an extensive review I was involved in as a research librarian. The massive study was a systematic ...

Recommended for you

Babies need free tongue movement to decipher speech sounds

October 12, 2015

Inhibiting infants' tongue movements impedes their ability to distinguish between speech sounds, researchers with the University of British Columbia have found. The study is the first to discover a direct link between infants' ...

Women and men react differently to infidelity

October 8, 2015

If your partner has sex with someone else, it is considered infidelity - even if no emotions are involved. But it is also considered infidelity when your significant other develops a close personal relationship with someone ...

Repeating aloud to another person boosts recall

October 6, 2015

Repeating aloud boosts verbal memory, especially when you do it while addressing another person, says Professor Victor Boucher of the University of Montreal's Department of Linguistics and Translation. His findings are the ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.