effects of exercise on depression

1. Exercise and depression
DONE BY: EMAN AL-ZAWWAD

2. What is depression
 medical illness

3.  major mood disorders
 Other factors

4. suicide
According to the WHO suicide occurs in close to one
million cases every year making it one of the 20 most
common causes of death.

5. The Prevalence
 According to WHO depression is ranked fourth in Disability Adjusted Life
Years (DALYs) , and it’s expected to reach second rank by the year
2030.
 The National Institute of Mental Health2
 http://www.nimh.nih.gov/health/statistics/prevalence/major-
depression-among-adults.shtml

6. Cont.
 An article published in JAMA Psychiatry (August 2013 ) showed
that depression affects 30.6% of men and 33.3% of women, which is
not a statistically significant difference.
 The National Institute for Clinical Excellence (NICE)3 estimates that in
the United Kingdom 21 in every 1,000 16-to-65 year olds live with
major depression.
 In Australia only 1 in every five people with clinical depression is
accurately diagnosed.
 http://www.medicalnewstoday.com/articles/8933.php

7. Famous people
 Princess Diana
 http://depression.about.com/od/famous/p/princessdiana.htm

8.  Jim Carrey
 http://mentalhealthdaily.com/2014/11/16/jim-carreys-battle-with-
depression-and-how-he-overcame-it/

9.  John Claude Van Damme
 http://bipolar.about.com/cs/celebs/a/jeanclaude.htm

10.  Buzz Aldrin
 one of America’s most famous astronauts, flew to the moon in 1969,
but later suffered from depression and alcoholism. He worked his
way through, and even served as chairman of the National Mental
Health Association.

11.  Joanne Rowling (J. K. Rowling)
 Depression hit author J.K. Rowling after her first marriage broke down
after just two years. She credits writing her first Harry Potter novel with
helping her overcome the depression.

12. Other famous people,
 https://www.youtube.com/watch?v=fs3wkO1qWMM

13. Type of depreesion
 clinical depression
 Dysthymic disorder (dysthymia)
 Psychotic depression
 SAD (seasonal affective disorder)
 Bipolar disorder (manic-depressive illness)
http://www.medicalnewstoday.com/articles/8933.php
Abraham Lincoln suffered from
"melancholy", known today as
clinical depression

14.  Postpartum depression (postnatal depression).
 http://babel.hathitrust.org/cgi/pt?id=umn.31951d02850777y;view=1
up;seq=1

15. Causes of depression
 Unknown
 Genes.
 biochemical environment.
 personal experience and psychological factors.
 A study published in Archives of Psychiatry found
that MRI (magnetic resonance imaging) scans showed patients with
clinical depression had less brain volume in several regions,
including the frontal lobe, basal ganglia and hippocampus. They
also found that after treatment the hippocampus returned to
normal size.
 http://archpsyc.jamanetwork.com/article.aspx?articleid=1107416&r
esultClick=3

16.  The Stanford School of Medicine says that genes do play a role in
causing depression. By studying cases of major depression among
identical twins (whose genes are 100% identical) and non-identical
twins (whose genes are 50% identical) they found that heritability is
a major contributory factor in the risk of developing depression.
 http://depressiongenetics.stanford.edu/mddandgenes.html

17. Signs and symptoms
 the most common symptoms:
Psychological signs and
symptoms
Physical signs and
symptoms
Social signs and
symptoms

18. Psychological signs and symptoms:
 Persistent sadness or low mood
 Thoughts and feelings of worthlessness
 Feelings of self hatred
 A feeling of hopelessness
 A feeling of helplessness
 Feeling like crying
 A feeling of guilt
 Irritability - even trivial things become annoying
 Angry outbursts
 Intolerance towards others
 Persistent doubting - finding it very hard to decide on things
 Finding it impossible to enjoy life
 Thoughts of self harm
 Thoughts of suicide
 Persistent worry
 Persistent anxiety.

19. Physical signs and symptoms
 Body movements.
 Problems with focusing.
 Speech.
 Eating patterns change, appetite changes.
 Low sex drive.
 Lack of energy, fatigue, tiredness.
 The woman's menstrual cycle.
 Restlessness.
 Unexplained aches and pains, such as headache, backache or
digestive problems.
 Sleeping disturbances ( insomnia or Hypersomnia).

20. Social signs and symptoms
 Underperforming at work
 Not doing well at school
 Avoiding keeping in touch with friends
 Abandoning interests and hobbies
 Having family/home problems.
 https://www.youtube.com/watch?v=mlNCavst2EU#t=158 video
about sign &symptoms

21. How do I know if I am depressed?
 More than two weeks.
 Self-test.
 http://www.depression.org.nz/depression/self+test
 Zung Self-Rating Depression Scale:
- was designed by Duke university in North Carolina .
- by Psychiatrist William W.K. Zung to assess the level of depression for
patients diagnosed with depressive disorder

22. Treatment options
 Medication for depression - Antidepressants
1- SSRIs (selective serotonin reuptake inhibitors) - are the newest
antidepressants; they are also the most popular. Prozac (fluoxetine),
Celexa (citalopram), and Zoloft (sertraline) are all SSRIs.
2- SNRIs (norepinephrine reuptake inhibitors) - are similar to SSRIs.
Effexor (venlafaxine) and Cymbalta (duloxetine) are SNRIs.

23. Cont. treatment
 Psychotherapy
 Two main types of psychotherapy:
1- Cognitive-behavioral therapy (CBT) - helps the patient alter his
negative way of thinking and behaving. These negative styles may be
contributing to the depression.
https://www.youtube.com/watch?v=mlNCavst2EU#t=158
https://www.youtube.com/watch?v=95SNt21Jyyk
2- Interpersonal therapy (IPT) - helps the patient through uneasy
personal relationships that could be exacerbating the depression.
https://www.youtube.com/watch?v=Y5lRIb0ctH4

24. Electroconvulsive therapy
 It is used for some patients who do not improve with medication,
psychotherapy, or a combination of both.
 ECT has improved greatly over the years and does provide
significant benefits for some patients. Side effects, such as memory
loss, confusion and disorientation generally go away not long after
treatment is administered.
 https://www.youtube.com/watch?v=-T0mwzXHgvI

25. Exercise
 It has a beneficial role in treating depression.
 There are many evidences that supporting this idea.

26. Key article
 Tiltel: Systematic Review(Physical exercise and depression).
 Authors: Sebastian Eriksson and Gunvor Gard.
 Objectives: to review studies that used physical exercise as an
intervention to treat major depression, focusing on methodology,
mechanisms of action, types of physical exercise and treatment
outcomes.

27. Cont.
 Methods:
- review of the literature in the databases PsycINFO, PubMed, Psyc
ARTILCES and PsycCRITIQUES From 2000–2010.
- Search terms were ‘major depression’, ‘exercise’, ‘outcome’,
‘physical activity’ and ‘aerobic training’.
- Sample size ranged from 30-202.
- The inclusion criteria were: RCT (randomizing controlled trial)
treating depression with physical exercise
- Participants were from any age and gender.
- No limitation on medication status.
- Sedentary life style participants.

28.  Exclusion criteria were:
1- studies that used combination of exercise and nutrition counselling.
2- studies that used subjects with other common co-morbidities of
depression.
3- postpartum depressive disorders.

29. Cont.
 Results: Eight studies fulfilled their inclusion criteria .
 1- Seven of the eight studies showed significant improvement in
mood and decrease in depression.
 2-Physical exercise had the same positive effect as anti-depressant
( sertraline) in two studies.
 3- physical exercise and sertraline which were given together in one
of two studies had a positive effect.
 4-Three studies measured an increase in aerobic capacity, two with
correlated mood improvements. One showed a correlation
between increased muscle strength and reduced feelings of
depression.

32. Cont.
 Conclusion:
Physical exercise is an effective treatment against depression.
Furthers studies are needed ,and must focus on the knowledge about
mechanisms of action, type of exercise, intensity and frequency.

33. Activity!
 https://www.youtube.com/watch?v=141jmEQznK0

34. Other evedince
 In the United States, the Institute for Clinical Systems Improvement
(ICSI)
 In 2010, a Journal of Family Practice article
 In the state of Victoria in Australia
 http://www.medicalnewstoday.com/articles/246391.php

35. What Are the Psychological Benefits of
Exercise With Depression?
 Endorphins
 Receptors
 Brain
 Neurotransmitters
https://www.youtube.com/watch?v=6OOCR5uNp7s
https://www.youtube.com/watch?v=HiQh4pYWfFk

36. Health benefits of exercise
 Reduce stress
 Ward off anxiety and feelings of depression, Boost self-esteem
 Improve sleep
 It strengthens your heart.
 It increases energy levels.
 It lowers blood pressure.
 It improves muscle tone and strength.
 It helps reduce body fat.
 It makes you look fit and healthy
 Improve cognative performance, creativity, and imagination. (brain).
 https://www.youtube.com/watch?v=LdDnPYr6R0o

37. Type of exercise that are better for
depression
 Biking –Dancing –Gardening -Golf (walking instead of using the cart)
 Housework, especially sweeping, mopping, or vacuuming
 Jogging at a moderate pace , Low-impact aerobics
 Playing tennis, Swimming, Walking
 Yard work, especially mowing or raking.
 Yoga.
 Because strong social support is important for those with depression,
joining a group exercise class may be beneficial. Or you can
exercise with a close friend or your partner. In doing so, you will
benefit from the physical activity and emotional comfort, knowing
that others are supportive of you

38. Exercise activity!

39. How Often Should I Exercise to Ease
Depression?
 Web-med, at least 20 to 30 minutes, three times a week.
 https://www.youtube.com/watch?v=HiQh4pYWfFk

40. What Are Some Tips for Getting
Started Exercising?
 Choose an activity you enjoy.
 Put your exercise routine into your schedule
 Variety of exercise.

43. References
 Eriksson, S., & Gard, G. (2011). Physical exercise and depression. Physical Therapy
Reviews, 16(4), 261-268. doi: 10.1179/1743288X11Y.0000000026
 Online article retrieved from
http://www.medicalnewstoday.com/articles/8933.php
 Online article retrieved from
http://www.webmd.com/depression/guide/exercise-depression?page=1
www.youtube.com
 Online article retrieved from
http://babel.hathitrust.org/cgi/pt?id=umn.31951d02850777y;view=1up;seq=1
 Online article retrieved from
http://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-
adults.shtml