The thing about depression is that you don’t know how bad you feel until you don’t feel bad anymore. It’s like wearing a veil that subtly shades everything in your life until you can’t remember a time when rainbows weren’t made in varying grays and when the sky didn’t feel like a weight on your shoulders. But then perchance you get better and glimpse for a moment what everyone else sees: that the sky has been inspiring men to fly since long before Icarus and Daedalus took their ill-fated flight. And while one fell broken to earth and the other soared onward with a broken heart, both knew for a moment what it felt like to be held. Weightless. With the sun in their faces.
Once you know what not-depressed feels like – I won’t call it happiness since while that too is very real, it is fleeting and I’ve found it is better to be surprised by joy rather than expectant of continuous happiness – you want the key to get out of your cell. I know this feeling well. With a personal history of several depressive episodes and with a family tree shaped like a weeping willow, I can recite drug names and treatment methodologies like an encyclopedia. But my experience goes far beyond the academic past tense. I am currently taking an anti-depressant and have been for a couple of years now. I may be on one for the rest of my life. I hope not which is why I’m forever searching for alternatives.
There are other keys. Medicine, yes, and also therapy, electro-shock treatments, journaling, supplements, light – the list is long but there is one whose effectiveness is consistently backed by research. Exercise, time and again, has been shown to alleviate mild depression even better than anti-depressants and to ameliorate more severe depressive episodes, especially when used in conjunction with other therapies. It’s such a cure-all that it is often the first thing good doctors prescribe. But it isn’t quite so simple and a new study shines light on the nuanced way that exercise and depression interact.
Dr. Madhukar H. Trivedi, a professor of psychiatry at the University of Texas Southwestern Medical Center in Dallas, studied 126 patients who had been on SSRIs (selective serotonin reuptake inhibitors – a type of anti-depressant) for at least two months and were still depressed. He divided the groups in half with one group doing light exercise several days a week and the other group doing more intense exercise for the same amount of time.
First, the good news: At the end of 4 months “29.5 percent [of study participants] had achieved remission, ‘which is a very robust result,’ Dr. Trivedi said, equal to or better than the remission rates achieved using drugs as a back-up treatment.”
Now for the confusing news: Patients who did the more intense exercise were more likely to achieve a remission of their depression. Unless they were women with a strong genetic history depression (aHEM). This group was the least likely to feel better but when they did, it was with the slower, easier exercise. Also, people in the intense exercise group were more likely to quit exercising than people in the more relaxed group.
The bad news, part 1: This left fully 70% of patients still depressed despite exercising and taking meds.
And the bad news, part 2: There was no control group in the study so who’s to say if it was the exercise or just good ol’ time that made the difference? Or the placebo effect?
For myself, exercise has been crucial to managing my depression and anxiety (I’m like one of those barrels full of plastic monkeys when it comes to mental illness, you pull one out and a whole slew come out entangled with it). Exercise, especially intense exercise, always, always makes me feel better. Lots better! Unfortunately it makes me feel so much better that it became my one and only coping tool which is a good part of how I ended up an exercise addict.
I don’t know what the solution is. Balance is hard for me to find and even harder for me to stick with. And yet I keep trying to glue more feathers to my wax wings in hopes of flying again. Even if it means I fall, broken. Everyone always feels so bad for the overzealous Icarus who was felled by his own ecstasy but they forget that before that he was flying. And even when he plunged headlong into the ocean I like to think he knew again – just for a moment – what it felt like to be held. Weightless. With the sun in his face.
Have you ever experienced depression? What has worked for you (or not worked)? Anyone else kinda want to drop-kick a researcher who doesn’t have a control group?