Tuesday, January 19, 2016

Exercise Can Improve the Quality of Life in People with Depression

 

A recent study has shown that exercise improves the physical and psychological quality of life in people suffering with depression. Whilst exercise is considered to be a good anti-depressant for depression, little research has been conducted into its effect on the different domains of Quality of Life (QoL).
Depression is a chronic condition that has a huge impact on an individual’s physical and mental health which inevitably impacts their QoL.
The WHOQOL Group define QoL as “an individual’s perception of their position in life in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards and concerns.”
Due to this association between depression and a poor QoL, Schuch and colleagues decided to review research that has investigated this relationship in people with depression. Participants would need to have scored themselves on various physical and psychological domains including: activities of daily living, energy and fatigue, mobility pain and discomfort, work capacity, bodily image, feelings, self-esteem, learning and memory to name a few.
Pharmacological treatments aim to reduce the symptoms of depression, however there are still reports of impairment with regards to an individual’s QoL and the domains listed above. With the benefits of exercise shown in many studies the researchers reviewed several studies whereby exercise effects were analyzed against QoL domains. The individuals in these studies were adults with a diagnosis of major depressive disorder (MDD) or dysthymia (a disorder within the depressive disorder spectrum). These people then took part in physical activity and a QoL assessment as part of the research, with their results compared to a non-active control group who completed the QoL assessment and suffered with depression.
The findings showed that those in the exercise group had improved physical and psychological domains and overall QoL. However such effects were not seen on social relationship and environment attributes.
When considering the control group there were no noticeable improvements on any domain or overall QoL. The lack of improvement for the control group and the improvement seen with the exercise group, suggests exercise is an effective strategy in improving the physical and psychological wellbeing of an individual who suffers from depression whilst also having benefits to their overall QoL.
Schuch and colleagues concluded by saying that this study shows the importance of not relying of pharmacological treatments as a sole treatment for depression. While there are clear benefits to pharmacological treatments, they are not sufficient as they don’t appear to improve QoL. This means that other strategies to combat low levels of QoL in people with depression are needed and here we can see exercise provides one.
The researchers suggested areas for improvement in future research within this area. They claimed there is a need for the design of exercise tests to be improved when examining the QoL of people with depression. This would help evaluate the impact of different exercise characteristics such as group or individualized sessions and sample characteristics such as gender and depression severity on the overall and domain QoL. Further comparisons with antidepressant medication in such research need to be made. This study appears online in the Psychiatry Research Journal.
References:
Schuch, F, B., Vancampfort, D., Rosenbaume, S., Richards, J., Warde, P, B., Stubbs, B. 2016. Exercise improves physical and psychological quality of life in people with depression: A meta-analysis including the evaluation of control group response. Psychiatry Research, 241, 47-54.
The WHOQOL Group. 1995. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc. Sci. Med. 41 (10), 1403–1409.

Depression is a serious mental illness that can interfere with a person's life. It can cause long-lasting and severe feelings of sadness, hopelessness, and a loss of interest in activities. It can also cause physical symptoms of pain, appetite changes, and sleep problems.
The Centers for Disease Control and Prevention (CDC) found that nearly 10 percent of adults age 40-59 had depression over a 3-year study period. But despite its prevalence, depression isn't always easy to identify.
Symptoms and causes of depression can vary widely from person to person. Gender may also play an important role in why a person is affected by depression, and what it feels like to them.
Contents of this article:
  1. How depression feels
  2. Common causes and risk factors
  3. Depression and women
  4. Depression and men
  5. When to see a doctor

How depression feels

depressed person
Depression is a common mental illness that may vary from person to person.
One of the common misunderstandings about depression is that it's similar to feeling sad or down. Although many people with depression feel sadness, it feels much more severe than emotions that come and go in response to life events.
The symptoms of depression can last for months or years and can make it difficult or impossible to carry on with daily life. It can disrupt careers, relationships, and daily tasks such as self-care and housework.
Doctors will usually look for symptoms that have lasted at least 2 weeks as possible signs of depression. Depression may feel like:
  • There's no pleasure or joy in life. A person with depression may not enjoy things they once loved and may feel like nothing can make them happy.
  • Concentration or focus is impossible. Making any kind of decisions, reading, or watching television can seem taxing with depression because people can't think clearly or follow what's happening.
  • Everything feels hopeless, and there's no way to feel better. Depression may make a person feel that there's no way ever to feel good again.
  • Self-esteem is absent. People with depression may feel like they are worthless or a failure at everything. They may dwell on negative events and experiences and be unable to see positive qualities in themselves.
  • Sleeping is difficult. Falling asleep at night or staying asleep all night can feel nearly impossible for someone with depression. A person may wake up early and not be able to go back to sleep.
  • Energy levels are low to nonexistent. Some people feel like they can't get out of bed, or feel exhausted all the time even when getting enough sleep. They may feel that they are too tired to do simple daily tasks.
  • Food doesn't seem appetizing. Some people with depression feel like they don't want to eat anything, and have to force themselves to eat. This can result in weight loss.
  • Food is a comfort or coping tool. Although some people with depression don't want to eat, others can overeat and crave unhealthy or comfort foods. This can lead to weight gain.
  • Aches and pains are constant. Some people experience headaches, nausea, body aches, and other pains with depression.
Many people mistakenly believe that being depressed is a choice, or that they need to have a positive attitude. Friends and loved ones often get frustrated or don't understand why a person can't "snap out of it." They may even say that the person has nothing to be depressed about.
Depression is a real mental illness. Those who have depression cannot simply decide to stop feeling depressed. Unlike typical sadness or worry, depression feels all-consuming and hopeless.

Common causes and risk factors

Depression can be caused by a number of factors. Though a single cause cannot always be found, experts recognize the following as possible causes:
  • Genetics: Depression and other mood disorders can run in families, though family history alone does not mean a person will get depression.
  • Life events: Major life changes and stressful events may trigger depression. These events include divorce, the death of a loved one, job loss, or financial problems.
  • Certain illnesses: Anxiety, long-term pain, diabetes, and heart disease may make someone more likely to develop depression.
  • Drug and alcohol abuse: In some cases, drug and alcohol abuse may cause depression. Other times, depression may cause a person to start abusing drugs or alcohol.
  • Some medications: Certain prescription medicines may increase the risk of depression. These include some high blood pressure medications, steroids, and some cancer drugs.

Depression and women

A woman lying on her bed covering her face with herhands
Studies suggest that women experience depression as much as men.
Research suggests that the causes of depression may be different for women than for men.
One study of twin brothers and sisters published in The American Journal of Psychiatry found that personality and relationships with others were more likely to play a role in the onset of depression. In particular, the study stated that marital problems, the relationship with parents, and lack of social support were more likely to cause depression in women than men.
Neuroticism, or being in a negative emotional state, was also a primary cause of depression in the women studied.
A study in the Journal of Affective Disorders also found that women's symptoms of depression were different. The women studied were more likely to have panic and anxiety disorders in addition to their depression.
Other studies have indicated that women may be more likely to gain weight and have excessive sleepiness than men.
Women's hormone changes may also play a role in how and when depression affects them. Research on this hormonal link has found:
  • Girls who have a family history of depression may be more likely to experience the onset of depression at puberty
  • Women with depression have more severe symptoms during the premenstrual phase of their cycle, even if they are already taking antidepressants
  • Postpartum depression occurs after giving birth and affects 1 in 7 women
  • During the menopause transition, a woman's risk of depression increases
  • Women have a two to three times greater risk of getting depression during this time, even if they never had depression in the past

Depression and men

A man uses his laptop looking sad whilst his daughter sits on his lap and kisses him on the cheek
Depression may not have a single cause but there are many factors that could be linked to it.
A study in The American Journal of Psychiatry found that men were more likely than women to have depression due to the following:
  • Drug abuse
  • Childhood sexual abuse
  • Prior history of depression
  • Major stressful life events
The study also suggested that men may be more likely to become depressed as a result of failures to achieve goals in life and low self-esteem. Financial and legal issues and career problems were found to cause depression more frequently in men than women.
The study mentions events such as losing a job and worrying about failing as a family provider as possible examples of what may trigger depression specifically in men.
Symptoms of depression in men may also be different. An analysis in JAMA Psychiatry found that men were more likely than women to experience anger attacks, aggression, and risk-taking behavior as depression symptoms.
Though it is commonly thought that women suffer from depression more frequently than men, the study suggests that men and women may both equally suffer from depression.
The differences in symptoms and what men report to their doctors may make depression harder to diagnose in men. Traditional symptoms of depression such as sadness and crying may be more frequently hidden or not reported by men. Some may feel that these symptoms go against society's idea of being a man.

When to see a doctor

Those who are experiencing symptoms of depression should seek medical assistance. Depression can worsen without treatment and affect a person's quality of life.
A family doctor or mental health professional will discuss treatment options to help the person manage their depression and carry on with daily life.
In severe cases, depression can lead to thoughts of suicide or physically harming oneself. Any suicidal thoughts or statements about "not wanting to live" should be taken seriously. In times of crisis, a person should seek help from a hospital emergency department.

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