Exercise as a First Line Treatment for Depression, Anxiety and Stress [Pocast Series]
[:55] Dr. Bantham introduces her guest, Dr. Carol Maher
Dr. Carol Maher is Professor of Population and Digital Health at University of South Australia.
She is also a Deputy Director of the Alliance for Research in Exercise, Nutrition and Activity (ARENA).
[1:15] Study conclusions on effectiveness of exercise and physical activity
“Our conclusion at the end of it all was we really should feel very confident recommending physical activity and exercise as an effective treatment for depression, anxiety and stress.”
[2:58] Exercise as a mainstay approach
“So it's really interesting that the leading U.S. clinical guidelines for managing depression and anxiety consider exercise as an alternative treatment. Because that really implies that there's not evidence behind it or that it sort of isn't congruent with mainstream medicine. And neither of those things is true. Exercise is very well accepted by mainstream medicine as holding real physical and mental health benefits.”
[9:15] Bridging the evidence gap
“That's the real gap that this study has filled. You know, I think the problem has been that there is absolutely tons of evidence, individual studies that have been done on exercise and mental health. Yet, it's not being used consistently as a treatment in the health system.”
[12:17] Effectiveness of interventions by frequency, intensity, time, type
“So, and also when we looked at dosage, we actually found that the reasonably modest dosage seemed to be just as effective as a higher weekly dosage of exercise. So, so that would suggest that even just like a reasonably small amount of exercise still holds good benefit.”
[16:30] Effectiveness of shorter programs
“From this review, I can't tell you why the effects are a little bit less for longer programs. I can only take some guesses of why it would be. Certainly it could be to do with adherence, like that people start to fall off the wagon a bit with their exercise. And it could be that, no, they're not falling off the wagon, but as their fitness improves, perhaps their program needed to become a bit more intense to keep improving their kind of fitness.”
[19:04] Exercise has a larger effect than medication and psychotherapy
“I must admit, I was surprised that, at the size of the effects that we found. And, you know, I think a big part of why this study has had a quite a lot of interest in the media is because the effects of exercise actually seem larger than the effects for medications.”
[19:58] Exercise as a legitimate form of treatment for depression and anxiety
“I think it's really important that when we talk about the results of our study, on one hand, I think our results show exercise really needs to be considered a legitimate and important form of treatment for depression and anxiety. However, it would be a mistake to interpret our findings as saying we should use exercise instead of medication and psychotherapy. That would be a very harmful takeaway message.”
[22:00] Takeaways for clinicians
“I think there'll be a lot of doctors that when someone comes to them with depression and anxiety, would say, try to eat well, get some exercise, make sure you're getting enough sleep. But it'd be like a very short conversation. And then most of the session is focused on a prescription and perhaps referring them for the psychotherapy. I would love for the lifestyle management to be more strongly featured in medical management.”
[24:54] Takeaways for policy makers
“Certainly it would be beneficial if there could be more education for general practitioners and physicians to feel sort of well educated about the benefits of exercise for mental health, and some basics on how to prescribe exercise as a treatment.”
[27:22] Takeaways for patients
“I think the takeaway is, the benefits of exercise for mental health are real and substantial. And they have the benefits directly on depression and anxiety. They've got other benefits though, too, because they avoid the side effects of medication.”
