SMU.edu - Exercise is a magic therapy for many people with depression and anxiety disorders, and it should be more widely prescribed by mental health care providers, according to researchers who analyzed the results of numerous published studies.

“Exercise has been shown to have tremendous benefits for mental health,” says Jasper Smits, director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas. “The more therapists who are trained in exercise therapy, the better off patients will be.”

Smits and Michael Otto, psychology professor at Boston University, based their finding on an analysis of dozens of population-based studies, clinical studies and meta-analytic reviews related to exercise and mental health, including the authors’ meta-analysis of exercise interventions for mental health and studies on reducing anxiety sensitivity with exercise. The researchers’ review demonstrated the efficacy of exercise programs in reducing depression and anxiety.

The traditional treatments of cognitive behavioral therapy and pharmacotherapy don’t reach everyone who needs them, says Smits, an associate professor of psychology.

“Exercise can fill the gap for people who can’t receive traditional therapies because of cost or lack of access, or who don’t want to because of the perceived social stigma associated with these treatments,” he says. “Exercise also can supplement traditional treatments, helping patients become more focused and engaged.”

The researchers presented their findings March 6, 2010 in Baltimore at the annual conference of the Anxiety Disorder Association of America. Their workshop was based on their therapist guide “Exercise for Mood and Anxiety Disorders,” with accompanying patient workbook (Oxford University Press, September 2009).

“Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger,” Smits says. “Exercise appears to affect, like an antidepressant, particular neurotransmitter systems in the brain, and it helps patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing.”

After patients have passed a health assessment, Smits says, they should work up to the public health dose, which is 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity activity. At a time when 40 percent of Americans are sedentary, he says, mental health care providers can serve as their patients’ exercise guides and motivators.

“Rather than emphasize the long-term health benefits of an exercise program – which can be difficult to sustain – we urge providers to focus with their patients on the immediate benefits,” he says. “After just 25 minutes, your mood improves, you are less stressed, you have more energy – and you’ll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise; it is the very reason to exercise.”

Smits says health care providers who prescribe exercise also must give their patients the tools they need to succeed, such as the daily schedules, problem-solving strategies and goal-setting featured in his guide for therapists.

“Therapists can help their patients take specific, achievable steps,” he says. “This isn’t about working out five times a week for the next year. It’s about exercising for 20 or 30 minutes and feeling better today.”

Editorial note - I wholeheartedly agree with these researchers, but would like to add the comment that it is all too often very, very, very difficult to get patients to comply with exercise or physical activity recommendations - and that is true even when therapists and doctors are really trying to help motivate patients to exercise. This can be true even of young, healthy college students(!). After years of observing this exercise motivation problem, my current opinion is that the most effective general antidote would be for public schools to stop making exercise and recreation/lifestyle issues the lowest priority of their mission. Drugs, high-tech entertainment, and internet absorption are lazy diversions but also powerful agents that not only pull young people away from exercise and a healthy lifestyle - they actually seem to completely de-prioritize it in their emotional minds to the level that it is almost unconsciously regarded as a waste of time and thus cannot be considered seriously as an option on which to expend real, physical “effort.” The better therapists and schools can get at motivating people to exercise, the better for all of us - Dr Z.