Exercise is now seen as one of the most effective treatments for depression, particularly in Britain under the guidance of GPs. Sylvia Thompsonexamines the case for introducing similar regimes in the Republic.
GPs across Britain are now offering their patients exercise therapy for the treatment of mild to moderate depression, according to a new study.
The research, which was carried out by the Mental Health Foundation in Britain, found that almost two thirds of GPs now believe a supervised programme of exercise can be very or quite effective in treating mild to moderate depression.
Exercise as a form of treatment for various health conditions has been on the health agenda in Britain for a long time, according to Dr Catherine Woods, senior lecturer in exercise and health psychology at the School of Health and Human Performance, Dublin City University.
"There is good evidence to suggest that there are links between exercise and depression and that people who are active appear less likely to get depressed," she says.
"Some studies have also found that exercise is as effective as psychotherapy in the treatment of mild to moderate depression. Exercise can also have positive side effects on a number of other conditions."
The British study is part of a wider Mental Health Foundation campaign to promote exercise referrals to stem the spiralling costs of anti-depressant medication. "It's interesting to see that the Mental Health Foundation is encouraging the British government to divert 5 per cent (£20 million) of the annual spend on anti-depressant prescriptions to develop and promote exercise referrals as a treatment for mild to moderate depression," says Woods.
In Britain, there are more than 1,300 exercise referral schemes which GPs can access. The staff on such exercise referral schemes have been specially trained to guide, motivate and support people who don't feel very fit or sporty. Many local authorities also have walking schemes and some offer opportunities to do conservation work under supervision (www.greengym.org.uk).
Currently, in Ireland, there isn't any national structure that GPs can use for exercise referrals. However, regular physical exercise is widely acknowledged as being important for good mental and physical health.
"When we treat depression we look at every aspect of a person's life and we encourage them to take exercise, get fresh air and go outdoors, although we don't have a specific exercise programme," says psychiatrist Dr Geraldine Lister, a board member of Mental Health Ireland.
Lister points to a useful leaflet on the benefits of exercise to mental health, produced by the Dundalk Mental Health Association. The leaflet explains how studies have found that regular exercise reduces stress and anxiety and improves wellbeing and self-esteem.
It also encourages people to plan an exercise programme, setting realistic targets and to have regular health check ups throughout the programme.
Psychiatrist and psychotherapist Dr Michael Corry prescribes exercise to all his patients. "Depression is the draining away of the life force and the will to live and sometimes the mind is so tired of thinking and ruminating and regretting that you have to break the sequence and park the mind," he says.
"What happens with many people with depression is that they wake up and lie in bed, running videos of all that is wrong in their lives. I say to them to have their track suit and running shoes ready and as soon as they wake up to get out of bed, have a glass of water, go to the toilet and then get out into nature to walk or run.
"That's what breaks the mind-body cycle and gets the body moving first," he says.
"Body work such as yoga and massage are also important, so if they don't want to run, they can do yoga or join a gym. Exercise is also critical to get your appetite back and helps you get tired by natural means.
"Exercise helps people reach their own levels of calmness when the mind actually stops. When people exercise on a regular basis, they will also cut back on alcohol, cigarettes, starchy food and fizzy drinks," says Corry.
Dr Andrée Rochfort, spokeswoman for the Irish College of General Practitioners (ICGP) says that not only is exercise valuable for maintaining good mental health and treating mild to moderate depression but it is also of value for people with mental illnesses.
"There are psychological benefits of exercise for people with psychiatric conditions, such as schizophrenia, alcohol misuse disorders and for those in recovery from major depression," she says.
"Exercise is simple and cost-effective and has positive side effects, such as improving social inclusion, rehabilitation and reducing stigma," she says.
Rochfort says that exercise therapy can be used with psychotherapy and/or medication.
"There is a lot of potential to look at in its own right too and to gather evidence and put it in the domain of GPs, psychologists and psychotherapists in this country," she says.