Depression: The cheapest antidepressant

Philip J. Goscienski, M.D.

January 2008

From Abraham the patriarch to Abraham the 16th president, depression has afflicted persons of great stature as well as the most humble. The perception that depression affects more of us than ever is reflected in our use of Prozac and similar drugs. During the 1990s antidepressant use nearly tripled. Americans spend more than 13 billion dollars a year on these drugs and that number can only increase as our population ages.

How are aging and depression related? The signs of this disorder include lowered mood, fatigue, a sense of worthlessness and a preoccupation with death, even suicide. A few generations ago, when the majority of us lived in or near farming communities, we spoke of retirement as being "put out to pasture" but back then the pasture wasn't crowded and few people lingered there long. A retiree today can look forward to a couple of decades or more of life without a job. More than half will contend with at least one chronic illness such as heart disease, diabetes, osteoarthritis and dementia. Some will outlive their savings. Too many will fail to pursue stimulating hobbies, volunteer activities or simply staying active in organized groups. These are the depression-susceptibles, the target market for drugs that alleviate depression.

There is one population group that has avoided depression in spite of the realities of life or who are overcoming it after it has begun: exercisers.

Daily physical activity brings with it much more than a stronger heart and lungs. It increases blood flow to the brain to supply it with fresh oxygen and nutrients. When we exercise we produce chemicals (ketones) that supply energy to brain cells, endorphins that improve mood and tryptophan that releases serotonin, the "feel-good" hormone.

Exercise doesn't have to be intense, such as running, in order to ward off or alleviate depression. In multiple studies from mainstream medical centers, persons with mild to moderate depression have found significant relief of symptoms from just 30 minutes a day of brisk walking, swimming or cycling.

When antidepressant drugs fail, exercise may help. More than 50 percent of a group of seniors whose drugs failed to bring them out of their depression improved significantly in only 10 weeks of twice-weekly exercise. They did mild calisthenics, lifted light weights and stretched to music. To be sure, associating with a group of like-minded individuals was a factor in raising these folks from depression.

No one is too old to exercise. Aging does bring the need for certain precautions, however. A thorough medical exam is mandatory to rule out unsuspected illness such as heart disease, high blood pressure, osteoporosis or diabetes. Each of these conditions will benefit from increased physical activity but they require supervision.

Anyone that has not exercised regularly must start slowly in order to avoid the soreness that we have all experienced when we use muscles that have been resting for months or years. A slow approach will also minimize injury; it takes weeks for unused tendons and ligaments to regain a healthy blood flow and youthful elasticity.

Two great selling points for exercise: it has almost no side effects and the price is right.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.