Exercise (Walking) Increases Effectiveness of CBT in Reducing Depression and Suicidal Thoughts

Depression is now the leading cause of global disease burden. This means that depression is a greater cause of loss of quality of life and days without illness than other illnesses such as heart disease and type 2 diabetes. This week the Mental Health Foundation published a report indicating that only 13% of people in the UK report living with good mental health. More than ever we need to find ways to support mental wellness and increase the efficacy of standard treatment.

I have reported elsewhere research indicating the beneficial effects of physical exercise on mental health. Exercise improves brain function in a number of ways including increasing blood flow to the brain, promoting the growth of new brain cells and increasing levels of serotonin and dopamine, neurotransmitters associated with good mood and satisfaction. A new study compared the effectiveness of Cognitive Behavioural Therapy (CBT), a recognised effective treatment for depression, against a combined treatment package of exercise and CBT for treating depression. In this Iranian study 54 (70 started, 16 dropped out) sedentary people with mild to moderate depression were assigned to either a combined CBT and exercise group or a CBT only group. The CBT was delivered in groups of 4-6 people, one 90-minutes session per week for 12 weeks. Interestingly, and importantly, the exercise was not strenuous or high-impact. It involved:

  • 5 minutes of warm up flexibility exercises
  • 5 minutes of clapping and light movements
  • 20 minutes walking at moderate intensity
  • 5 minutes cool down and deep breathing.

This was repeated three times per week for 12 weeks in the evening.

The authors conclude that both groups saw improvements in their depression and reduced suicidal thoughts. However, the combined CBT and exercise group also improved their daily functioning and the combined treatment was superior than CBT alone at reducing depression and suicidal thoughts.

Using exercise as an adjunct to traditional therapy provides a low-cost, safe, easily accessible way to improve the effectiveness of standard treatment that has the added benefit of improving physical health too. This work adds further support to the importance approaching mental health from a whole-body perspective.

 

Reference

Abdollahi, A., LeBouthillier, D. M., Najafi, M., Asmundson, G. J. G., Hosseinian, S., Shahidi, S., Carlbring, P., Kalhori, A., Sadeghi, H. & Jalili, M. (2017). Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression. Journal of Affective Disorders, https://doi.org/10.1016/j.jad.2017.05.012