LESSON THREE

Lesson Summary: This lesson will look at how exercise is used in the treatment of
depression. It will look at What is exercise? As well as aerobic exercise, physical
activity, and strength training.
Lesson Content:
What is exercise? Exercise is defined as a physical activity that is planned, structured,
and receptive. Exercise is well recognized as a beneficial influence on depressive
symptoms. Exercise may provide a diversion from depressive thinking and increase
self-efficacy.
Cardiovascular Exercise: The benefits of cardiovascular exercise for the treatment of
depression have been known for over 20 years (Danielsson, Noras, Waern, & Carlsson,
2013). Some studies have shown that after 10 weeks of cardiovascular activity people
show a significant reduction in depressive symptoms, and a significant improvement in
cardiovascular fitness (Stanto & Happell, 2013). Cardiovascular exercise refers to
exercise supported by aerobic metabolism (walking, jogging, cycling, and swimming); it
is often performed at an intensity of 60-80% of maximal heart-rate two- three times a
week.
Physical Activity: Physical activity is defined as body movement produced by the
movement of the skeletal muscle that results in energy expenditure (Danielsson, Noras,
Waern, & Carlsson, 2013). While any physical activity does seem to make a difference
with the amount or severity of depression it appears that an actual exercise regime is
better for reducing depression.
Resistance Training: Resistance (or weight) training, much like cardiovascular excise
reduces the depression significantly more at a higher intensity than at a lower intensity
(Stanton, Reaburn & Happell, 2013). Resistance training seems to work better on
depression in younger people than older (Stanton, Reaburn & Happell, 2013). Although
the results for both were still significantly better than not doing any exercise.

Presently, there are no best practice guidelines for the prescription of exercise for
patients with depression (Stanto & Happell, 2013). A program of cardiovascular
exercise should be undertaken three times weekly, for a minimum of 30 minutes per
session, at moderate intensity, for a minimum of eight weeks to be effective (Stanto &
Happell, 2013). Furthermore the program should accommodate any comorbidites, allow
for patient preferences, and be supervised. Building on these guidelines, the national
depression initiative, beyondblue, recommends that exercise be undertaken three times
weekly, for 45 minutes, in order to be helpful in promoting well-being and lifting mood
(Stanto & Happell, 2013).

References:
Danielsson, L., Noras, A. M., Waern, M., & Carlsson, J. (2013). Exercise in the treatment of
major depression: A systematic review grading the quality of evidence. Physiotherapy Theory &
Practice, 29(8), 573-585. doi:10.3109/09593985.2013.774452
Stanton, R., & Happell, B. M. (2013). An Exercise Prescription Primer for People with
Depression. Issues In Mental Health Nursing, 34(8), 626-630.
doi:10.3109/01612840.2012.758207
Stanton, R., Reaburn, P., & Happell, B. (2013). Is Cardiovascular or Resistance
Exercise Better to Treat Patients With Depression? A Narrative Review. Issues In
Mental Health Nursing, 34(7), 531-538. doi:10.3109/01612840.2013.774077