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    Exercise likely to be best treatment for depression in coronary heart disease

    Depression is common. It can affect anyone, leaving them with feelings of hopelessness and low energy, emptiness and constant fatigue.

    For those with coronary heart disease, a type of heart disease that develops when the arteries of the heart cannot deliver enough oxygen-rich blood to the heart, treating depression and this condition can take the joy out of life.

    But a study, led by researchers at RCSI University of Medicine and Health Sciences, published in the June edition of Psychosomatic Medicine, indicates that exercise is probably the most effective short-term treatment for depression in people with coronary heart disease, when compared to antidepressants and psychotherapy or more complex care.

    This means those who are diagnosed with this heart condition can have a better chance at fighting depression, without needing collaborative care – such as treatments devised by a multidisciplinary team of clinicians, with input from the patient.

    “Depression is common in patients with coronary artery disease. Having both conditions can have a significant impact on the quality of life for patients so it is vital that they have access to the most effective treatments,” commented senior lecturer in division of population health sciences, RCSI, and the study’s first author Dr Frank Doyle.

    “Our study indicates that exercise is likely to be the best treatment for depression following coronary artery disease. Our findings further highlight the clinical importance of exercise as a treatment, as we see that it improves not only depression, but also other important aspects of heart disease, such as lowering blood pressure and cholesterol, in these patients,” added Doyle.

    “We continue to see emerging evidence of the importance of lifestyle changes to treat disease – in comparison to other treatments – but further high-quality research is needed. People with coronary heart disease who have symptoms of depression should talk to their doctor about treatments that are most suitable for their personal needs, and clinicians can be confident of recommending exercise to their patients.”

    The researchers of the study reviewed treatment trials which investigated antidepressants, psychotherapy, exercise, combined psychotherapy and antidepressants, and collaborative care.

    To measure effectiveness, the researchers looked at factors – including patient adherence to the treatment (dropout rate) and change in depressive symptoms – eight weeks after commencing treatment.

    The strongest treatment effects were found to be exercise and combination treatments (antidepressants and psychotherapy). However, as the combination study results have a high risk of bias, the findings of the review suggest that exercise is probably the most effective treatment. Antidepressants had the most research support, while psychotherapy and collaborative care did not perform very well.

    There are many reasons why exercise can be a mental benefit, especially powerful for people who suffer from depression.

    “When you get the blood flowing and moving around, it releases endorphins,” Stephen Graef, PhD, a sports psychologist at The Ohio State University Wexner Medical Center, told Healthline.

    “Endorphins are released as a way to kind of combat the fatigue and the pain that we experience through physical movement such as exercise,” Graef explained.

    “From a mental health perspective, that is also going to give us those benefits of those same chemicals because they have that feel good, opiate-type of feeling to them.”

    While you should always consult with your doctor about changing your treatment options and before you start an exercise program as alternative treatment, here are some exercises you should include in your exercise when you are feeling down.

    Yoga:

    In a small 2007 study, published in Evidence-Based Complementary and Alternative Medicine, all of the study’s participants, who had taken yoga classes, experienced “significant” reductions in depression, anger, anxiety, and neurotic symptoms.

    Walk in the woods:

    In a 2009 study, published in Environmental Health and Preventive Medicine, Japanese researchers sent participants to either a wooded or urban area. They found that those who’d taken a 20-minute “forest bath”, had lower stress hormone levels than the participants who had been in a city.

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