WOULD YOU RATHER CHOOSE PILL POPPING OR RUNNING?

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With WHO announcing that about 280 million people are suffering from depression worldwide, it is safe to say that depression is not just expanding but actually swallowing our population slowly. And we are at an impasse when it comes to treatment and recognition for the condition. Would you rather choose therapy, medication, or just a lifestyle modification? It is an equally difficult decision for the person suffering and the doctor treating it. What to choose, when on most days, the person can be not even be motivated enough to toss and turn in their bed? Depression and anxiety disorders affect not only mental but also physical health, so the need for effective treatment becomes more important.

After observing the people around me and innumerable surveys, there has been a consensus that people tend to avoid addressing their mental health, even after the mental health awareness revolution of the 21st century. In addition to that, people who are bold enough to seek help end up dropping out when advised to take medication. So when the MOTAR study, Mood Treatment with Antidepressants or Running, was started, we knew what the study group was going to prefer, but the real question remained if their preference was as effective as medication, and also if people are genuinely able to follow up with the lifestyle changes they so often prefer.

The study included 141 people who underwent a 16-week treatment plan; they were divided into two groups based on a partially randomized preference list. The antidepressant group included 45 people, and the running therapy group included 96. For the antidepressant group, they were started on an initial dose of escitalopram, an SSRI. Later, they were followed up by a psychiatrist at 2, 6, 10 and 16 weeks to assess drug effects, side effects, tolerance, and dose maintenance. A second drug sertraline was added if the first drug was ineffective and compliance was recorded as per the patient’s diary. For the running therapy, 45-minute sessions were organized, and the plan was to have the participants attend them at least 2-3 times a week. Running sessions were carried out and supervised; they always started with a 10-minute warm-up exercise period, followed by 30 minutes of jogging at an intensity that maintained heart rate within the assigned training range (the first 4 weeks at 50–70% of heart rate reserve and the subsequent 12 weeks at 70–85% of heart rate reserve). At the end, there were 5 minutes of cool-down exercises. Along with this, the participants were made to discuss their past exercise experiences with information about various aspects like nutrition, injuries, sleep, fatigue, and so on. For compliance, attending two sessions per week, or roughly 22 attended sessions, was the criteria.

At the end of the study, only 110 people completed the 16-week routine, while 31 people dropped out. In comparison, the results showed that treatment adherence was significantly higher in the antidepressant group. The treatment results, however, were quite the opposite, as both groups had a similar mental health outcome, but the running therapy group got far better results in the physical component of health. The favorable physical health components included waist circumference, weight, heart rate, heart rate variability, blood pressure, and lung function. There was a significant decline in physical health in the antidepressant group due to common side effects of the drug, like weight gain.

In the end, the research clearly advocates that exercise therapy has a lot of prospects for maintaining the mental and physical health of people. If we count the advantages of exercise therapy over drugs in layman’s language, we can count a lot of them:

  1. Affordable
  2.  Fewer side effects
  3. Prevention of innumerable lifestyle diseases
  4. Promotes discipline
  5.  Indirectly increases longevity
  6.  Not stigmatized
  7. Increases stamina
  8. Improves mood

A few more can be added to the list, but the only major disadvantage it holds is that it needs willpower and motivation to maintain the habit. It ends up being a major drawback because it is difficult for people suffering from depression to maintain motivation. As a result, the help of friends, family, and therapists becomes very important.

The pathophysiology of exercise therapy includes the fact that, first of all, it is a good distraction, and secondly, it plays a role in inducing the release of endorphins. This creates a sense of well-being and eases the condition. To get started with it, talk to your healthcare advisor and prepare a healthy routine for any physical activity you like. It need not be just running; it can be swimming, dancing, aerobics, yoga, or anything of choice. Follow it with discipline without making it a task for yourself, and whenever you feel demotivated or feel a setback, contact your loved ones or therapist for advice. This simple routine can lead to a positive outcome without any side effects.

For people with busy routines, it can be remembered that 150 minutes of moderate exercise per week is considered sufficient, so you only need to take out a maximum of 25 minutes in a day for yourself.

Finally, like any other treatment plan, the choice remains in the hands of the patient. Not every treatment plan works for all people, so if exercise doesn’t work, you can always get medication or other therapies. However, research has proven time and again that including exercise in your routine is good for mental and physical health, so it is at least not something anyone should try to avoid.

In conclusion, I would rather run than pop pills daily.


 

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About the author

Dr Shreya Singh is an MBBS student at BJGMC, Pune. Being an introvert she likes spending much of her time with books and stories. She loves to write, read, draw, paint and everything that gives her a new perspective of the world and allows her to express herself.

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