The trouble with prescribing exercise to depressed patients is that they are often too depressed to want to exercise. It can be like prescribing reading exercises to strengthen the vision of a blind person. With no energy or motivation, a severely depressed person may have no chance of being able to follow through.
For patients who are mildly depressed, while it may not be easy, it is more realistic to think that an exercise regimen can be pulled off. While it remains unclear as to whether this exercise will treat depression, there are clearly additional benefits that make it well worth trying.
Perhaps the biggest benefit is on weight, an issue for many a depressed patient as both the illness and the medication treatment of it can cause weight gain. The other huge benefit is on general health, as exercise reduces risk of many illnesses including heart disease, stroke and diabetes.
But all treatments have side effects, and exercise is no exception.
The downside to an exercise prescription is that if people think they should be exercising and are not able to fire up the willpower to get it done, they can experience more of the guilt and self-loathing that they already have in abundance from the depression itself.
So there is a balance to be struck between pushing for more exercise if it can be accomplished vs. accepting that the depression has made this impossible for the time being.
That will do it for now. Time to go for a run. I will, incidentally be passing by Meadowbrook, home of Michael Phelps' North Baltimore Aquatic Club, on my route.
Yes, we are very proud here in Baltimore!
Dr. James Potash is an associate professor of psychiatry and co-director of the Mood Disorders Program at the Johns Hopkins School of Medicine in Baltimore. If you have questions or comments, please e-mail email@example.com. To participate in our genetic and clinical studies, call 1-877-MOODS-JH.