Worldwide, one in eight people have a mental disorder such as depression, schizophrenia, and anxiety. In the US, major depressive disorder affects around 7.1% of the population, and around 18.1% of Americans have anxiety disorders. There is much money to be made from giving out medication for these mental health issues. Without insurance, a 30-day supply of depression medication can cost anywhere between $10-30 for generic drugs and $230-$1990 for the brand-name variations. Medication for anxiety can be similarly expensive (without insurance).
The idea that depression is caused by low serotonin levels and that medication corrects this imbalance has been disproven. And as this 2017 article explains, we still don’t know whether medications like Prozac are actually effective treatments for most people who have depression.
A new meta-analysis of numerous randomized controlled trials suggests that exercise is more beneficial for relieving the symptoms of depression and anxiety than pharmaceuticals or psychotherapy. The researchers who conducted the meta-analysis found that exercise was approximately 1.5 times more effective at treating these conditions. While exercise reduced the mental health issues in study populations between 42-60%, psychotherapy and pharmaceutical interventions only reduced these problems by 22-37%.
150 minutes of physical activity each week resulted in significant reductions in depression and anxiety, and this physical activity could be as moderate as walking 20-40 minutes a day. However, high-intensity forms of exercise, according to the study, produced the greatest benefits to those struggling with mental health issues.
Exercise releases endorphins, the chemical signals in the brain that contribute to feelings of wellbeing. Physical activity also reduces inflammation in the body, a problem which can contribute to a general feeling of unwellness. Exercise might work to reduce anxiety by reducing muscle tension and thus anxiousness, although more work in this area is needed.
It is clear that exercise confers many benefits for mental health, but it is rarely the first thing that physicians prescribe to their patients. Too often, doctors immediately write out a prescription for medications that have side effects and might not be doing all that much.
There are several reasons why exercise is not commonly prescribed by physicians against mental health disorders, or is only mentioned as a tangential way to improve symptoms. Patients might be skeptical that simply increasing their exercise could help what they are feeling – medication that promises to correct a chemical imbalance in the brain seems on the surface to be a more modern and effective treatment.
Doctors might be aware of this perception and want to preserve their image as a source of authority, or they might not be aware of the research on the powerful benefits of exercise against mental health disorders. Often, medical school focuses heavily on prescribing drugs as the first line of defense against an illness. In addition, doctors might believe that their patients are capable of taking a pill each day, but would not be able to stick with an exercise regimen. This reason is sometimes why doctors prescribe pills over dietary changes that would treat the root causes of someone’s disease.
It is important that exercise be seen as a legitimate treatment for mental health issues rather than just something added as an afterthought in addition to prescription drugs. In recent years, doctors in some regions of the globe have begun to prescribe nature walks for their patients over pharmacotherapy. In Canada, the organization PaRx (Park Prescriptions) works with licensed professionals to prescribe patients to spend time outdoors to improve their mental and physical health.
The research to support these prescriptions is clear, and it’s time for the treatments that physicians prescribe to catch up with the science.