The truth about running and depression

Mental health treatment is difficult. Most medications have side effects that range from unpleasant to truly unpleasant, and often other options are based on wishful thinking rather than proven medicine. This becomes even more intriguing when the news seems to indicate that depression can be treated by just jogging a few times a week. As headlines around the world have said recently, a new study appears to show that running therapy is just as effective in treating depression as pharmaceutical interventions.

Whenever you read headlines like these, you need to remember one simple rule: If it sounds too good to be true, it probably is. Although exercise may be helpful to some extent in treating mental health problems, there is no good evidence that running is as effective as SSRI medications such as Prozac and Lexapro.

The study that is making headlines everywhere is a new publication in the Journal of Affective Disorders. The study itself is quite simple. The authors describe the paper as a partially randomized patient preference study. In practice, this involves selecting people with depression or anxiety and asking them to choose their preferred treatment: standard antidepressants or exercise therapy. Running therapy involves group runs led by a trainer two to three times a week for a total of four months.

At the end of four months, the authors report, the two therapies did not differ from each other significantly on mental health outcomes (my emphasis). However, the running group lost a little weight and got a little healthier, leading to the recommendation that exercise therapy should be considered standard practice for people with depression and/or anxiety disorders. Europe. Hence the titles. Running to beat depressionIt is as effective as taking medication, claims the New York Post. The article includes this quote from the paper’s lead author: Both interventions helped address depression to the same extent.

But if you look a little closer at this article, the argument is that jogging is equivalent for medicine seems to be completely collapsed. First, the groups were not truly randomized. That would involve sorting people into treatment groups, not allowing them to choose which treatments they want to try for themselves, as researchers have done. This is a problem because it means that the people chosen to take this or that therapy may be very different from each other, which could explain the differences in depression outcomes at the end of the study. Indeed, going deeper into the article, it turns out that people who choose to take medication suffer from much more depression and anxiety than those who choose jogging therapy. Honestly, this is a bit obvious when you think about it. People who are truly depressed may not want to run two or more times a week!

There is also the small matter of which word meaning appears above. The authors correctly reported that in a statistical test, no statistical significance the difference between jogging and medication to alleviate depression or anxiety. But if you look at the supplemental appendix, it appears that people who took the drug improved their depression/anxiety scores on average twice as much as the runners. It’s true that this effect may not have been statistically significant in the test the researchers used. The fact that the study was so small, only 141 people, makes it difficult to know what the results mean. A more accurate explanation is that the drug had twice the effect of running in the study, but we don’t know if that was random noise or a real effect. The sample size is simply too small to say either way.

Overall, the study itself is extremely weak. Not only was it non-random and quite small, but the authors also pre-registered a very different protocol just four years earlier. (Preregistration helps hold authors accountable and allows us to ask: Do researchers actually do what they say they do when they start work? Maybe they will fiddle around with data until they receive it any interesting results, even weak results?) In 2019, they published a protocol for the same study, except instead of looking at depression and anxiety scores, the primary outcome of interest was Biological aging, metabolic stress, and neurobiological abnormalities. The 2019 protocol also included a control group of people without mental health problems. The statistical analysis plan in the original protocol also did not mention the final analysis the authors performed. This type of discrepancy is often a sign of so-called selective reporting or result switching, a practice known to significantly skew clinical trial results.

So the results from this particular test are almost completely unreliable. What does the rest of the literature show?

Honestly, this study is very relevant. Overall, other studies on exercise for depression are of extremely low quality. According to a 2013 Cochrane review, often considered the gold standard for evidence-based medicine, of the 39 trials published at the time on the issue, only six completed even minimal quality checks. Looking at just those six half-baked articles, there was at best a very small improvement in depressive symptoms for those treated with exercise therapy. There are very few trials looking at exercise and medication to treat these conditions, and none are reliable. Although a more recent review, published in the British Journal of Sports Medicine, caused controversy earlier this year by suggesting that exercise should be the main method of managing depression, it mainly Weakly provides similar evidence to the 2013 Cochrane review.

Ultimately, this new study adds virtually nothing new to our understanding of exercise or running as a treatment for mental health problems. To the extent that the results tell us anything, they do seem to suggest that the drug is more helpful than running two or three times a week, but even that result is highly doubtful.

One specific result of this trial will appear as you read it: Of the 96 people who chose to do running therapy, half of them stopped running after the 4-month mark. One thing that can be learned from this article is that even for highly motivated people, people select to try running therapy for their mental health problems, many people will stop the therapy soon after. Meanwhile, 82% of those taking the medication remained compliant at the same time.

This doesn’t mean that if you’re anxious or depressed, running or another form of exercise isn’t worth a try. if you Maybe exercise, it will probably help your mental health to some extent. Honestly, every study we’ve ever done shows that exercise is good for your health, physically and mentally. But the evidence also seems to suggest that as a practical intervention, exercise has limited applicability to real people in the real world. And there is currently no good reason to believe that it will be as effective medicine.

State of mindis the cooperation ofSlateAndArizona State Universityprovides a realistic look at our mental health system and how to improve it.

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