Exercise and Positive Psychotherapy:
Better than Antidepressants

By: Michael G. Conner, Psy.D

Too often we accept the outdated assertion that medication and psychotherapy are the “proven” treatment mode for depression. Positive psychotherapy and exercise can reduce or eliminate symptoms of depression and anxiety in almost anyone. There are good studies that demonstrate this and my work with patients confirms it.

Exercise is an important and positive addition to psychotherapy. Books, articles and guidelines for combining exercise and psychotherapy have been developed. I’m so convinced of this that I installed an exercise gym in my office for patients. I also have simple exercise equipment patients can take home with them. The combined results are immediate and powerful. I can hardly  imagine the use of antidepressants as a first option if a patient is severally depressed.

According to the U.S. Health Department, more and more people are depressed. The reasons are stress, the consequences of stress, and a culture that promotes the pursuit of stimulation and pleasure as distraction or escape from emotional problems. Instead of more healthy activities, people are pursuing stimulation and pleasure through food, alcohol, television and video games while sitting on the couch.

Why do health care professionals in the U.S. recommend antidepressants without requiring more healthy and proven approaches first? There are two reasons.

Antidepressants are big business. Americans spend more than 86 billion dollars a year on antidepressants alone. Pharmaceutical companies spend nearly 10 billion dollars each year on marketing and promotion. Antidepressants are among the most commonly prescribed and most profitable drugs in America. Very little money is spent in the U.S. to promote awareness of healthier alternatives among health care professionals.

Second, people in the U.S. seem to believe drug marketing. Research results are widely misinterpreted and oversimplified in U.S. newspapers, magazines and on television. The problem has become so wide spread that many health care and mental health professionals misunderstand the research as well. Health care in Europe, England and Canada is based on more accurate information.

The Biggest Misunderstanding

Antidepressants can help a few people. Journalists and advertisements incorrectly report that antidepressants can help up to 65% of people diagnosed with depression. But when you read the research, and account for placebo effects, you realize that 40 to 50% of depressed people would get better without an antidepressant. Only 15 to 25% improve somewhat on drugs. Research repeatedly confirms that 40 to 50% of depressed patients get better because of the passage of time, changes they make in their lives, and fortunate events. And if you read all the studies on antidepressants you discover that nearly 6 out of 10 studies show that antidepressants don’t work at all. The failed studies are never publicized and are often kept secret. In fact, the “new generation” of antidepressants (like Prozac) are not more effective than the old ones. The new ones are just more expensive with different risks and side-effects.

There are some important realities that are supported by research and publications.

  • Many antidepressants require higher doses over time.
  • Stopping antidepressants quickly, especially after years of use, can in some cases, be very unpleasant or even dangerous.
  • Antidepressants, some more than others, can increase the risk of destructive, violent and suicidal behavior.
  • The main differences among antidepressants are the side effects and allergic reactions.
  • The more stimulating antidepressants, like Effexor, tend to be more addictive.
  • Very few people will find one antidepressant more effective than another. (Some just make you feel worse than others.)

How Do Most People Recover From Depression?

Most people get better because of the passage of time, fortunate events, or positive changes in their life style. Medications can prevent people from making changes in their life. In Europe, many people who stay on antidepressants for 10 years are generally worse off than those who chose healthy alternatives. Psychotherapy and exercise can help create a better life.

Exercise and Positive Psychotherapy

Exercise can benefit people of all ages. Almost any strenuous exercise can reduce or eliminate symptoms of depression. This can include activities like walking, hiking, rowing, biking, running or weight lifting. Exercise on a daily basis that involves social interaction is best. The effect of exercise is positive, both immediately and long term.

The following will be true for the vast majority of people.

  • Positive psychotherapy is an effective treatment for depression (and anxiety).
  • Psychotherapy will be more effective and less expensive in the long run than antidepressants.
  • Exercise is more effective than antidepressants.

People who have not seen a health care professional in a long time, and those with health problems, should have a medical check-up before entering a new exercise program. This is especially important for people who have high blood pressure, are overweight, smoke, are diabetic or have family history of heart disease. People with skeletal or muscle problems should consult with a physical therapist.

Sustaining Motion

Positive psychotherapy is more than just talking about problems. It is about supporting a healthy lifestyle where people are engaged in meaningful, stimulating and rewarding activities. The biggest challenge for a person who has been depressed is to keep exercising. People are more likely to continue exercise if their activity involves positive social experience, scheduled times for exercise and when they measure progress and pay attention to all the benefits. Exercise and positive psychotherapy can eliminate depression and create joy.

Dr. Conner is a psychologist who completed a research and training fellowship in graduate medical education and health education. He provides training, evaluation and intervention services for adults, families and youth. Dr. Conner's practice includes clinical, medical and family psychology. He is a Board Certified Expert in Traumatic Stress, Emergency Crisis Intervention, and Emergency School Response. This article is also available at www.CrisisCounseling.Com. Dr. Conner’s practice is located in Bend Oregon and he can be reached at 541 388-5660

Copyright 2008, Michael G. Conner