Exercise 'best cure' for depression

Published on 29/03/2005 02:17

DEPRESSED patients should be offered exercise "on prescription" by their GPs in place of drugs, according to a report by mental health campaigners published today.

Studies have shown that exercise can produce significant and comparable improvements in patients relative to those who only take anti-depressant medication.

It has also been shown that those who continue to exercise after completing an initial trial were much less likely to experience a return of depression than those in the group taking anti-depressants.

The Mental Health Foundation (MHF) said GPs should be offering all patients with depression a programme of exercise to help combat their symptoms.

A report titled Up and Running?, published by the charity today, marks the start of a year-long campaign calling for more exercise therapy for people with mild or moderate depression.

It comes amid growing concern about the side-effects and over-prescribing of anti-depressants in the UK.

Guidelines now state that anti-depressants should not be used as a "first-line" treatment for mild depression.

The majority of the drugs are also no longer recommended for under-18s due to possible side-effects including the increased risk of suicide.

MHF said that growing evidence showed that a supervised programme of exercise on prescription could be as effective as anti-depressants in mild to moderate depression.

But its report said GPs were still turning to the drugs as their first option because they believed there was a lack of available alternatives, such as counselling.

The cost of anti-depressant prescriptions in England has risen by more than 2,000 per cent in 12 years, it added.

Anti-depressants are the most commonly prescribed psychiatric drugs in Scotland and in recent years their prescription has increased dramatically.

In 2002/03 the NHS in Scotland spent 11 per head of population on anti-depressants with three and a quarter million anti-depressant prescriptions at a gross ingredient cost of more than 55 million.

In the last ten years the number of anti-depressant prescriptions in Scotland has trebled while the cost has more than quadrupled over the same period.

Spending on anti-depressants in Scotland is 40 per cent higher per head than in England, according to NHS Scotland’s own statistics.

A poll of 200 GPs carried out by the MHF found that only 5 per cent used exercise as one of their three most common treatment responses to depression.

In contrast, 92 per cent of GPs used anti-depressants as one of their three most common treatment responses.

The survey also found that 78 per cent of doctors had prescribed an anti-depressant in the last three years, despite believing an alternative treatment might have been more appropriate.

Three-quarters of those doctors said they had done so because a suitable alternative, such as counselling, was not available.

Dr Andrew McCulloch, MHF chief executive, said: "Patients with mild or moderate depression asking their GPs for help are currently being denied an effective treatment option - exercise referral.

"There are some obstacles standing in the way of exercise on prescription for all, but they’re not insurmountable.

"Society needs to be educated about the benefits of exercise in treating mild or moderate depression, and GPs need to be made aware that exercise referral is available."

The MHF has called for the government to invest 20 million in developing and promoting exercise referral as a treatment for depression across the UK - representing around five per cent of the annual spend on anti-depressants in England.

• Campaigners in Scotland seeking alternative cures for depression are to host a comedy night in support of the charity the Depression Alliance.

Staged at the Three Tuns venue in Edinburgh, the comics and compres hope to keep their performance going for a record-breaking 36 hours from 30 March to 1 April.

'IT CHANGED MY WORLD'

BEA Thompson, 43, had been suffering from anxiety and depression for several years before being referred to the Active Lifestyles Exercise Referral Scheme in Bromley, London. She credits the programme as the catalyst for her recovery.

She said: "At my low point, I was very ill and debilitated. I’m a graduate and I’ve worked in business and management, but I was homeless and had been socially housed in a completely different area. It was a mammoth task to go out and make sure I had enough benefits or electricity, or even to see a doctor."

In 2003, Ms Thompson saw a leaflet for the Active Lifestyles scheme and asked her GP for a referral in the hope it might help her.

She said: "The night before I couldn’t sleep because I was so anxious about it, and I was absolutely wrecked when I got there, but Gloria [the referral officer] was superb. She was totally positive and didn’t think it was weird that this was a huge step for me.

"When I left the gym that morning I felt as if someone had given me a million pounds - it was the sense of achievement, the fact that I’d been understood and that I now had somewhere to go regularly.

"There was a huge sense of community. And the emphasis was positive - it changed my world."