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While a new study says exercise may not have the same anti-inflammatory effects for depressed people as it does for people who aren't depressed, experts say that doesn't mean people living with depression don't have anything to gain from physical activity.
The benefits of exercise and moderate alcohol consumption may be at least partly lost on people living with depression, said researchers from Duke University.
Their study, appearing in the journal Brain, Behavior, and Immunity, said the anti-inflammatory effects usually associated with exercise and tempered drinking are diminished in people who have depression.
In this case, researchers looked at a biomarker known as C-reactive protein (CRP) that predicts a person's future risk of inflammatory conditions like heart disease, diabetes and possibly hardened arteries. Exercise and moderate drinking (up to two drinks and one drink daily for men and women, respectively) have been shown to reduce a person's risk for heart disease and diabetes. It also lowers CRP levels, which reduces inflammation.
Depression, on the other hand, elevates CRP levels and increases heart disease and diabetes risk.
Here's what they found, after studying 222 healthy adults who didn't smoke and hadn't been previously diagnosed with a psychiatric condition:
- Participants who were physically active saw lower CRP levels, and thus less inflammation – with the exception of those physically active participants who were depressed.
- Among men, moderate drinking was associated with lower levels of CRP, but only in those who weren't depressed.
"We're not saying that exercise isn't helpful for those with depression," said lead author Edward Suarez in a statement. "What we saw is that depression has effects beyond what has previously been reported. Even if mental health improves, the anti-inflammatory benefits of physical activities may lag behind."
That means primary care providers may need to consider the mental state of their patients when counseling them on how to reduce their risk of heart disease and other chronic conditions, the report's authors added.
Depression and physical activity in South L.A.
Betty Mendoza is a licensed clinical social worker for the Los Angeles Child Guidance Clinic, a mental health provider that serves South Los Angeles. She says depression has plenty of physical and emotional side effects: changes in sleep habits, changes in appetite, a lack of concentration and motivation, reduced energy, sadness and a lack of interest in "things or activities that an individual used to like to do in the past," to name just a few.
"It becomes a big ordeal to have to engage in different types of activities," she said.
Meaning it can be a herculean struggle to even muster up the energy or willpower to get out of the door to exercise. That may make the prospect of exercising while depressed altogether bleak, especially considering the new findings from Duke that say depressed people who exercise may not be reaping the same benefits as exercisers who aren't depressed.
But Mendoza agreed with Suarez, the lead author. She says even if exercise doesn't always produce the desired physical results in people who are depressed, it can still be a major boon to their mental and emotional well-being.
"What I have noticed in my clients is that when they do make a commitment to some sort of exercise plan and they stick with it, they do feel much better about themselves," she said, citing studies that have shown that the serotonin levels in the brain that result from exercise can help with feelings of depression. "So exercise does actually help individuals who are feeling depressed."
That's not across the board, though. Mendoza says she also has patients whose self-esteem is so low, and whose depression is so severe, they can't maintain a regular exercise routine.
"Even though they do make attempts to work out, it just doesn't feel the same," she explained. "It just doesn't feel to them like they've accomplished something. So they eventually end up giving up."
The latest data available from L.A. County's Department of Public Health from 2009 shows that around 14 percent of South L.A. adults had, at one point in time, been diagnosed with depression. About 14 percent of southside adults also reported experiencing "frequent mental distress," including depression, which was the highest rate in the county.
The numbers also show a rising trend in depression in the area. In 1999, about 7 percent of adults had been diagnosed with depression. Ten years later, that percentage had virtually doubled.