By: Jessica Miller, M.D., FABPMR
Depression is a very complex emotion that is influenced by many factors. It can be brought on by significant life altering events. In many cases, genetics and gene expression can play a crucial role. While it is not thought possible to change your genes, it is possible to change your gene expression (the way your genes work). In addition, there are many lifestyle modifications you can make to improve your emotional state.
The number of research articles written on the causes and treatments for depression is staggering. It has been repeatedly demonstrated that people suffering from depression have altered brain chemistry and function. The ENIGMA consortium, a large multi-center collaboration of 70 institutions, has analyzed both genetic data and neuroimaging studies with regard to depression. They have established that the size of the hippocampus, the area of the brain responsible for memory and emotion, actually decreases in response to chronic depression. So what can you do to prevent this? Exercise!
An excellent article written by Lynette Craft and Frank Perna, in The Primary Care Companion – Journal of Clinical Psychiatry, addresses various theories as to why exercise helps depression. These theories range from the physical and chemical effects exercise has on the brain to changes in psychology brought on by exercise. The physical and chemical effects include increased body temperature (higher temperature increases activity in certain parts of the brain), release of endorphins (compounds that relieve pain and increase pleasurable feelings), and availability of neurotransmitters (thought to decrease depressive symptoms). The concentrations of these neurotransmitters are often lower in depressed people. In fact, most anti-depressant medications work by preventing breakdown of these important neurotransmitters. Psychological theories concerning benefits of exercise on depression focus on likening exercise to a meditative state providing a distraction from negative thoughts and a sense of confidence offsetting depression through the consistent following of an exercise program.
Most likely all of these hypotheses are at least partially correct. So what’s the take home message? Stick to it and continue exercising! The most important times to exercise are the times you don’t want to exercise. It is rare that you will leave an exercise session feeling worse than when you entered. Not every day will be the best day, but you just need to show up and give it your all. Just focus on all the benefits you obtain from routine exercise!
Jessica Miller, M.D., FABPMR, is board certified in Physical Medicine and Rehabilitation and part of the medical staff at Hackensack Meridian Health Raritan Bay Medical Center. She is currently completing an Integrative Medicine fellowship under Dr. Andrew Weil at The University of Arizona Center for Integrative Medicine. Dr. Miller incorporates her traditional western medical training with a more integrative approach to address the root causes of disease states. By altering certain factors such as diet, environmental exposures, gut health, and physical activity, Dr. Miller modifies the severity of disease expression. Her office is located in Suite 203, 2 Hospital Plaza, Raritan Bay-Old Bridge. Dr. Miller will lead a discussion on integrative medicine and heart health at the Joyful Heart Tea event,August 24, 4 p.m., at Raritan Bay–Perth Amboy in Centennial Hall. To make an appointment or to register for the event, call 1-800-DOCTORS
