The Link Between Depression, Mind-Body Exercise, and Antidepressant Treatments

Mind and body exercises (MBE) and antidepressant treatment were both bidirectionally linked with depressive symptoms after 2 years, according to study results published in Journal of Affective Disorders. This finding suggests that patients with more severe symptoms of depression are more likely to engage in these treatments, particularly antidepressant therapy.

The longitudinal cohort study included 3269 men and 4318 women aged 24 to 74 years who participated in the Swedish Longitudinal Occupational Survey of Health. The participants completed self-report questionnaires assessing depressive symptoms and participation in exercises related to mind (eg, meditation, mindfulness, relaxation techniques) and body (eg, yoga, tai chi, qi gong). The investigators obtained antidepressant prescription data from the Swedish Prescribed Drug Register and performed analyses with Structural Equation Modeling.

The investigators found that adults who participated in MBE and filled prescriptions for antidepressants in 2012 had elevated depressive symptoms 2 years later (standardized regression coefficients [SRC], 0.04 [95% CI, 0.01-0.06] and 0.06 [95% CI, 0.04-0.09], respectively).  Similarly, depressive symptoms were correlated with subsequent participation in MBE and antidepressant treatments (SRC, 0.05 for both). In post hoc analyses, antidepressants, alone and in combination with MBE, independently predicted more severe depressive symptoms 2 years later, suggesting that “those with more severe symptoms of depression may have been more likely to [receive] antidepressant medication.”

Engaging in physical exercise was significantly associated with lesser depressive symptoms 2 years later (SRC, -0.04), and in turn, depressive symptoms and antidepressants were linked to reduced exercise 2 years later (SRC, -0.01 and -0.02, respectively). Physical exercise was bidirectionally associated with MBE. Of note, women and individuals with higher levels of education were more likely to engage in MBE.

The study authors acknowledged that confounding by indication is a possible explanation for the findings, as individuals with depression are more likely to use MBE and/or antidepressants. Like many subjective measurements, self-reports of depressive symptoms and MBE have significant limitations. In addition, prescription data did not account for adherence.

The investigators concluded, “The results from this study give some new information on what people are doing to manage depressive symptoms on a societal level, regarding self-care (MBE, physical exercise), medication, and the combination of both.”

Reference

Rådmark L, Magnusson Hanson LL, Montgomery S, Bojner Horwitz E, Osika W. Mind and body exercises (MBE), prescribed antidepressant medication, physical exercise and depressive symptoms – a longitudinal study [published online January 10, 2010]. J Affect Disord. doi:org/10.1016/j.jad.2020.01.012