Diagnosis of Depression
A person who suffers from a major depressive disorder must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2- week period. This mood must represent a change from the person’s normal mood. Social, occupational, educational, or other important functioning must also be negatively impaired by the change in mood. A depressed mood caused by substances (such as drugs, alcohol, medications) or a general medical condition is not considered a major depressive disorder. Major depressive disorder cannot be diagnosed if a person has a history of manic, hypomanic, or mixed episodes ( e.g. a bipolar disorder) or if the depressed mood is better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, a delusion or psychotic disorder.
This disorder is characterized by the presence of a majority of the following symptoms:
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g feels sad or empty) or observation made by others (e.g appears tearful). (In children and adolescents, this may be characterized as an irritable mood.)
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- Significant weight loss when not dieting or weight gain (e.g. a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day
- Insomnia, early- morning awakening, or oversleeping
- Psychomotor agitation or retardation nearly every day
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive inappropriate guilt nearly every day
- Diminished ability to think or concentrate, or indecisiveness, nearly every day
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. (1)
Depression And Exercise
National surveys have suggested that sedentary adults are at much higher risk for feeling fatigue and depression than those who are physically active(4, 16). In one study of 1,536 Germans, the odds of being depressed were more than three times higher for sedentary versus physically active adults (18). Since 1980, numerous studies and reviews of the literature have concluded that exercise is associated with reduced depression (2, 3, 9, 10, 12, 13, 16). Both acute and chronic exercise have been associated with reduced depression, with the greatest improvements seen in clinically depressed subjects who exercise frequently for several months (13). Two meta- analyses of the literature have shown that all age groups, both men and women, across persons differing in health status gain strong antidepressant effects from regular, long-term aerobic exercise (12, 13).
In general, depressed patients have been found to be physically sedentary and to experience a reduction in their depressive feelings when they initiate regular exercise. It has been proposed that exercise is as effective as group or individual psychotherapy, or meditative relaxation, in alleviating mild-to-moderate depression (9, 10, 13). However, exercise plus psychotherapy have been shown to be better than exercise alone in reducing depression (10).
Researchers at Duke University have shown in a randomized clinical trial that 16 weeks of aerobic exercise (three supervised group sessions per week, 30 minutes per session, with 15 minutes of warm-up and cool-down) was as beneficial as treatment through medication (Zoloft) in reducing depression scores among 156 male and female patients with major depression (3). Most of the reduction in depression scores occurred within the first 4-8 weeks of exercise. Six months after treatment concluded, relapse rates were significantly lower in the exercise compared to medication group (2). These data indicate that aerobic exercise therapy is effective and feasible over the long term in reducing depression among patients with major depression. It is not suggesting to not take anti-depressant medication or not receive psychotherapy, but rather that the effect of exercise on depression has been shown to be effective and is therefore feasible to use in conjunction with medication and/or psychotherapy.
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If you have Depression, learn about how Depression is a chronic disease which is eligible to receive a Medicare Rebate when seeing an Accredited Exercise Physiologist:
Did you know you could get up to 50% off with a Medicare Rebate?
Learn how an Accredited Exercise Physiologist can help you to begin and maintain exercise in your life, so you can enjoy the health benefits of Exercise for Diabetes:
What Does an Exercise Physiologist Do?