Quickest & Easiest Way To Decrease Depression Symptoms For Breast Cancer Patients

exercise-for-depression-cancer-treatment-protocolWe’ve known for decades that even a single bout of exercise can elevate our mood, but could it be enough to be used as a treatment for major depression?

We’ve known that physical activity has been associated with decreased symptoms of depression. For example, if you look at a cross-section of 8,000 people across the country, those that exercised regularly were less likely to have a major depression diagnosis. That’s just a snapshot in time, though. In that study, the researcher openly acknowledges this may be a case of reverse causation. Maybe exercise didn’t cut down on depression, maybe depression cut down on exercise. The reason depression may be associated with low physical activity is that people may feel too lousy to get out of bed. What we’ve needed was an interventional study where you take people who are already depressed and randomize them into an exercise intervention.

That is what researchers from Duke University Medical Center did. They randomized men and women over age 50 with major depression to two groups: one who did an aerobic exercise program for four months and another that took an antidepressant drug called Zoloft. In my video Exercise vs. Drugs for Depression you can see a graph of their changes. Before exercise, their Hamilton Depression scores were up around 18 (anything over seven is considered depressed). Within four months, the drug group came down to normal, which are exactly what the drugs are supposed to do. What about the exercise-only group, though? Exercise had the same powerful effect.

The researchers concluded that an exercise training program may be considered an alternative to antidepressants for treatment of depression in older persons, given that they’ve shown that a group program of aerobic exercise is a feasible and effective treatment for depression, at least for older people.

Not so fast, though.

A “group program?” They had the exercise group folks come in three times a week for a group class. Maybe the only reason the exercise group got better is because they were forced to get out of bed and interact with people—maybe it was the social stimulation and had nothing to do with the actual exercise? Before you could definitively say that exercise can work as well as drugs, what we would need to see is the same study, but with an additional group who exercised alone with no extra social interaction. And those same Duke researchers did just that,

They created the largest exercise trial of patients with major depression conducted to date, and not just including older folks, but other adults as well with three different treatment groups this time: a home exercise group in addition to the supervised group exercise and the drug group as before.

And they all worked about just as well in terms of forcing the depression into remission. So we can say with confidence that exercise is comparable to antidepressant medication in the treatment of patients with major depressive disorder.

Putting all the best studies together, researchers indicate that exercise at least has a moderate antidepressant effect, and at best, exercise has a large effect on reductions in depression symptoms and could be categorized as a very useful and powerful intervention. Unfortunately, while studies support the use of exercise as a treatment for depression, exercise is rarely prescribed as a treatment for this common and debilitating problem.

Exercise may compare favorably to antidepressant medications as a first-line treatment for mild to moderate depression, but how much is that really saying? How effective are antidepressant drugs in the first place? Check out my video Do Antidepressant Drugs Really Work?

For dietary interventions that may improve mood, see:

Exercise can also help with ADHD (Treating ADHD Without Stimulants) and improve immunity (Preserving Immune Function in Athletes With Nutritional Yeast), not to mention extend our lives (Longer Life Within Walking Distance). But what we eat matters: Paleo Diets May Negate Benefits of Exercise.

In health,

Michael Greger, M.D.

Michael Greger, M.D., is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous “meat defamation” trial. Currently Dr. Greger proudly serves as the Director of Public Health and Animal Agriculture at the Humane Society of the United

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Fighting Breast Cancer Related Depression With Greens

Fighting Breast Cancer Related Depression With GreensWhy does frequent consumption vegetables appear to cut ones odds of depression by more than half? And by more frequent they mean eating vegetables not 3 or more times a day, but just 3 or more times a week. But even that seemed to cut the odds of developing depression by 60% after controlling for a long list of variables.

In the 2012 study that found that eliminating animal products improved mood within 2 weeks. The researchers blamed arachidonic acid, primarily in chicken and eggs, which may adversely impact mental health via a cascade of brain inflammation, but better moods on plant-based diets could also be from the good stuff in plants,a class of phytonutrients that cross the blood brain barrier into our heads. This recent review in the journal Nutritional Neuroscience suggests that eating lots of fruits and vegetables “may present a noninvasive natural and inexpensive therapeutic means to support a healthy brain. Yeah, but how?

Well to understand the latest, we need to understand the underlying biology, the so-called monoamine theory of depression, the thought that depression may arise out of a chemical imbalance in the brain. Here’s the oversimplified version: One of the ways the billions of nerves in our brain communicate with one another is through chemical signals called neurotransmitters. Here’s the end of one nerve and the beginning of another.

This is what it actually looks like under amicroscope. Note the two nerve cells don’t actually touch—there’s a physical gap between them. To bridge that gap, when one nerve wants to tap the other on the shoulder it releases chemicals into that gap, including three monoamines, serotonin, dopamine and norepinephrine. These neurotransmitters then  float over to the other nerve to get its attention. The first nerve then sucks them back in to be reused the next time it wants to talk, but it’s also constantly manufacturing more and an enzyme, monoamine oxidase, is constantly chewing them up to maintain just the right amount.

The way cocaine works is by acting as a monoamine reuptake inhibitor. It blocks the first nerve from sucking back up these three chemicals and so there’s this constant tapping on the shoulder this constant signaling to the next cell. Amphetamines work in the same way but also increase their release. Ecstacy works like speed but just causes comparatively more serotonin release.

After awhile, the next nerve may be like enough already and down-regulate its receptors to turn down the volume. It puts in earplugs. So you need more and more of the drug to get the same effect, and then when you’re not on the drug you may feel crappy because normal volume transmission just isn’t getting through.

Antidepressants are thought to work along similar mechanisms. People who are depressed appear to have elevated levels of monoamine oxidase in their brain. That’s the enzyme that breaks down those neurotransmitters, and so if you have too much of that enzyme in critical parts of your brain, as the study show—the black circles are the levels in the brains of depressed individuals, and white circles that of the healthy individuals, if your levels of your neurotransmitter-eating enzyme is elevated, then your levels of neurotransmitters drops, and you become depressed, or so the theory goes.

So a number of different classes of drugs have been developed. The tricyclic antidepressants, named because they have three rings like a tricycle, appear to block norepinephrine and dopamine re-uptake, and so even though your enzymes may be eating these up at an accelerated rate, what gets released sticks around longer. Then there were the SSRIs like Prozac, the selective serotonin reuptake inhibitors. Now you know what that means—just blocks the reuptake of serotonin. Then there are drugs that just block the reuptake of norepinephrine. Or more dopamine. Or the opposite. But if the problem is too high levels of monoamine oxidase, why not just block the enzyme? Make a monoamine oxidase inhibitor—and of course they did, but they’re considered drugs of last resort because of serious side effects, not the least of which is the dreaded “cheese effect,” where eating certain foods while on the drug can have potentially fatal consequences. If only there was a way to tamp down the activity of this enzyme without the whole bleed-into-your-brain-and-die thing.

Now we can finally talk about the latest theory as to why fruits and vegetables may improve our mood. There are inhibitors of the depression-associated enzyme in various plants. There are phytonutrients in spices, such as clove, oregano, cinnamon, and nutmeg, but people don’t eat enough spices to get enough into the brain. This dark green leafy has a lot, but its name is tobacco, which may actually be one of the reasons cigarettes make smokers feel so good. OK, but what if you don’t want brain bleeds or lung cancer?

Well there is a phytonutrient found in apples, berries, and grapes, and kale, onions, and green tea that may indeed affect our brain biology enough to improve our mood.

Doctor’s Note

More on the inflammatory omega-6 arachidonic acid in chicken and eggs that may impact mental health via a cascade of brain inflammation in:

For other natural treatments for mental illness, check out:

I got some feedback from those that previewed this video on DVD that my explanation of MAO inhibition was a bit much (too complicated). I think there are different camps of NutritionFacts.org viewers. Some that just want to know the bottom-line, and others that are fascinated by the underlying mechanisms and are eager to learn the underlying biology (the “why” not just the “what” and “how”). I’d be interested in everyone’s feedback. Do these more in depth explanations add or detract from the educational value?

Michael Greger M.D.About Michael Greger M.D.Michael Greger, M.D., is a physician, author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous “meat defamation” trial. Currently Dr. Greger proudly serves as the Director of Public Health and Animal Agriculture at the Humane Society of the United States.

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