Middle-aged people with high fitness levels are 56 percent less likely to eventually die from heart disease following a depression diagnosis, according to a new study by researchers at the University of Texas (UT) Southwestern and The Cooper Institute.

The study, published in the journal JAMA Psychiatry, reveals the many ways in which depression can impact health and mortality. According to the researchers, the earlier you become active, the better your chances of preventing depression, which in the long run will help lower the risk of heart disease.

The study also highlights the importance of overcoming a common dilemma among patients already struggling with depression: How does one cope with hopelessness and still find the motivation to exercise?

“Maintaining a healthy dose of exercise is difficult, but it can be done. It just requires more effort and addressing unique barriers to regular exercise,” says Dr. Madhukar Trivedi, co-author of the study and Director of the Center for Depression Research and Clinical Care, part of the Peter O’Donnell Jr. Brain Institute at UT Southwestern.

Trivedi cites previous studies showing that depressed patients can often perform about three-fourths of the exercise they’re asked to do. He suggests that patients with depression take several steps to boost their chances of success:

  • Set aside a consistent time to exercise each day, but do not get discouraged by stretches of inactivity. Resume activities as soon as possible.
  • Keep a log to track progress.
  • Vary the exercises to avoid monotony. Keep the workout interesting and fun.
  • Exercise with a friend.
  • Task someone with holding you accountable for maintaining the exercise regimen.

The researchers utilized a Cooper Institute database of participants who had their cardiorespiratory fitness measured at an average age of 50 years.

Using Medicare administrative data, the researchers then established correlations between the participants’ fitness at midlife to rates of depression and heart disease in older age. They found that participants with high fitness levels were 56 percent less likely to eventually die from heart disease following a depression diagnosis.

Trivedi says the results are just as relevant to younger age groups, in particular college-aged adults who are entering the workforce.

“This is the age where we typically see physical activity drop off because they’re not involved in school activities and sports,” Trivedi says. “The earlier you maintain fitness, the better chance of preventing depression, which in the long run will help lower the risk of heart disease.”

Depression has been associated with several other chronic medical conditions such as diabetes, obesity, and chronic kidney disease, which can influence whether antidepressants are likely to help. For patients with these conditions, the more appropriate treatment may be exercise.

Trivedi says this may be due, at least partially, to the general health effects of physical activity, including the fact that exercise reduces inflammation that may cause depression. By reducing inflammation, the risk for depression and heart disease are lowered.

“There is value to not starting a medication if it’s not needed,” says Trivedi, who’s leading a national effort to establish biological tests for choosing antidepressants. “Being active and getting psychotherapy are sometimes the best prescription, especially in younger patients who don’t have severe depression.”

Trivedi has put together large studies to further solidify the cause and effect among fitness, depression, and heart disease. One example is RAD, Resilience in Adolescent Development, a 10-year study that will enroll 1,500 participants who are at risk of developing depression but have not done so yet.

The study’s main focus is to determine whether personal factors such as lifestyle and biology impact a teenager’s ability to resist mood disorders. But researchers will also measure fitness levels and track whether depression and heart problems occur in later years.

“There is enough evidence to show that the effect of low fitness on depression and heart disease is real,” Trivedi says. “But further study is needed to establish the mechanism by which this effect happens.”

Dr. Willis is the Director of Epidemiology at The Cooper Institute and lead author of the study. He adds that the new findings show the ongoing importance of fitness throughout life.

“Now we know that the long-term benefits, and the connection between mind-body wellness, are more significant than we thought. We hope our study will highlight the role of fitness and physical activity in early prevention efforts by physicians in promoting healthy aging,” says Willis.

Source: UT Southwestern Medical Center