An Irish systematic review of current research has found resistance training may be a very helpful treatment for depression.
And this may be important when we consider the impact depression has on the world today.
Many of us have a broad appreciation of what depression is on an intellectual level. But as an often covert mental health condition, we may not respect its personal impact. We certainly don't appreciate how hard it is to conquer.
Staggeringly, the World Health Organisation estimates "more than 264 million people worldwide are affected by depression". And with approximately 7.8 billion people in the world, it means almost one in three of us suffers from the condition.
That means either you have depression or someone in your family or friendship group potentially does. It's no wonder depression is a leading cause of disability worldwide.
So it's encouraging when a study collates the effects of something like resistance training on depressive symptoms. Particularly when it might just be the first of it's kind to do so.
Study Design
The Irish researchers decided to conduct a systematic review of clinical trials using a resistance training intervention and a control group (no intervention). The idea was to measure the impact of weight training on depressive symptoms.
Each study included in the review measured depressive symptoms before a resistance training intervention and at a later date for comparison.
Overall, 33 randomized-controlled trials (RCTs) made the cut. The overall number of participants was 1877, with 947 a part of a resistance training group and 930 control.
The average age of all participants was 52 years, with two-thirds female.
Of most note, the average weight program was three sessions a week for 16 weeks.
In terms of the quality of the RCTs included, the average Detsky Quality Assessment score was 10.5/13. This suggests the studies included in the systematic review were relatively strong with a lower risk of inherent bias.
Is Resistance Training an Effective Treatment for Depression?
The systematic review found resistance training had a significant effect on depressive symptoms across the board. Interestingly, this was independent of any participant characteristics or differences in training programs.
Their analysis showed those diagnosed with mild to moderate depression had "significantly larger reductions in depressive symptoms".
Similarly, the review also found that relatively shorter resistance training sessions (<45 minutes) had a greater effect on depressive symptoms.
Interestingly, each participant's health status, training volume, and strength gains did not correlate with the anti-depressive effects of resistance training. This means that resistance training may be an effective treatment for depression regardless of any additional health and fitness gains.
The encouraging thing about this review is its results are strong despite a broad range of resistance training programs. This suggests the specifics of a resistance training program may not be as important as just doing it.
There may be an optimal regime for treating depression, but this is unfortunately outside the scope of the systematic review. Either way, it's great to know resistance training might help.
Overall, these results are impressive. They initiate a conversation for the treatment of depression beyond traditional avenues like Psychology and medication.
Resistance Training Program for Depression
Considering this review doesn't specify what the ideal resistance training program is, it might be worthwhile to cover what this may look like from a Physical Therapy perspective. After all, why not try and make your body function better at the same time, right?
From my perspective, these are some basic principles and exercises to follow.
The perfect weight for you is one that generates moderate fatigue after 8-12 reps. This is without sacrificing good technique.
Starting exercises should include those that represent important physiological movements:
- Squats
- Deadlift
- Bench Press
- Seated Row
- Shoulder Press
- Planks
From here, the difficulty can be scaled up or down based on technical competency.
Other exercises like bicep curls and tricep extensions are helpful, but these movements are represented in seated rows and bench press if just looking for functional gains.
These basics may be a simple place to start for those looking to see the effect of resistance training on their depression.
Limitations
As with any study, we need to consider its limitations and the ability to generalize the results. In short, we need context.
Related: Here's why I think the current evidence-based model is a little unbalanced
The poor quality of design and likelihood of potential bias renders many RCTs inherently biased. And with a larger number of studies used in this review, poorly designed studies may compound and compromise its findings.
So it's great to see the authors of this study independently assess the quality of each RCT via the Detsky assessment tool. Although the average score was 10.5/13, some studies did score 7s and 8s. These lower-scoring studies did not blind allocation or assessment (people knew which groups and assessments they were exposed to), so it's harder to decipher the impact of chance on their results.
Now the beauty of a systematic review is we get a broad overview of a number of study results. Considering the overarching findings support resistance training as a treatment effect for depression, these lower results may not matter too much.
The study itself mentions a "notable lack of clear and complete reporting of intervention design, protocol, data analyses, participant information, medication use, adherence, and compliance." Essentially there were some gaps in how uniform the studies were across the review. If they didn't account for medication use it may seriously cloud the robustness of these results. Particularly if used at the same time.
Interestingly, the age range of each RCT shows that the majority of participants were above 50 years of age. There wasn't a strong representation of teenagers and those in their twenties in this review. These results were strong enough to suggest we can generalize them, but more needs to be done.
Conclusion
With depression such a common mental health condition, it's encouraging to potentially add resistance training to the list of viable treatments.
If you suffer from depression, there are worse things you could do with your time than lifting a few weights. As this review suggests, it may not matter what you do, or whether you derive other health benefits from it. Just doing it may be enough to help treat your depression and it's symptoms.
If you'd like to start immediately and see what resistance training may do for your symptoms, follow the very basic guidelines above. If this systematic review has found a genuine link, you may feel some positive changes.
Association of Efficacy of Resistance Exercise Training With Depressive Symptoms: Meta-analysis and Meta-regression Analysis of Randomized Clinical Trials
Brett R. Gordon, MSc1; Cillian P. McDowell, BSc1; Mats Hallgren, PhD2; et al
JAMA Psychiatry. 2018;75(6):566-576. doi:10.1001/jamapsychiatry.2018.0572