Previous research shows that although exercise improves chronic health conditions such as heart disease and diabetes, patients with these conditions often suffer from depression.

A review of studies has found that feelings of depression could be one reason patients fail to follow their doctors’ orders on exercising and eventually become less physically active.

The analysis evaluated 11 studies comprising some 20,000 patients. Eight studies reported that having symptoms of depression after a coronary event, such as heart attack, was a significant risk factor for developing a sedentary lifestyle or a poor adherence to an exercise regimen recommended by the patients’ doctor.

One study, for example, investigated the role of depression and anxiety in 224 heart attack survivors, at three months and 12 months after their hospitalization. Of those with anxiety and depression during hospitalization, 59 percent had a significant decrease in exercise after three months, compared with 31 percent of those without depression. A year later the gap widened, with 51 percent of depressed patients exercising less compared with 26 percent of non-depressed patients.

The studies used different methods to measure depression and physical activity and there was a great difference in how they compared factors such as the patients’ health, physical activity and depression.

There are many suggested theories to explain why depression leads to a decline in activity.

“We have hypothesized that there are both behavioral habits associated with depression, such as smoking and obesity, which may then limit exercise motivation and enjoyment, as well as biologic factors that can cause obesity and decrease energy level, exercise tolerance and pain threshold,” said Babak Roshanaei-Moghaddam, lead author of the study.

 “Depression can indeed make people have less motivation and energy to exercise,” said Evette Joy Ludman, of Seattle-based Group Health Cooperative, who had no affiliation with the study. “The sad part about this is that physical activity is not only important for preventing and managing many chronic conditions; it can be very helpful for improving mood and other symptoms of depression.”
References:
1. Roshanaei-Moghaddam B, Katon WJ, Russo J. The longitudinal effects of depression on physical activity. Gen Hosp Psychiatry 31(4), 2009.

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