Exercise for the treatment of depression, anxiety and insomnia

Dr Giresh Kanji talks about the importance of exercise in the management of depression and insomnia in general practice. Giresh is a musculoskeletal pain expert in Auckland. He’s founder of the New Zealand Pain Foundation and has many years of experience researching and managing pain. His PhD explored the causation of headache disorders, the migraine gene and the role of the sympathetic nervous system in chronic pain.

Case Study

A 42 year old advertising account manager and mother of 1 comes to see you. She is distressed as is going through an employment dispute at work. She works 14 hours a day, 6-7 days a week. She isn’t sleeping well. She drinks a bottle of red wine a night and is experiencing depressed mood and is anxious.

You discuss the options; one of which is incorporate some daily exercise, ideally at least 30 minutes of moderate to vigorous exercise each day.

She ask if it will work? Is exercise enough?

Topics

Why would people exercise for depression?
Is there a physiological explanation for exercise working?
What is the best dose of exercise?
How frequently should one exercise and for how long?
What about walking, most patients I see say they walk regularly, is it helping their depression?
What are the barriers to implementing an exercise regime?
What about insomnia and exercise is there any evidence here?

Take home messages

Exercise is a proven treatment for depression. It’s not just a good idea.
Exercise is also going to help the symptoms commonly associated with depression including insomnia and anxiety.
Minimum dose is 30mins of moderate exercise at least 4 times a week for at least 8-12 weeks.