The New Path to Happy
Women and Depression
Depression hit Cortney Rice, now a 28-year-old research analyst in Tarrytown, New York, the summer after her sophomore year in college. "I couldn't get out of bed for days on end," Cortney says. She also started getting migraines and experienced long crying jags. "I didn't want to see anyone or answer the phone. I was too tired to hold up my end of the conversation, anyway." Things got so bad that Cortney took a year off from college to go through therapy. She also got a puppy that needed daily walking, which turned out to be one of the most crucial decisions she made on her way to recovery.
Approximately 12 million women develop depression each year. That means that one out of every eight women you encounter throughout the day -- on the elevator, in line at the supermarket, or in the next cubicle at work -- will suffer from this illness at some point in her life. And yet, according to the American Psychological Association (APA), doctors fail to diagnose women who are struggling with depression nearly half of the time. "People with this disease may not list their symptoms in a way that makes it easy to spot," explains Peter D. Kramer, MD, a clinical professor of psychiatry at Brown University and author of Listening to Prozac and Against Depression. "For women, in particular, there is an endless explaining away of the illness. But just because you can rationalize the way you're feeling -- 'I'm unhappy because my marriage isn't working or my job is stressful' -- doesn't mean it's not a symptom." Once a woman is diagnosed, she's often put on medication: Ten percent of American women 18 and older take an antidepressant, according to the National Center for Health Statistics. "Antidepressants have been a blessing. They've been proven effective and frequently lifesaving," says Henry A. Nasrallah, MD, a professor of psychiatry, neurology, and neuroscience at the University of Cincinnati College of Medicine and editor of Current Psychiatry. But medication alone is often not enough: For many women, treatment is most effective when it's a combination of therapies, including medication, talk therapy, and exercise. "The more tools you use to treat depression, the better the outcome will be," says Gail Saltz, MD, an assistant professor of psychiatry at the Weill Medical College of Cornell University in New York City.
Healthy Body, Healthy Mind
One treatment that's especially effective but often overlooked by doctors: exercise. Reams of research now show that working out plays a critical role in maintaining good mental health -- and can even help prevent depression. One groundbreaking study at the University of Texas Southwestern Medical Center found that jogging, walking, biking, or doing some kind of aerobic activity for 30 minutes three to five times a week reduced the symptoms of depression by nearly 50 percent; another reported that regular workouts can lower your risk of developing depression in the first place. "Exercise raises the levels of neurotransmitters, which help stabilize mood," explains Madhukar Trivedi, MD, lead author of the studies and director of the university's mood disorders research program. "Working out could also increase levels of a protein called brain-derived neurotrophic factor (BDNF), which helps normalize brain function. Antidepressants have also been shown to increase BDNF." Or, as John Ratey, MD, a psychiatrist who is writing a book about exercise and the brain, puts it: Taking a 12-minute walk may be the holistic equivalent to taking Prozac. It has a similar effect on the brain.
Working up a sweat has a strong psychological impact as well: "By exercising, patients are actively participating in their treatment," explains Dr. Trivedi. "It gives them a feeling of control and accomplishment." Indeed, that's what it did for Cortney. "Just going out to walk my dog for 10 minutes -- which was a big deal because I could barely get out of the house to see my therapist -- made me feel like I'd done something," she explains. "That sense of accomplishment also gave me more confidence in my ability to get over my depression." Not only that, exercise's effects are long lasting: Another study, conducted by James Blumenthal, MD, a professor of medical psychology at Duke University, and his colleagues, found that formerly depressed patients who were in remission and who exercised moderately (for example, taking a 30-minute walk four or five times a week) were less likely to suffer a relapse.
