exerciseDepressed mood is one of the most common problems I see in my practice with men. Feeling low is not the only symptoms guys complain of. Often low mood is coupled with a lack of energy, sleep disruption, reduction of libido, anxiety and appetite changes. Sometimes men feel so bad they think life is not worth living and feel suicidal. Depression is a serious health problem that can lead to death and should never be ignored. The question is how should it be treated?

I recommend a three pronged attack to get your life back on track. Antidepressants, cbt (cognitive behavioural therapy), and exercise.

Antidepressant medication is helpful for many men particularly if your low mood is starting to interfere severely with your life, for example by taking a lot of time off work. Antidepressants, however, should never be the only answer. It is really important that you get to understand ‘the depressed mind’, and how to combat it.

Depression is notorious for ‘rekindling’, that is, coming back again and again and becoming a chronic health concern. If depression is only treated with antidepressants, and you don’t learn the strategy’s you need to stay well, then you risk chronicity becoming a problem.

In fact there is a lot of research around that shows that antidepressants and a talking therapy like cbt, have a cumulative effect upon each other. That is to say having cbt while being on an antidepressant produces a positive effect greater than either antidepressants or cbt on their own.

Is there anything else a man can do? Well I’ve long held the hunch that exercise is a key factor in men’s emotional health. I’m sure it plays a role in women’s emotional health too; I just think it’s even more important for men. In fact a 2007 study in Psychosomatic Medicine found it the equal of antidepressants in curing depression. For this reason I also recommend exercise for the men I se e who are depressed.

There is a problem with exercise in depressed people, in that they often feel too tired and lethargic to get going with an exercise program. I advocate starting with a small but regular exercise regimen: one that is easily achieved. Say a five minute walk to the shops and back, three times a week. Once the routine has bedded down, start increasing the duration and intensity of the exercise. Your ultimate target is three half hour sessions of vigorous, pulse raising, exercise a week. Like antidepressants, it can take several weeks before the benefits of exercise take hold, so stick with it.

I see the best results with men who adopt all three strategies: antidepressants, cbt and exercise. However not everybody’s depression is severe enough to warrant an antidepressant, and some men simply don’t want to take a drug. I can understand and respect this. For these men, knowing that exercise is as effective as an antidepressant in shifting mood is really helpful information. I suspect exercise coupled with cbt is the way to go for these men.

The worst thing you can do if depression has got a hold of your life, is ignore it. If you are feeling depressed at the moment, the time to do something about it is now.

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