This article tackles boxing and depression, in order to understand this interaction, we need to know more about depression before explaining how it interelates with boxing. Depression is the world’s most prominent non-communicable disease. According to the World Health Organisation (WHO), depression is the leading cause of disability in the US and Canada, ahead of coronary heart disease, cancer and AIDS. Not surprisingly, mood disorders are a focal point for psychiatric work.
People often have difficulty distinguishing depression from simply feeling down. Many symptoms of depression are felt by those who are not clinically depressed but are experiencing an off day. Many of the symptoms can be opposites making diagnosis even more complicated. Those suffering from depression may show symptoms of sleeping too little or too much, eating very little or overeating, severe outbursts or becoming sullen.
Clinically, the difference between depression and a bad mood is the number of presenting symptoms. According to the DSM 5 (the manual used by psychiatrists and clinical psychologists to diagnose), one needs a collection of symptoms to be considered depressed. In reality, most people know whether the mood they are feeling is more than a passing state and is pervasive enough to be more than just a bout of the blues.
Pharmaceutical intervention for depression focuses on increasing three related neuromodulators in the brain known as monoamines; norepinephrine, dopamine and serotonin (see last week’s blog). In particular, the majority of drugs used to treat depression slow receptive uptake of neurotransmitters in the brain, the net effect being that you have more of the chemical circulating than would otherwise be the case. SSRIs (selective serotonin receptor inhibitors), such as Prozac and Lexapro, are effective in treating depression but also have a range of side effects, such as weight gain, sexual dysfunction, and withdrawal effects. Similar effects are found for the drugs that inhibit the reuptake of norepinephrine and dopamine (NDRIs). Moreover, anti-depressants don’t work for everyone. For some poor unlucky people, the SSRIs and NDRIs result in side effects for no gain.
Depression can be considered a form of pain. Depression is a hibernation response to keep still and stay out of harm’s way during a painful psychological disturbance. The impact is primarily an inability of the brain to adapt. The impact is on areas like the hippocampus, becoming locked into negative memories. The brain can’t reach alternate conclusions about the cause of depression that it is trying to process.
Boxing and depression, how exercise is benfecial in the treatment of depression
Given the prevalence of depression, its debilitating effects and the ineffectiveness of medication for some, we need alternative treatments. One such treatment is exercise. Exercise not only positively impacts the production of monoamines but also the brain’s natural painkillers, the endorphins. We have opiate receptors in the brain specifically for endorphins, and it is the link between exercise and a mental high, known as the runner high, which is, for many people, the introduction to the benefits of exercise for mental health. Endorphins are, however, not simply a natural high. Endorphins calm the brain and relieve muscle pain, lessening the mental anguish of depression.
Exercise, however, does more than increase the production of feel-good chemicals in the brain. Exercise protects the neurons by increasing what is known as brain-derived neurotrophic factors (BDNF). Amongst other things, BDNFs protect neurons from the adverse effects of cortisol covered in last week’s blog and increase neuromodulator uptake. BDNFs help neurons communicate, grow and aid neuroplasticity, which is central to the brain’s capacity to adapt and develop new thoughts. BDNFs are vital for executive functioning (think high reasoning); therefore, exercise is likely to play a facilitative role in psychotherapy (Ratey and Hagerman, 2008).
Given the positive effects of exercise on mental health, why is its role in mental health treatment not discussed more? The reality is that the scientific community has long known the positive effects of exercise on preventing or limiting the effects of depression. In a study dating back to 1974, people with no sign of depression which became inactive were 1.5 times as likely to develop depression (Housman, & Dorman, 2005). In this same study, those that were inactive and became active were no more likely to have depression than those with a history of poor mental health.
The findings of the 1974 study are not unique. A Dutch study of nearly 20,000 twins demonstrated that exercise reduced anxiety and depression (Willemsen., Vink., Abdellaoui, Den Braber., Van Beek., Draisma., … & Boomsma, (2013). Furthermore, Blumenthal and colleagues (2007), in their examination of exercise and medication, concluded that exercise was as effective as medicine in treating depression. More accurately, exercise was the most significant predictor of whether someone felt better, including psychotherapy. While exercise is not a replacement for medicine, there is a strong case that exercise be part of a treatment protocol. Exercise works as a prevention and cure and is effective for those for whom medication is unhelpful (Rethorst. & Trivedi, 2013).
Trivedi and his lab have developed protocols for the prescription of exercise for the treatment of depression. Protocols for exercise are very much in their infancy, but intensive workouts over an extended period (30-60 minutes) 3 times a week, burning up to 14,000 calories per week, seems adequate. Exercise is effective and intensive exercise over an extended period is very effective.
Boxing and depression: How does Boxing Help with Depression
High-intensity workouts are where boxing comes in. Boxing as an exercise modality positively impacts neurotransmitters, BDNFs, plasticity and executive functioning. A typical 45-60 minute class, run by Spartans, hits the prescribed exercise intensity without depletion. Workouts are designed to energy, focus, and recovery, leading to increased calmness.
Recognising how difficult it is for people to start an exercise programme often when experiencing depression, Spartans have developed a dedicated programme for psychological repair. The 12-week programme starts with minimal intensity, using our InGymXperience@home, slowly but methodically progressing a person to in-gym training and finally to class interaction.
With our commitment to science, we monitor our clients’ progress through our Spartans Mind app. We hope to have publishable results that track the effectiveness of the various protocols we implement.
Pound-for-pound, it is hard to find a better exercise than boxing to integrate with psychotherapy to treat depression. Spartans are incredibly excited to be leading the way in furthering exercise science to treat depression.
References
Blumenthal, J. A., Babyak, M. A., Doraiswamy, P. M., Watkins, L., Hoffman, B. M., Barbour, K. A., … &
Sherwood, A. (2007). Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic Medicine, 69(7), 587.
Housman, J., & Dorman, S. (2005). The Alameda County study: a systematic, chronological
review. Journal of health education, 36(5), 302-308.
Ratey J., & Hagerman, E. (2008). Spark. Little Brown and Company.
Rethorst, C. D., & Trivedi, M. H. (2013). Evidence-based recommendations for the prescription of
exercise for major depressive disorder. Journal of Psychiatric Practice, 19(3), 204-212.
Willemsen, G., Vink, J. M., Abdellaoui, A., Den Braber, A., Van Beek, J. H., Draisma, H. H., … &
Boomsma, D. I. (2013). The Adult Netherlands Twin Register: twenty-five years of survey and biological data collection. Twin Research and Human Genetics, 16(1), 271-281.