Integrating exercise into depression care

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On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole discuss the evidence supporting exercise as an effective treatment option for mild to moderate depression. They explore how exercise might be used effectively and the challenges involved in implementing it for patients.

Dr. Nicholas Fabiano, a second-year psychiatry resident at the University of Ottawa, is co-author of the paper "Exercise as treatment for depression." He surveys the evidence showing that exercise can be as effective as antidepressants and psychotherapy for mild to moderate depression. He explains the FITT principle (frequency, intensity, type, and time) for prescribing exercise and stresses the need for setting realistic goals. Dr. Fabiano's article recommends physicians reference a practical guide for exercise for people who have depression, written by Dr. Michelle Fortier and colleagues.

Dr. Fortier, a physical activity psychologist and professor at the University of Ottawa’s School of Human Kinetics, offers her perspective on encouraging patients with depression to include exercise as part of their overall treatment plan. She suggests bringing kinesiologists into primary care to help patients overcome barriers to exercise. Dr. Fortier talks about the importance of small, manageable steps and using motivational interviewing techniques to engage patients. She also discusses the "commit 10" approach, which encourages patients to start with just ten minutes of activity over a two week period.

Throughout the episode, the hosts and guests stress the importance of empathy, realistic goal setting, and systemic support to make exercise a practical treatment option for depression. They highlight the overall benefits of movement for both mental and physical health and advocate for a more integrated approach to patient care.

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