http://revistas.utm.edu.ec/index.php/Recus

e-ISSN 2528-8075/ VOL 6/No. 1/ENERO – ABRIL/2021/pp. 42-45

Unidad de Cooperación Universitaria. Universidad Técnica de Manabí. Portoviejo. Ecuador

Depressed people and physical exercise

Personas deprimidas y ejercicio físico

Emerson Roberto Yépez Herrera

Gisela Catalina Padilla Álvarez

Deysi Elizabeth Apolo Eguez

Noemí Fernanda Caizaluisa Barros

Abstract

Depression is a mental disorder that is increasing each year, according to statistics over the world. Sports has become a good method to

prevent and encourage the treatment of the mental disorder. The aim of this article to determine the benefits of sports in the treatment of

depression. Method: The information was taken from Science Direct with the keywords (depression or mental disorders) and (physical

exercise OR physical activity). The information was analyzed through systematic literature analysis. It was given priority to articles, that

were published in the last 5 years. The number of the total articles was 498 which is related to the objective of this investigation. From

498 articles 24 were selected to develop the research. Results: Sports, according to studies, help people who have depression synthons.

Conclusion: Physical exercise is a method, which can prevent and help medical treatment, however, it is necessary to increase the research

in this area.

Resumen

La depresión es un trastorno mental que aumenta cada año, según las estadísticas en todo el mundo. El deporte se ha convertido en un

buen método para prevenir y fomentar el tratamiento de los trastornos mentales. El objetivo de este artículo es determinar los beneficios

deportivos en el tratamiento de la depresión. Método: La información se tomó del Science Direct con las palabras clave (depresión o

trastornos mentales) y (ejercicio físico o actividad física). La información se analizó a través de un análisis sistemático de la literatura.

Se dio prioridad a los artículos publicados en los últimos 5 años. El número total de artículos relacionados con el objetivo de esta

investigación fue 498. De ellos se seleccionaron 24 para desarrollar la investigación. Resultados: Los deportes, según estudios, ayudan a

las personas que tienen síntomas de depresión. Conclusión: El ejercicio físico es un método, que puede prevenir y ayudar al tratamiento

médico, sin embargo es necesario incrementar la investigación en esta área.

Keywords/ Palabras clave

Exercise; physical activity; depression; mental disorder/Ejercicio; actividad física; depresión; trastorno mental

*Dirección para correspondencia: gcpadilla@espe.edu.ec

Artículo recibido el 24 - 03 - 2021 Artículo aceptado el 28 - 04 - 2021 Artículo publicado el 30 - 04 - 2021

Conflicto de intereses no declarado.

Fundada 2016 Unidad de Cooperación Universitaria de la Universidad Técnica de Manabí, Ecuador.

Licenciado. PhD. Psicología aplicada. Departamento de Ciencias Humanas y Sociales. Universidad de las Fuerzas Armadas- ESPE. Quito, Ecuador, eryepez@espe.edu.ec,

https://orcid.org/0000-0002-9776-2815

Licenciada. Psicología aplicada. Departamento de Ciencias Humanas y Sociales. Universidad de las Fuerzas Armadas- ESPE. Quito, Ecuador, gcpadilla@espe.edu.ec,

https://orcid.org/0000-0003-4187-1331

Licenciada. MSc. Psicología aplicada. Departamento de Ciencias Humanas y Sociales. Universidad de las Fuerzas Armadas-ESPE. Quito, Ecuador, deapolo1@espe.edu.ec,

https://orcid.org/0000-0002-9953-930X

Licenciada. MSc. Psicología aplicada. Departamento de Ciencias Humanas y Sociales. Universidad de las Fuerzas Armadas-ESPE. Quito, Ecuador, nfcaizaluiza@espe.edu.ec,

https://orcid.org/0000-0001-7722-4908

43 REVISTA RECUS. PUBLICACIÓN ARBITRADA CUATRIMESTRAL. EDICIÓN CONTINUA.UTM - ECUADOR

e-ISSN 2528-8075/ VOL 6/No. 1/ENERO – ABRIL/2021/pp. 42-45

Depressed people and physical exercise

Yépez Herrera, Padilla Álvarez, Apolo Eguez, Caizaluisa Barros

Unidad de Cooperación Universitaria. Universidad Técnica de Manabí. Portoviejo. Ecuador

1. Introduction

Depression is a disorder, which affects about 300 million people over

the world. It represents 4,4 % of the world population. Generally,

depression appears in young people, who are from 15 to 29 years old

(Organización Mundial de la Salud, 2018a). This mental disorder affects

people´s development during their daily activities. When depressed

people have a high level of depression, they can kill themselves, so there

are 800.000 suicides, and the figures increase (Organización Mundial de

la Salud, 2018b). There has been an approximate increase of 308 % in

cases of adolescents’ depression in the last decade (Organización Mundial

de la Salud, 2017).

According to the Diagnostic and Statistical Manual of Mental

Disorders (DSM-5), depressive disorders appear in different ways. One of

the main disorders are: Major Depressive Disorder and the Persistent

Depressive disorder (Distimia) (American Psychiatric Association, s.f.).

The Major Depressive Disorder’s symptoms are:

− Sadness

− Lack of self-esteem

− Culpability

− Loss of appetite

− Sleep disturbances

− Lack of concentration

− Tiredness

The Persistent Depressive disorder (Distimia) symptoms are the same

as the depressive disorder with lower intensitive but they tend to be more

durable (American Psychiatric Association, s.f.).

According to the World Health Organization, severe depressive

episodes are the fifth most disabling state of human health worldwide.

Meanwhile in the America region that depressive episodes are the first

after of acute schizophrenia, untreated cervical spinal cord injury, severe

multiple sclerosis, and severe heroin dependence (Organización

Panamericana de la Salud, 2018).

According to the Ministry of Public Health (MSP) of Ecuador, the

health professionals attended 42.823 cases of mental disorders in January

2018. Most of the disord ers were related to stress and affective and

neurotic disorders (World Health Organization, 2018).

The number of suicides according to the INEC and the MSP registers

a total of 1,205 cases in 2017. The majority of the cases correspond to the

female sex (Instituto Nacional de Estadísticas y Censos, 2017).

Those kinds of disorders have been studied and they had represented

an investment to the public system in different countries. It is considered

that 50 % of people, who had the symptoms of depression, don’t receive

any medical attention (Álvarez, Pereira & Ortuño, 2017), because there is

not money to spend in those kinds of sickness. 1 % of the annual state

budget is allocated to patient care who have depression in many countries

(Organización Mundial de la Salud, 2018a).

There is not a law about mental disorders in Ecuador, but there are

terms, objectives, principles, and strategic guidelines that allow to control,

try and prevent mental disorders (Ministerio de Educación, 2015).

Mental disorders should be attendant by professionals, moreover the

usage of medication, and psychotherapy must be done with care. The

professionals usually prescribe medications which are inhibitors that

allow serotonin and norepinephrine reuptake. The usage of

antidepressants is common too (Álvarez, Pereira & Ortuño, 2017).

Psychotherapy is a term used for the treatment of a disorder based on

the conversation about the problems that happen to the patient, this

method allows them to adapt to an emotional crisis and be able to

overcome the difficulties. This way, the person can take control of their

life again, set their goals, and acquire healthier behaviors (Domènech &

Odriozola, 2016).

As preventive methods and in cases where depression occurs in a mild

form, it could be treated without medication, so in these cases, physical

activity could be used as a complement to the treatment of different types

of disorders.

This review aims to evaluate the existing literature about mental

disorders and physical activity.

2. Methods and Materials

A systematic review was carried out in this investigation, so there are

scientific articles which focus on the benefits that physical activity can

offer in mental disorders such as depression. The reports from the ministry

of public health and the world health organization were analyzed to do

this article. Moreover, the clinical practice guidelines and articles, which

were published in the last five years, considered too. The inclusion criteria

(IC) used for the selection of the bibliography were:

IC-1: Publication date between 2014-2019.

IC-2: Scientific review and related experimental articles.

IC-3: Reports and studies conducted by organizations focused on

public health, both national and international.

IC-4: Newspaper, opinion articles, and all articles that are not found

in selected databases.

The keywords and descriptors used to generate the search in Spanish

were Exercise, Physical activity and Depression.

3. Results

A total of 498 articles were obtained from the database but 24 articles

were used for this research after applying inclusion and exclusion criteria.

19 articles from the Sciencedirect database and 5 articles came from

reports and studies carried out by organizations dedicated to the study of

public health in Ecuador and other countries.

Causes

There is not a unique cause for depression. It seems to be a result of a

combination of various factors such as genetic, psychological or

biochemical. (Pérez et al., 2017). On the other hand, various studies also

indicate a close relationship between depressive disorders and a sedentary

lifestyle (Villegas, 2010).

In order to make a proper diagnosis, several methods can be used,

among the main ones we have (Departamento de Psiquiatría y Salud

Mental Sur, 2016):

− Physical examination: There are cases in which depression

may be related to some physical health problems that have not

been diagnosed.

− Psychiatric evaluation: The professional will be able to ask

questions about the symptoms. The patient must answer the

questions. The professional will try to find out about patient’s

thoughts, what kinds of feelings are frequently presented, as

well as an evaluation about the behavior.

REVISTA RECUS. PUBLICACIÓN ARBITRADA CUATRIMESTRAL. EDICIÓN CONTINUA.UTM - ECUADOR

e-ISSN 2528-8075/ VOL 6/No. 1/ENERO – ABRIL/2021/pp. 42-45

Depressed people and physical exercise

Yépez Herrera, Padilla Álvarez, Apolo Eguez, Caizaluisa Barros

Unidad de Cooperación Universitaria. Universidad Técnica de Manabí. Portoviejo. Ecuador

− Laboratory tests: Complete blood count tests are usually

performed to determine that the thyroid gland is working

incorrectly.

− DSM-5: These are criteria on which the professional can be

based on the diagnosis of depression, which is found in the

Diagnostic and Statistical Manual of Mental Disorders (DSM-

5), published by the American Psychiatric Association from

the United States.

Prevention

There are many treatments for depression as well as medicine which

must be associated with secondary effects such as: weight gain, insulin

resistance, among others. It is important to get healthy habits such as

proper diets, avoiding tobacco use, and regular medical check-ups

(Álvarez, Pereira & Ortuño, 2017). Therefore, for these purposes, the

practice of exercise can be used as a complementary treatment, also

helping the symptomatic control of other associated diseases.

Relationship between physical exercise and depression

There is a study with 364 adult people who were in a community

intervention program of physical activity. The adults frequently used to

make walks and included socio-cultural activities for 9 months. It showed

that there is a favorable effect on self-esteem in adults as well as favorable

effects on hypertension, dyslipidemia, excess weight and

anxiety/depression (Villalobos et al., 2019).

Another study, with 371 students for the university, showed the

physical activity is closely related to levels of anxiety and depression, so

students, who made physical activity, showed lower levels of anxiety and

depression than sedentary students (Olmedilla, Ortega & Candel, 2015).

However, it is important to consider the type of exercise, because the

patient must enjoy the activity without violence, extreme competitiveness,

or some form of intensity or compulsory work that, on the contrary, could

worsen psychopathological conditions (Leiva et al., 2017).

4. Discussion

Physical activity has a positive effect on people with depressive

disorders, but its effectiveness lies more in the type of activity that is

carried out than in the frequency with which it is practiced (Riahia et al.,

s/f).

The types of exercise that are carried out are mainly of three forms:

• Aerobic exercises, which produce a high consumption of

oxygen. It is also called oxidative, so the cardiorespiratory

system is worked to a greater extent.

• Anaerobic or glycolytic exercises such as weightlifting, so

resistance muscle is the main form of work (Berlanga &

López, 2015).

• Flexibility exercises such as yoga or tai chi where breathing is

combined with movements and body postures allowing the

body to relax (Gallego et al., 2016).

The benefits of those types of exercises are many. Hallgren shows in

his research that exercises of various types have an effectiveness rate of

78 % from a total of 946 patients (Alonso, Pérez, S. & Pérez, R., 2018).

Brain. There are neurotransmitters that are responsible for mood

swings in people such as dopamine, serotonin, norepinephrine. (Goodale,

2007). Sports practice allows better brain irrigation, allowing neurons to

oxygenate and the brain synapse to perform properly (Curtelin, 2016).

Adherence. People with depression show a lack of interest,

demotivation, or pessimism, so they have problems creating adherence to

the application of treatments. In those cases, professionals can help them

to develop a link between the patient and treatment through therapy. As a

result, it will increase the confidence of the patient, so it could be possible

to generate adherence and motivate sports practice (American Psychiatric

Association, 2014).

The rates of people with depression and increased illnesses have

caused that the World Health Organization promotes sports as a

preventive treatment. The idea is that the government and people make

aware of the importance of healthy style life.

Several studies show the benefits that exercise offers to patients with

depressive symptoms, so physical exercise is considered as a preventive

method and complementary for the treatment of said disorders. However,

some clinicians abstain from recommending sports practice as a

complement to patient treatment.

On based on this research it is not recommended that physical exercise

supplies the medical advises because they are professionals in the area, so

they prescribe drugs and therapeutic interventions which should be joined

will exercise.The information obtained in this study had made it possible

to demonstrate the positive results that sports practice offers for people

with depression. For example, aerobic exercise plays an important role

thanks to the cardiovascular effort that encourages blood circulation

without forgetting the importance of enjoyment the patient must feel.

It is important to promote sport as a preventive method to some illness

because it allows creating healthy habits which will reduce the risk of the

development of depression.

Finally, it is necessary to increase studies about this topic to get more

information that will permit the applicability in disease prevention

programs.

Reference

Alonso, R, Pérez, S, & Pérez, R. (2018). Ejercicio físico como tratamiento

eficaz para la depresión y sus beneficios. VI congreso internacional

de deporte inclusivo, 109-113.

Álvarez, M. M., Pereira, V., & Ortuño, F. (2017). Tratamiento de la

depresión. Medicine, 12(46), 2731-2742. DOI

10.1016/j.med.2017.12.001.

American Psychiatric Association (2014). DSM-5. Manual Diagnóstico y

Estadístico de los Trastornos Mentales. 5ta edición.

American Psychiatric Association (s.f.). Diagnostic And Statistical

Manual Of Mental Disorders. Fifth Edition

doi.org/10.1176/appi.books.9780890425596.

Berlanga, L., & López, J. (2015). Actualizaciones en fisiología del

ejercicio. Exercise Physiology & Training. ISBN: 978-84608-

6074-7.

Curtelin, P. D. (2016). Flujo sanguíneo y oxigenación cerebral durante el

ejercicio de alta intensidad en seres humanos (Doctoral

dissertation).

Departamento de Psiquiatría y Salud Mental Sur. (2016) Universidad de

Chile. U cursos.

Domènech, J. G., & Odriozola, V. N. (2016). Psicoterapias cognitivas.

Psiquiatría Biológica, 23, 40-45.

45 REVISTA RECUS. PUBLICACIÓN ARBITRADA CUATRIMESTRAL. EDICIÓN CONTINUA.UTM - ECUADOR

e-ISSN 2528-8075/ VOL 6/No. 1/ENERO – ABRIL/2021/pp. 42-45

Depressed people and physical exercise

Yépez Herrera, Padilla Álvarez, Apolo Eguez, Caizaluisa Barros

Unidad de Cooperación Universitaria. Universidad Técnica de Manabí. Portoviejo. Ecuador

Goodale, E. P. (2007). El papel de la norepinefrina y de la dopamina en la

depresión. RET: revista de toxicomanías, (50), 19-22.

Gallego, J., Aguilar-Parra, J. M., Cangas, A. J., Rosado, A., & Langer, A.

I. (2016). Efecto de intervenciones mente/cuerpo sobre los niveles

de ansiedad, estrés y depresión en futuros docentes de educación

primaria: un estudio controlado. Revista de Psicodidáctica, 21(1),

87-101.

Instituto Nacional de Estadísticas y Censos. (2017). Día Mundial de la

Salud, egresos hospitalarios, registro de recursos y actividades de

salud, defunciones generales.

Leiva, A. P., Márquez, P. G. O., Rodríguez, C. G., Navas, J. M. M., &

Bozal, R. G. (2017). Ejercicio físico y calidad de vida en estudiantes

universitarios. International Journal of Developmental and

Educational Psychology, 2(1), 437-446.

Ministerio de Educación. (2015). Informe de Evaluacin del Sistema de

Salud Mental en Ecuador utilizando el Instrumento de Evaluacin

para Sistemas de Salud Mental de la OMS (IESM-OMS) Ecuador.

Olmedilla, A., Ortega, E., & Candel, N. (2010). Ansiedad, depresión y

práctica de ejercicio físico en estudiantes universitarias. Apunts.

Medicina de l'Esport, 45(167), 175-180.

Organización Mundial de la Salud (2017). Porque hablar sobre la

depresión es importante. Márquez P. 2017. Recuperado de

https://www.paho.org/hq/index.php?option=com_content&view=a

rticle&id=13102:depression-lets-talk-says-who-as-depression-

tops-list-of-*causes-of-ill-health&Itemid=1926&lang=es

Organización Mundial de la Salud. Depresión, datos y cifras. (Marzo

2018a). Recuperado de https://www.who.int/es/news-room/fact

sheets/detail/depression

Organización Mundial de la Salud. Suicidio, datos y cifras. (Agosto

2018c). Recuperado de https://www.who.int/es/news-room/fact-

sheets/detail/suicide

Organización Panamericana de la Salud. (2018). La carga de los trastornos

mentales en la Región de las Américas. Washington, D.C.: OPS;

2018.

Pérez, P. E. A., Cervantes, R. V. M., Hijuelos, G. N. A., Pineda, C. J. C.,

& Salgado, B. H. (2017). Prevalencia, causas y tratamiento de la

depresión Mayor. Revista biomédica, 28(2), 73-98.

Riahia, M. A., Haddada, M., Ouattasa, A., & Goebela, R. (2016). The

moderating effect of physical exercise in anxiety disorder: a review.

Eur Proc Soc Behav Sci, 5, 280-285.

Villalobos, F., Vinuesa, A., Pedret, R., Reche, A., Domínguez, E., &

Arija, V. (2019). Efecto de un Programa de actividad física sobre la

autoestima en sujetos con enfermedades crónicas. Ensayo de

intervención comunitaria «Pas a Pas». Atencion Primaria, 51(4),

236-244.

Villegas, S. F. (2010). Exercise and Depression. Revista Colombiana de

Psiquiatría, 39(4), 732-748.

World Heath Organization (2018). Young People And Mental Health In A

Changing World (WFMH). Recuperado

https://www.paho.org/hq/index.php?option=com_docman&view=

list&format=