The biannual Invictus Games — a multisport competition for wounded, injured and sick soldiers and veterans  — has brought more than 5,000 participants from 21 nations to Düsseldorf.

Many of them have reported dealing with mental health issues such as post-traumatic stress, depression and anxiety, which can often diminish quality of life and lead to further illnesses. Psychotherapy and antidepressant drugs, the most common approaches for treating depression, are not always effective.

Electroconvulsive therapy, a procedure that involves sending small electric currents through the brain, is sometimes used for treatment-resistant or severe depression. It is a very effective treatment in most cases, though it is also considered a major intervention and performed under anesthesia. 

'Evidence-based treatment option'

Anti-depression therapy is often combined with sports. Backed up by studies, therapists have long reported that exercise can complement depression therapy. Now, some are asking whether sports alone might be enough for some patients to overcome depression.

If so, patients would no longer have to rely on counseling, which can last for years, and could forgo antidepressants. The advantages are obvious: There would be no side effects — except perhaps for sports injuries such as sprained ankles and sore muscles.

In collaboration with scholars from Australia, Belgium, Britain, Sweden and Brazil, researchers from Potsdam University's Department of Sport and Health Sciences systematically reviewed 41 studies on the subject of exercise and depression for a meta-analysis published in February in the British Journal of Sports Medicine.

The authors conclude that sports can offer "a further evidence-based treatment option for the large amount of untreated individuals with depression, including individuals who refuse or cannot tolerate medication and/or psychotherapy." They add, however, that "given the high heterogeneity and mainly small and selected samples of the included studies, this requires individual decisions involving the treating physician to determine if and which conditions of exercise are the optimal treatment of choice while also recognising the potential synergistic effects of exercise in managing both physical and mental well-being."

Exercise equals endorphins

Engaging in sports and exercise of any kind — jogging, cycling, yoga, etc. — triggers the release of endorphins, or feel-good hormones, in the brain. These can help alleviate depression and mood swings.

In addition, exercise has been shown to reduce stress in people who experience depression and people who don't alike. Exercise is also linked to improved sleep quality. This, too, can help alleviate depression, distract from negative thoughts and focus attention on positive sensations. Moreover, exercise can improve brain functionality.

Exercise has also been shown to promote neuroplasticity, or the brain's ability to adapt to new stimuli or information. People with depression often suffer from severely diminished neuroplasticity. 

Engaging in regular intense exercise may offer an opportunity for people with depression who do not want to take antidepressants to alleviate the effects of the disorder.

This article was originally written in German.