Major Depressive Disorder, A Pandemic In Our Time

Major depressive disorder, a pandemic in our time

According to data from the World Health Organization, it is estimated that more than 350 million people in the world suffer from a depressive symptom or episode;And according to the World Health Organization, depression is the main cause of disability worldwide. For their part, about 260 million people experience anxiety disorders.

There are numerous graphics that show an estimate of the prevalence of both disorders in the world, based on medical, epidemiological information as well as surveys and regression metals.

In a study on the knowledge and perception of depression in the Spanish population included in the Spanish acts of psychiatry, most of the people interviewed did not accept to receive a pharmacological treatment of one year duration, being the most mentioned adverse effect the agency, main reason why the people interviewed were reluctant to accept this type of treatment.

According to the Department of Health and Human Services of the United States, it is nothing more than social stigma and distrust of drugs and their effects the main reasons that lead the depressed population to not seek professional help or of any kind,despite clearly recognizing their symptoms. Returning to the study in Spain, only 50% of the people who had been treated for depression believed that they had had enough support in both the workplace and in the family and 18% came to hide it, specifically for fear of social stigma (especially in the workplace).

Probably these examples, although perhaps to a lesser extent, could also be extrapolated to the case of anxiety, and many other psychological disorders.

It could be said, in short, that the general tendency of most of the population is to be reluctant to seek professional help to solve pathologies of this type, especially when it comes to resorting to psychological and/or pharmacological therapy, eitherFor fear, insecurity or lack of information, among many other reasons.

The main motivation of this review project is to be able to delve into this problem, based on the enormous amount of studies and research in the field of psychology and physical and sports activity, to defend with some scientific rigor the need for the need for the need for the need forinclusion of activity and physical exercise as an effective therapy in the presence of symptoms of depression and anxiety -or both-. Mainly, given the total absence of any social stigma linked to the performance of physical exercise or some concrete sport, and also at the low cost that can be its practice – unlike the diversity of pharmacological treatments or therapeutic sessions to which not allPopulation strata can access – as well as the ease of being able to prescribe it and control it in most cases by health and sports professionals.

THEORETICAL FRAMEWORK

According to Lemos (2000), depression is a clinical syndrome in which the main disorder is a decrease in mood to which other symptoms are associated, caused by a multiplicity of factors and whose consequences are usually usually quite serious in aWide variety of areas of life: economic, social, emotional ..

The causes yet are not entirely clarified and are presented in a variety of forms, which makes it difficult to propose that markedly multifactorial character of the syndrome. In addition, comparing WHO data, the incidence of depression has increased in recent decades in the general population worldwide despite the effort overturned in its treatment from the field of therapy or pharmacotherapy, since it can be seen that, in Spanish studies such as the Screen study, despite the different treatments there are high relapse rates (in this case around 60%) and the remission rates are quite low in relation to the enormous incidence it has in the setof the population.

The generalized anxiety, meanwhile, for Lemos, is a mental state that is characterized by generalized emotional discomfort, an unpleasant apprehension that can arise in the face of a real or imaginary danger and that drives the person who suffers from increasing their degreeof surveillance and alert and its ability to action. This becomes a disorder when non-realistic or excessive concerns appear, motor tension or vegetative hyperactivity (CIE-10, 1994). Both depression and anxiety, or its combined version – given that, although they may seem not opposite pathologies and depending on the situation they can occur at the same time (for example, in patients with organic diseases) and favor some comorbidityAmong these – they aggravate and/or add traditionally recognized risk factors such as obesity, hypertension, high cholesterol, various heart disease or sedentary lifestyle. In addition to favoring behaviors that could put the lives of those who suffer these pathologies at risk such as suicide attempt, whose risk is three times higher in patients diagnosed with depression compared to the general population according to the data consulted in the European Journal of researchIn Health, Psychology and Education 2015.

In a study conducted by the National Health Survey of 2017, it was reflected that chronic anxiety and depression are located in the 10th and 11th positions of the Self-Declared Prevalence Ranking in the non-institutionalized population of the 15 yearsFrom now on, declaring almost in the same proportion (6.7%). 3.9% of the population referred both, and 9.6% chronic anxiety and/or depression, 13.0% of women and 5.9% of men. 2.1% of the population declared to suffer ‘other mental problems’.

Thus, with the hope of improving this scenario, it has been greatly investigated with the purpose of obtaining responses to its tangible causes and solutions. When performing a quick search on the issue, a look at the results mostly shows an inverse relationship between the practice of physical activity in general and different mental pathologies that suggest that, probably, the prescription of physical exercise programs in the differentTherapy phases could contribute significantly to the improvement of the symptoms of the named pathologies.

OBJECTIVES

This project is proposed to systematically review the relationship between physical activity and two of the most common disorders within the population: depression and anxiety;In order to find the basis of solid scientific evidence to defend the inclusion of physical exercise programs in therapeutic interventions as one of the best alternatives to traditional, expensive therapy, and that in many cases includes drugs, one ofThe main reasons why people suffering from these disorders reject professional help.

METHODOLOGY

For the elaboration of this bibliographic review project we have proceeded to carry out a systematic analysis of the literature related to the previously exposed keywords, that is, studies, research, reviews or surveys focused on the relationship between physical activity and exercise andMental health, consulting different online databases (Pubmed, Academic Google, Scielo …) as well as diversity of books, studies and publications of scientific journals consulted in their entirety in digital format. The consultation preference has been based, first, on the date of publication (studies between 1990 and 2019) since it has tried to seek to capture this project is a compilation of various information as updated as possible. In addition, it has been tried to take into account as much as possible, as a variable of interest, the impact index of each publication according to the year in which it was published to obtain a certain perception of the quality and veracity of the articles used forThe development of this bibliographic review.

Analysis of the information collected

Bodin and Martinsen investigated the association between physical activity and its antidepressant effect on clinical depression, through "self-efficacy". According to Bandura, behavior and motivation are regulated by thought and involve three types of expectations: situation, result and self-efficacy or perceived self-efficacy. This is described as the belief that a person has of possessing the capacities to perform the necessary actions that allow him to obtain the desired results. To measure them, they used two different activities where humor changes were measured: the first consisted of simply exercise in a static bike since this exercise provides a high and stable state of self-efficacy;in front of martial arts sessions with low initial self-confidence, but ascending in time. The sample was formed by 12 people clinically diagnosed with depression with an average of 36 years, these will complete sessions of 45 minutes of both two exercises. Prior to these sessions, they put a controlled waiting situation. During martial arts, the group that participated showed that the changes were much greater than those that had static bike. This showed that the increase in self-efficacy can be important for positive changes in mood.

Following the thread of physical exercise and depression, in the study carried out by Barriopedro, Eraña and Mallol (2001), seniors who did physical exercise or group activities also showed lower levels of depression to sedentary. In this study, subjects were divided into three groups: physical exercise for 45 minutes or more a day, subjects who carried out groups but non -physical and sedentary subjects. Through the Beck Depression Inventory inventory (BDI).

In the case of Akandere and Tekin (2005), the effects on young university students were observed to eliminate anxiety. This study collected a total sample of 311 students who had never previously participated in a program that involved any type of exercise. This sample was constituted by 7 different faculties. To know the anxiety features of each person, Spielberger’s Stai was used. 30 of the 60 students were chosen with the highest anxiety features and were assigned to an exercise program, while the other 30 formed the control group. To keep control of anxiety levels in both groups, tests were established before, during and at the end of the exercise program. In this case, the exercises consisted of aerobic work for 30 minutes such as: gymnastics, volleyball and athletics.

In another study that implements the exercise in the elderly, of Hill and Cols. (2007), an improvement could be seen both physical and psychological. In this case the sample was in a physical activity program for 6 months based on yoga, Tai Chi and strength training. Thanks to this, it could be concluded that depression decreased significantly.

The final conclusion of this study discovered that, the level of anxiety of women was greater than that of men. Ergo, it was deduced that the level of anxiety was related to the sex of the person. Plus the results showed that participating in an exercise program and physical activities decreased the level of anxiety of both sexes. Regarding age, no difference was found, since they all saw their reduced anxiety, but it was the group of between 19-20 years who showed a reduction greater than the rest. For this study, exercise has a key role to reduce anxiety levels.

These examples follow the line marked by other studies on the issue carried out some years ago, such as Sime (1984), Ragling and Morgan (1987) or Weiss (1993), according to which, summarizing, realizationDaily aerobic exercises for 20 minutes reduced daily anxiety effectively.

At the moment, according to the references consulted, no premise has been found on which science can be based to rigorhuman emotions. What does exist, as in all fields of science, is a diversity of theories that try to base that correlation based on different factors.

For example, according to Rossane Frizzo de Godoy in his article on the benefits of physical exercise on the emotional area, he mentions the authors North, Mcullager and Tran (1990), who made a meta-analysis in which they relate the practice in which they relate the practiceof physical exercise and the lower incidence of depressive paintings in adults (differentiating, among other variables, the specific moment of depression treatment). These authors also established a classification of the different explanatory hypotheses making a division into two large groups: on the one hand, the psychological mechanisms and, on the other, the physiological ones. In the former, the cognitive-sports hypothesis is distinguished according to which, in summary, the exercise could favor the elimination of the "depressive spiral" replacing negative thoughts and feelings with other positive ones;and, on the other hand, the hypothesis of social interaction and distraction. These last two would be explained by the feeling of pleasure of group interaction and social reinforcement of those who practice exercise and the existence of a simple distraction of concerns, respectively.

Within the physiological and biochemical mechanisms, meanwhile, is the hypothesis of the increase in cardiovascular activity, based on an alleged negative correlation between the level of aerobic capacity and depression;The amine hypothesis, according to which three neurotransmitters would explain the antidepressant effect ー serotonin, dopamine and norepinephrine ー since depressed individuals presented a decrease in the production of these amines, before which the exercise acted as an increased of said production;And, finally, the endorphin hypothesis according to which these, when produced after exercise, are able to produce euphoria states that contribute significantly to reduce the symptoms of depression.

In addition, Becker (2000), provides other hypotheses: the hypothesis of the reassuring effect (obtained through body temperature increase), the hypothesis of the increase in adrenal activity (more steroid reserves that fight stress) and, ultimately, the hypothesis of the discharge of muscle tension (through the relaxation of the contractions and decontractions of the musculature).

The interest that has emerged in recent years has been increasing in the relationship between physical exercise and its direct consequences on mental health. In 1985 Taylor, Sallis and Needle established a table, adapted by Weinberg and Gould in 1996 in which they related some psychological aspects that both in the clinical population and in the non -clinic are supposedly favored by a regular physical practice. Namely: they increased academic performance, assertiveness, trust, emotional stability, intellectual functioning, internal control locus, memory, perception, positive body image, self-control, sexual satisfaction, well -being and evenefficiency at work;At the same time that work absenteeism, alcohol abuse, anger, anxiety, confusion, depression, headaches, hostility, phobias, psychotic behavior, tension, type A behavior andErrors at work.

Another factors to take into account so that these benefits really exist is that of adherence, that is, its usual practice, which is the only thing that could guarantee these short and medium term benefits. In addition, as Miguel Morilla indicates in his article on the psychological benefits of physical activity and sport, it is necessary. It has been shown that exercise must have enough duration and intensity to produce positive psychological effects."

Already in 1984, Sime proposed a series of techniques to increase the antidepressant effects of physical activity taking into account the importance of adhesion and intensity. 

Conclusions

Once the data presented is collected and analyzed, we can begin by pointing out some of the possible weaknesses present in the different sources consulted. For example, the fact that the data of some of the studies reviewed are based on small samples, in the face of the enormous diversity within the general population. Therefore, it could be said that studies samples cannot be considered conclusive enough in some cases.

Another of the observed details is that among the studies you have to mix the concepts of physical exercise, physical activity and sport. This results in the clarification of these concepts being rather non -existent, which can make reading the results.