Into The Black Running can help combat the effects of depression, so why did the media begin to decry the notion earlier this year and just why do men find it so hard to talk about dealing with the black dog? MR finds out...
Words: Philip Wilding
I was somewhere along the Thames towpath when the gloom finally lifted. It might have been the family of ducks bobbing idly by in perfect symmetry as the sunlight bounced off a slowly undulating river the colour of pebbles, it might have been the playlist I was running to – New York hip hop and German heavy metal, you were bound to ask – but one thing was certain; something let the light in. I’d been running with my head tilted forwards, as if the stiffness in my neck wouldn’t let me look up. Though, the stiffness wasn’t in my neck, in was in my head. I don’t want to invalidate this article by making it all about me, but depression is more personal and far more reaching than you might imagine. This time, the starting points for my gloom were obvious; a failed relationship and the subsequent turmoil at home that brings, but that isn’t always the case, sometimes it descends while you’re sitting at your desk, or as you open your eyes in the morning, depression doesn’t care.
The last time I wrote about depression and the benefits of running to absolve the pain that it brings was for a column in this very magazine. A few things struck me about that article; one was how hard it was for me to write about how I struggled with the black dog (a now common phrase for depression coined, apparently, by Winston Churchill’s nanny, though it appears she was referring to a more general malaise affecting her young charge at the time), and that writing about how depression took over aspects of my life caused me to squirm, confronting it and admitting caused me nothing more than acute embarrassment.
I’m from a family of Welsh miners; introversion and feelings weren’t at a premium in our house. The second thing that struck me was the reaction it got, especially from men I thought I knew. Men in their thirties and forties who had one thing in common; they stayed mute and ran away as fast and far from the black dog as possible and it actually helped. Friends brought the column up, associates commented on it and the underlying, barely spoken message was the same; I get that too, I don’t really like to talk about it, but when it does fall on me, I, like you, get my trainers on and I go out.
So it came as something of a surprise when in June this year the BBC website reported that: “Exercise ‘no help for depression’, research suggests”, The Guardian wasn’t far behind; “Exercise doesn’t help depression, study concludes”. I looked up from lacing my running shoes and made a face I usually reserve for bad news. I wasn’t the only one, the reporting of the survey, conducted by teams from the Universities of Bristol, Exeter and the Peninsula College of Medicine and Dentistry and originally published in the British Medical Journal
, drew criticism from the Mind charity as well as one of the authors of the study, Professor Adrian Taylor from the University of Exeter.
Writing on the Mind website, he stated: ‘I was dismayed by the BBC website, which prompted me to complain about the headline. An apology was received and the headline changed within minutes. I know the damage has been done as the news item spread around the world, and I have had emails from lots of people trying to make sense of the news. No wonder most people don’t take science seriously or understand it, when so many mixed messages come out, and we are in the hands of sensationalism in the media.’
The BBC eventually went with the header: “Depression: Exercise advice questioned when added to standard treatments”, which made more sense of the research and was closer to the story too. But as Professor Adrian Taylor pointed out, by then, all sorts of people had hold of the wrong end of the story.
The NHS recommends exercise as one of its treatments for depression and was as skeptical about the way the fast reacting media had portrayed the report as Taylor. In a nutshell, what the actual report did was take 361 adults and looked at whether giving depressed patients additional support to encourage exercise proved beneficial. Standard NHS treatment for depression can include medication, therapy and physical activity. The research found that encouraging activity increased physical activity levels but did not reduce depressive symptoms more than standard care alone. Which isn’t to say that exercise doesn’t help, it does, though not in all cases, more extreme forms of depression can and will resist physical exercise, but for a lot of us struggling with anxiety and depression, exercise and running, especially outdoors, can be a real boon. Though that appears to have passed the headline writers by.
Kieran is 35 and a manager at an agricultural machinery manufacturer in Milton Keynes. A husband and father, in his spare time he plays rugby and teaches young people to play too. Outgoing, but by his own admission he’s been struggling with bouts of anxiety and depression since he was a teenager, even if he couldn’t quite pinpoint what was wrong at the time.
“I remember times of just not wanting to do anything”, he says, “and shutting myself away from people, that sort of thing. But I only really started to deal with it in the last eighteen months, to actually seek help, I’ve got two young children and I felt like I was being a bad parent because I couldn’t cope with certain situations, so I just wanted to try something, I’ve been divorced once and I didn’t want to get divorced again.”
A report published in 2005, Up and Running? Exercise therapy and the treatment of mild and moderate depression in primary care
, highlighted research that showed that outdoor exercise can be as effective as antidepressants in treating mild to moderate depression and anxiety. It’s not clear why that story was kept off the front pages when it was published, though it’s unwieldy title might have had something to do with it.
The Mind charity so believes in the benefit of outdoor exercise and the above research that they created something called Ecotherapy, tailored to helping people combat the effects of depression through exercise. Among its goals is ‘reducing isolation and loneliness’, boosting ‘confidence and self-esteem’ and ‘getting away from modern life and into a relaxing outside space’. It goes on, ‘there is still a big job to be done in raising awareness of the positive impact we can all experience from outdoor exercise, this is the case for the public at large, as well as GPs and health practitioners.’ Luckily for Kieran, his GP was forward thinking enough and after dosing his patient with tablets he suggested cognitive behaviour therapy through Mind.
“My doctor brought therapy up, I wasn’t sure,” says Kieran. “I thought it was going to be group therapy and we were all going to have to sit there and talk about our problems and I didn’t think that was really for me, and then as time went on and I finally admitted I had a problem, I decided I wanted to give it a go. I gave Mind a ring and they invited me to go on this six-week course, three hours a week, where they basically taught me how to recognize the signs of anxiety and depression, what’s actually happening and how you can start to cope with it.”
How often have we said that we didn’t want to sit with other people and talk about our problems? Or even admit that we had a problem? Is it the fear of our own frailty or the simple stigma of dealing with something that can’t be quickly explained? Growing up, if I felt down or inexplicably bleak, I was told to pull myself together or asked what it was exactly I had to complain about? And it was true, what did I have to complain about really? Though just because you can’t explain the nuances of the way you’re feeling or express them coherently doesn’t make it any less valid. Read that last sentence back and then imagine saying something similar to your mates down the pub.
“It’s a manly thing, isn’t it? Says Kieran, “you don’t want to admit that you’ve got a problem, I’ve played a lot of rugby, so you always find yourself with a big group of mates, and you’re always out drinking and stuff and it’s not very easy to turn around to friends who are eighteen to twenty stone guys and say, I’m feeling a little bit down at the moment. So instead of dealing with that I would withdraw and not go to training and that’s how I dealt with it. I can talk about it with my wife, but even that was a bit difficult to start with, but now I talk about it quite openly and if people can’t deal with it then people can’t deal with it, you know?”
Kieran’s not alone, none of us are. A staggering two million people visit their GP every year struggling with anxiety and depression. Factor in that 46.67m antidepressant prescriptions, at the mind-boggling cost of £270.17m, were prescribed last year in England alone too (that’s just England, I’m Welsh and with my hand on heart I can honestly say that we as a nation we struggle with our fundamentally unique brand of blues and we’re not above popping pills to help solve our problems either) and you’ve got a problem verging on the epidemic. One more fact, in 2004 the Department of Health estimated that a 10 per cent increase in adult physical activity would benefit the UK by £500 million a year and save an estimated 6,000 lives. That was eight years ago and I think we can all agree that things have not improved in the interim. Plus, those numbers didn’t factor in the potential economic impact of improved mental wellbeing. Do the math; it’s not difficult.
Which is not to say that running and exercise will work for everyone, but, speaking from personal experience, the benefits can be both extremely beneficial and, surprisingly, almost immediate.
“Oh yeah, I felt the benefit almost straight away,” says Kieran. “Mind taught us to have an active diary, planning, you know, on a Wednesday do ten minutes of running, if you want to do more than that then do more than that, but makes sure you do the ten minutes. I’d get in from work, get me short and shoes on and head out along the canal towpath; it was just brilliant. I find that if I want to think about stuff and sort things out in my head then I can and if I don’t want to, then I just whack the music on and get going.
“And, generally, by the time you come home and you’re hot and sweaty, nothing’s as bad as you think, you know? You tend to forget about it and you’re pleased with yourself because you’ve gone out and done something. And if I don’t exercise I notice it, if I can’t get out and do something, then it really effects me, it really brings me down, there’s a knock on effect if you don’t go out for a couple of days, you end up back at square one again and then you start exercising again and you feel fine.”
Come October, Kieran will be running his first half marathon at Royal Parks in aid of Mind. As a way of saying thank you to the charity and letting others know just what people like him sometimes have to go through.
“It was a race I’ve always wanted to do and it’s a charity that’ll bring awareness to my friends and family about what I’m going through without having to stand up in front of everyone and say, I suffer from anxiety and depression and it’s something that I’m probably going to have to cope with for the rest of my life. Getting out of the door was the hardest thing and they helped me with that. But as soon as you get out there it’s brilliant, people should try and remember that.”
For more information on running events that Mind’s involved in visit: www.mind.org.uk/events