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Depression – exercise and mindfulness ahead of medication in new treatment guidelines for mild cases

People suffering from mild depression should be offered exercise, mindfulness, therapy or meditation before medication, such as antidepressants.

New draft guidance, published by the National Institute for Health and Care Excellence (NICE) recommends that a “menu of treatment options” – including physical activity – should be offered to all patients before medication is considered.

A number of studies have suggested that exercise can be used as an effective treatment for depression.

Earlier this year, the Move Your Mental Health report – which summarised data from 1,158 studies and reviews 20+ types of physical activities in relation to mental health outcomes – found that people with depression should be prescribed exercise and then monitored for the first 12 weeks of their regime.

Out of the 1,158 studies, 89 per cent (1,029) reported "significant positive relationships" between physical activity and mental health outcomes.

The new NICE guidance also outlines new recommendations for people who are considering taking, or stopping, antidepressant medication.

These include the advice that patients should talk with their healthcare professional about the benefits and risks of medication.

"The healthcare professional should explain that withdrawal may take weeks or months to complete successfully, that it is usually necessary to reduce the dose in stages over time (called ‘tapering’) and that most people stop antidepressants successfully," the guidance reads.

Dr Paul Chrisp, director of the centre for guidelines at NICE, said: "People with depression deserve and expect the best treatment from the NHS which is why this guideline is urgently required.

"The COVID-19 pandemic has shown us the impact depression has had on the nation’s mental health. People with depression need these evidence-based guideline recommendations available to the NHS, without delay."

According to the Office of National Statistics, around one in six (17 per cent) adults aged 16 years and over in Great Britain experienced some form of depression in summer 2021.

The rate remains higher than those observed before the pandemic (July 2019 to March 2020), where 10 per cent of adults experienced some form of depression.

NICE  National Institute for Health and Care Excellence 
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People suffering from mild depression should be offered exercise, mindfulness, therapy or meditation before medication, such as antidepressants. New draft guidance, published by the National Institute for Health and Care Excellence (NICE) recommends that a “menu of treatment options” – including physical activity – should be offered to all patients before medication is considered. A number of studies have suggested that exercise can be used as an effective treatment for depression.
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A number of studies have suggested that exercise can be used as an effective treatment for depression / Shutterstock/NDAB Creativity
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