Public Health Report : Tai Chi for Depression
Author : Eric L. Zielinski
Previously known as melancholia, clinical depression or major depressive disorder has reached epidemic proportions in the U.S and throughout the world. Sadly, most moderate to severe cases get put on harmful medications to help minimize the symptoms. Like all drug therapy regimens, however, the root cause is not addressed whereas only the symptoms are masked. The world is crying out for science to validate more natural approaches to this debilitating disorder. Thankfully, researchers are becoming increasing interested in explaining why so many people battling depression receive great benefits from the age-old practice of Tai Chi
According to the National Institute of Health, “Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.” In addition, it is also reported that depression is the leading cause of disability for U.S. citizens age 15 – 44.
Depression is complicated and as psychologists continue narrow its diagnostic scope, the situation gets more convoluted. There are two different ways to view these staggering numbers. One, these numbers are validation that our current sedentary lifestyle filled with processed foods is causing significant harm and people are suffering at alarming rates because of it. Two, these numbers are misleading as too many people are being clumped into a mental disorder because diagnostic criteria continues to tighten up. In either case, the reality is that regardless whether or not people are actually clinically “depressed,” 15 million Americans have found valid reason to go to their doctor for help and, therefore need help.
Still not quite fully understood, the American Psychological Association (APA) describes depression as,
“More than just sadness. People with depression may experience a lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide. Depression is the most common mental disorder. Fortunately, depression is treatable. A combination of therapy and antidepressant medication can help ensure recovery.”
Sadly, the APA pushes drug therapy as their mainstay treatment protocol as the last statement from above indicates.
By far antidepressant medications are the most common treatments employed in people battling depression. The Centers for Disease Control and Prevention (CDC) reports that antidepressants are the third most common drug prescribed in the U.S. It’s alarming that more than eleven percent of Americans over 12 years old take them.
The following list of antidepressant medications and their related side effects comes from the U.K.’s National Health Service (NHS):
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs):
Tricyclic antidepressants (TCAs):
Monoamine oxidase inhibitors (MAOIs):
These medications have been linked to kidney and liver damage, Type II Diabetes, suicide and severe hyponatremia (drop in sodium levels) in the elderly, which can prove to be fatal.
Though none of these drugs have been approved by the Food and Drug Administration (FDA) for stress management, millions of American use them daily. According to the NHS “It is important to persist with treatment, even if you are affected by side effects, as it will take several weeks before you begin to benefit from treatment. With time you should find that the benefits of treatment outweigh any problems related to side effects.”
Nonetheless, as evident by the 400 percent increase in antidepressant use among Americans from 1988–1994 through 2005–2008, people are continuing to ignore these dangerous side effects and are seeking medications at an alarming rate.
Like other mental illnesses, medical journals are filled with studies proving how practicing regular Tai Chi can help prevent or manage issues like depression. The following are just a few examples:
• Ever since a 1989 study published in the Journal of Psychosomatic Research, the psychological benefits of those practicing Tai Chi has been extensively researched. In this now classic text, La Trobe University researchers assessed 33 Tai Chi novices and 33 regular practitioners. It was observed in both groups that “Tai Chi raised heart rate, increased noradrenaline excretion in urine, and decreased salivary cortisol concentration. Relative to baseline levels, subjects reported less tension, depression, anger, fatigue, confusion and state-anxiety, they felt more vigorous, and in general they had less total mood disturbance.” This study has laid the groundwork for hundreds of researchers to follow suit and tell the world confidently that Tai Chi is a fantastic tool to employ against chronic diseases like depression.
• To compare studies targeting Tai Chi and identify the physical and psychological health outcomes shown to be associated with them in adults older than 55, University of Arizona and Arizona State researchers evaluated 36 research reports with a total of 3,799 participants and observed the following: “Significant improvement in clusters of similar outcomes indicated interventions utilizing [Tai Chi and Qigong] may help older adults improve physical function and reduce blood pressure, fall risk, and depression and anxiety.” However, as researchers indicated, “Missing from the reviewed reports is a discussion of how spiritual exploration with meditative forms of PA, an important component of these movement activities, may contribute to successful aging.”
• Not only a complication of accidental falls, it has been shown that depression can also cause falls; thus, highlighting their bidirectional relationship. In other words, excessive fear of falling – also associated with depression – greatly increases one’s likelihood to fall. According to University of Toronto researchers, “Both depression and fear of falling are associated with impairment of gait and balance, an association that is mediated through cognitive, sensory, and motor pathways.” To complicate matters, anti-depressant medications can increase the risk of falls thereby putting an elderly individual battling depression between a rock and a hard place. University of Toronto researchers point out this challenging interplay in an article they published this past year in the American Journal of Geriatric Psychiatry. Their research caused them to conclude that,” Based on the current state of knowledge, exercise (particularly Tai Chi) and cognitive-behavioral therapy should be considered for the first-line treatment of mild depression in older fallers.” Tackling both a cause and a complication of depression, this study shows the interesting inter-relatedness of Tai Chi with a number of public health risks.
• In 2013, the Journal of Investigative Medicine published in article in which University of New Mexico researchers conducted a literature review evaluating how people with post-traumatic stress disorder (PTSD) respond to mind-body practices like Tai Chi. Of the 96 articles identified, 16 were used for the review and the researchers discovered, “Mind-body practices incorporate numerous therapeutic effects on stress responses, including reductions in anxiety, depression, and anger, and increases in pain tolerance, self-esteem, energy levels, ability to relax, and ability to cope with stressful situations. In general, mind-body practices were found to be a viable intervention to improve the constellation of PTSD symptoms such as intrusive memories, avoidance, and increased emotional arousal.” The authors encouraged readers, clinicians and patients to explore individualized treatment plans “enhanced by mind-body interventions as part of ongoing self-care.”
• A 2012 pilot study published in the American Journal of Physical Medicine and Rehabilitation evaluated 39 Chinese Americans to determine Tai Chi’s feasibility, safety, and ability to treat major depressive disorder. Of the 26 people who participated in the 12-week program, it was discovered that they fared considerably better than the 13 who did not practice Tai Chi with a positive treatment-response rate of 24 percent compared to 0 percent and remission rate of 19 percent compared to 0 percent, respectively. Although, just a pilot study by design, these encouraging results not only substantiate the need for larger research designs to be conducted to confirm these results, this article provides hope to a nation overflowing with clinically depressed people who are in desperate need of effective methods to decrease their mental illness.
A simple search for “depression” under the U.S. National Library of Medicine’s online search engine, PubMed.gov – resulted in over 290,000 hits. This means that almost 300,000 articles in medical journals indexed in PubMed alone report on data regarding this mental illness. In comparison, a similar search for HIV resulted in 255,000 entries. When considering the billions of dollars that have been raised in HIV research and awareness within the past 30 years, the significance of depression stands out significantly. There are not many illnesses or disorders that have been researched more than depression. Of these 290,000 articles referencing depression, just 63 connect it with Tai Chi. Obviously, more research is needed to substantiate Tai Chi’s effectiveness in managing and preventing depression. Nonetheless, the 63 articles that have already been published still provide a substantial foundation for larger studies to be conducted.
Western Journal of Nursing Research
American Journal of Physical Medicine and Rehabilitation
American Journal of Geriatric Psychiatry
Journal of Investigative Medicine
Journal of Psychosomatic Research
Public Health Report : Tai Chi for Depression
Author : Eric L. Zielinski