Effectiveness of Exercise as Treatment for Depression in People with MS.

Background: Major depressive disorder (MDD) is a highly prevalent condition in people with multiple sclerosis (MS), with a lifetime risk between 22.8% and 54.0%. Depression is associated with greater disability and suffering. Exercise is an effective treatment for depression in healthy human subjects. Therefore, exercise may have promise as a means of treating depression in people with MS. Research Aim: Evaluate the impact of exercise on depression, fatigue, pain, community participation, and health-related quality of life in people with MS. Methods: This is a randomized controlled study. Participants meet criteria for MDD and/or dysthymia and are sedentary. The treatment group receives nine sessions of a mostly telephone-based intervention designed to improve motivation to exercise and activity over 16 weeks. The waitlist control group receives treatment after 16 weeks. Outcome measures are PHQ-9 and SCL-20 depression measures and minutes of exercise. Results: The study is ongoing; therefore, the main analyses are pending. Here, we present the results of several cases to illustrate reactions to the intervention and changes observed. Case 1 is a 53-year-old woman diagnosed in 2001 with an Expanded Disability Status Scale (EDSS) score of 5. Her exercise activity increased from 0 to 165 minutes/week of gardening. Her SCL depression scores declined form 15 to 8. At Week, 6 she reported, “My mood has improved. I feel like I am accomplishing something.” Case 2 is a 57-year-old man diagnosed in 2005. His EDSS score was 6. His activity went from 0 to 300 minutes of rowing, stacking wood, and woodworking. His SCL depression scores fluctuated among 22, 10, and 25. He reported, “I’m doing this (exercise) for the purpose of being able to do the enjoyable activities that I used to be able to do.…I can’t do everything like I did before, but I feel like I am getting part of my life back.”