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Walk Away the Blues

Never Too Late



The Duke researchers also want to focus on a recently identified phenomenon called "vascular depression." They think damage to the vessels that supply blood to the brain may be to blame in up to one third of depression cases. Where depression is caused by such basic plumbing problems, pharmaceutical solutions may turn out to be less effective than exercises that help counteract cardiovascular disease, they believe.


Depression in older adults is of special concern because it can be mistaken for dementia or other age-related ailments rather than as a potentially treatable illness. And while it is not clear that old age alone increases the risk of depression, the physical ailments that afflict many people as they grow older can cause such a reaction. So can some of their medications.


Beth Ellis, 69, thinks the camaraderie of exercising at her local YMCA is part of what works for her. "There's something about exercising in a group that's also uplifting," she says. "It's sort of a community feeling."


What's more, she says, "My experience is that exercise is the most potent antidepressant you can imagine. I've been on Prozac from time to time during really bad periods, and it got me through." But each time she's on it, she eventually wants to stop her medication, and "exercise is one of the things that lets me handle it myself."


Exercising is no simple matter for Ellis. She has Charcot-Marie-Tooth disease, an incurable neurological disease that degrades sensation and motor control in the hands, feet, and limbs, leading to weakening of muscles through disuse. Ellis once was an avid runner, but as her disease progressed, running became impossible.


Losing her ability to run was a major blow for Ellis and likely triggered her depression. But now she goes to the YMCA for strength training, works on a cross-training machine, and does dance aerobics.


"So I'm still in the arena," says Ellis. "I am convinced that it really, really helps. If I'm unable to exercise for any reason, I really feel down in the dumps."


Scientists still are learning about why this is true. Is it exercise's effect on brain chemistry? Is it the boost to self-esteem? Is it the fellowship people gain when they exercise together? Or is it all of the above?


Urmson allows as how those questions are interesting. But the bottom line, she says, is simple: Exercise makes her feel better.


Has she slacked off since she first started working out after her accident? "Oh," she says with a laugh, "I'm afraid to stop."


David R. Dudley is based in Berkeley, Calif. His stories have appeared in The New Physician and The San Jose Mercury News.


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