The Catch-22 of exercise and depression

Doctor often advise people with heart disease to exercise. But cardiac patients are known to be at higher risk for depression, and some people with depression can't motivate themselves to get up and move.

That Catch-22 may be a major reason why so many cardiac patients do not follow the routine advice to become more physically active after being treated for a heart attack or other cardiac event.

Why does depression lead to a decline in activity among people who need it the most? It may be because depressed people adopt habits that make it harder to exercise, such as smoking or over-eating. Depression also decreases energy level, exercise tolerance and pain threshold.

"The sad part about this is that physical activity is not only important for preventing and managing many chronic conditions, it can be very helpful for improving mood and other symptoms of depression," Evette Joy Ludman, of the Group Health Cooperative in Seattle, said of the study.