The body of evidence supporting exercise as a treatment for depression and other mood disorders continues to grow.
Many psychiatrists and psychologists urge their patients to get more exercise and make other lifestyle changes.
But perhaps no one takes this idea further than Washington therapist Jane Cibel, a licensed clinical social worker and certified personal trainer who conducts traditional talk therapy while clients walk on a treadmill or crank out dumbbell curls.
In an hour-long therapy session, patients get their weekly counseling session along with a high-heart-rate, sweat-inducing workout.
Finally, Cibel seeks to exploit the generalized positive feelings that occur as a result of exercise to help rewire the brain.
The theory behind this is known as "neural Darwinism," a concept advanced by 1972 Nobel Prize winner Gerald Edelman, who asserted that people become optimistic or pessimistic based on habits of mind reinforced by specific neural connections.
"Your brain is made of cell clusters, and the thoughts you attend to dictate the connections between clusters," explained Cibel, who has a Ph.D. in social work from the University of Maryland along with certifications in personal training and sports nutrition from the International Fitness Professionals Association.
A typical client will warm up on a treadmill at around 55 to 70 percent of maximum heart rate, do some upper- and lower-body strength training (on machines or with dumbbells), maybe some core training and balance exercises, then more treadmill.
Participants in both moderately intense groups experienced a decline in depressive symptoms by an average of 47 percent after 12 weeks.
Blumenthal conducted oft-cited studies, published in Archives of Internal Medicine in 1999 and 2000, that treated older adults suffering from a major depressive disorder with 30 minutes of exercise three times a week or the antidepressant Zoloft, or both.
The woman said she had taken a diagnostic test, which indicated she was "slightly depressed," and her psychologist suggested she go on medication.