<Possible alternative 1: antidepressant medication>
In order to have an objective evaluation of the sportโs overall impact in the pandemic situation, alternative solutions that are currently being used should be thoroughly considered. One traditional way to treat depression patients is using antidepressant medication. Selective serotonin reuptake inhibitor, or SSRI, is the most common type of medication that is used to treat depression. The achievement of this medication is often tested by comparing its effect with the control group of a placebo, which is a pharmaceutically active substance that doesnโt have effects for easing the treated conditions (Kirsch). Using this method, Graham J Emslie, the pediatric psychiatrist from Southwestern Medical Center, draws a conclusion that supports the positive outcome of SSRI treatment: among 97 depression patients participating in the experiment, SSRI-treated patients after 1 week met the criteria of remission, or the medical state of decreasing or disappearance in signs of symptom. This rate is twice more than placebo-treated patients for the same period of treatment. When the remission is regarded as the ultimate purpose of the treatment, this result demonstrates medicationโs efficacy on depression patients.
<Limitations of antidepressant medication>
However, because medication inevitably accompanies adverse side effects, there are opposing views toward medication usage as a prominent treatment. To be specific, while SSRI eases depressed states by regulating serotonin, the chemical substance that regulates moods, its process simultaneously blocks the other hormone that manages levels of sodium in the body, according to Susan Jacob and Sarah Spinier, the pediatric doctors in Texas Childrenโs Hospital. They claim that this should be significantly considered since the decreased level of sodium in patientsโ bodies due to the intake of SSRI results in insomnia, confusion, and diarrhea, making them difficult to normally function in society. They further mention that most of the prominent medication often has an age limit, and that itโs difficult to be applied to younger people. Even though some mediation is allowed to be used for all ages, it tends to have higher levels of side effects in younger people including the children and adolescents. The reason why adolescents tend to have more side effects compared to adults is that adolescentโs organs that manage hormones are not fully developed, which makes them more vulnerable to even small changes. Considering that SSRI was verified in the US as the medication with the least adverse effect on adolescents, the side effects of other medications would further outweigh the benefit (Jacob, Susan, and Sarah Spinier 1619). Hence, extreme side effects exceed the positive implication, making it difficult to be used as the prominent treatment for depression patients- especially for the younger groups of people.
<Possible alternative 2: psychotherapy>
With these negative implications, another alternative solution, psychotherapy, is also being utilized to cure depression, especially because it doesnโt utilize synthesized chemicals that can negatively affect the body but rather focus on a mindset change. One common depression patients often demonstrate unrealistic negative thoughts about themselves and others, making it difficult to normally function in society. Most common forms of psychotherapy challenge these thoughts of patients by making them realize the presence of these negative thoughts in their cognitive process and assisting them to get rid of negative thoughts (McCarty, CarolinA., and John R. Weisz 883). This process can enhance the mood and alleviate patients from depressed states to eventually improve social functioning and problem-solving skills. On average, these positive changes could immediately lower the level of depression for about 75% of the depression patients in 12 weeks (Mufson 576).
Picture above demonstrates the relatively decreasing rate of depression after interpersonal psychotherapy (IPT) compared to the control in the experiment (ECS). Therefore, psychotherapy is a considerable solution that can help depressed patients to readjust to society without concerns about side effects that hinder their quality of life.
<Limitations of psychotherapy>
Though the short-term effect of psychotherapy may be acknowledged, disagreement exists for its usage as a most reliable solution, for psychotherapyโs effects are not continuous for a long time to relieve symptoms, which is the final goal of the treatment. To be specific, assuming that no other treatment was administered, the longest duration of treatment effect for depression patients was 3 months, which is far less than the time required for patients to recover (Weisz et al. 136). One of the dominant reasons for its shortcoming is the disparity of thoughts and beliefs between psychotherapists and patients, which gets extremely important for the younger groups of people including children and adolescents due to the age gap. This isnโt negligible when the whole point of treatment is having a conversation based on the understanding of each other. US magazine โPsychotherapy Networkersโ agrees to the idea by claiming that these inconsistencies mostly come from a lack of training for psychotherapists to understand children and adolescent culture (Edgette). Considering that this is written by psychotherapists, their acknowledgment of drawbacks in their own treatment further demonstrates the limitations of psychotherapy as a treatment for depression patients.
<Comparison between sports and other alternatives>
Sportโs effects are much more significant when itโs directly compared to the effect of medication, not just because sport doesnโt utilize chemical substances that can cause side effects for the patientโs body but also in means of efficacy, according to the research from B.N. Gangadhar, a professor from the National Institute of Mental Health.
To simplify the process of an experiment, he used yoga, a type of aerobic sports that can be a representation of other sports with its well-known effect for alleviating the depressive conditions. He substantiates the higher efficacy of sports practice in relieving depression symptoms by recording the results after each treatment using the Hamilton depression rating scale, the commonly used scale that measures the severity of depression based on the patientโs answer for questions designed to examine the symptoms. After 3 months of treatment, patients who took medication scored 10 in the Hamilton depression rating scale, while patients who practiced sport exercise scored 3 in the Hamilton depression rating scale as it is shown in the graph above. The result of this study is significant for demonstrating the effect of sport, for a score of 3 is considered normal, while a score of 10 is considered mild depression, showing the strong effectiveness of sport.
Even compared with psychotherapy, sport therapy had a much longer duration effect on relieving the depression symptoms because when no other treatment was administered, the duration of sportโs effect was 12 months, which is four times longer than that of psychotherapy and is also sufficient to meet the least amount of time required to cure depression (Craft, Lynette, and Frank Perna 106). This is because sportโs main focus is not direct communication between therapist and patient when it's used as a treatment, the ideal disparity doesnโt affect the progress of the exercise. This addresses the research question by demonstrating how sport has better efficacy than previous common treatments and can also solve the inevitable limitations in these treatments.
The other reason why sports has been consistently nominated over alternatives as the treatment for depression patients is because of the accessibility. Medication and psychotherapy often requires people to go out of their house, which sometimes becomes a much more difficult task for depressed patients. Moreover, depending on the societyโs cultural background, taking psychiatric medication or visiting the psychotherapist may appear as something to be ashamed of, especially for adolescent patients who may find themselves sensitive against surrounding peers. Yet, sport can be relatively easily accessed by people, regardless of age or other specific characteristics. Because sport has been recommended for depression patients with high feasibility, its numerous research and possibility of further development have demonstrated the reason to further evaluate sportโs impact on depression patients.
<Perspectives that should be considered>
In addition to the research results of researchers and professors, there are three stakeholders whose perspectives should be considered- an international health agency, state governments, and national health agency-because these institutions are the ones who provide appropriate guidance to people with great influence during the pandemic situation. Considering the perspective of the international health agency, sports seem like a plausible solution in a pandemic situation. In 2020, the World Health Organization stated that when people are very restricted in [their] movements, being active becomes more important. This highlights the importance of physical activity and sports during the pandemic situation. Nevertheless, the perspectives of other stakeholders question the feasibility of encouraging sports. To elaborate on, the California state government endorsed the action of staying at home on March 19, 2020 (โAbout COVID- 19 restrictionsโ). Though the given perspective might be considered as limited, the perspective of California state government is significant because it is one of the largest cities in America, and thus, it can be representative of other states. Such a perspective challenges people to play sports. Similarly, the health protection agency of the U.S. agreed with the state governmentโs idea. On October 28, 2020, the Centers for Disease Control and Prevention, a national health agency of the United States, stated that venturing out presents potential risks for peopleโs family and community because there are people who do not show any symptoms even though they are already infected, and going outside (โDeciding to Go Outโ). This implies the potential risks of going outside, which is required to play sports. Such a point of view might challenge the feasibility of the recommended choice, sports, by making people be concerned about going outside and having time to play sports.
<Sportโs feasibility in pandemic situation>
Yet, it should be considered that the mentioned perspectives of the state government and national health agency were based on the situation of 2020. Recently, because of the vaccines that are available, going outside has become less dangerous compared to the past situation. On May 14, 2021, the Centers for Disease Control and Prevention reported, โ46.6% of the total U.S. population have received at least one dose of vaccineโ (โCOVID Data Trackerโ). As nearly half of the citizens in America were vaccinated, going outside in the status quo will not be too dangerous compared to past situations. Even for children who are yet vaccinated, playing sports can still be safe and feasible for children if they are โadhering to social distancing rulesโ (Nyenhuis et al. 2153). Moreover, according to the Massachusetts executive office of energy and environmental affairs, sports and recreational activities can be divided into โLower Riskโ, โModerate Risk,โ and โHigher Riskโ based on โthe risk of transmission of COVID-19 inherent in the sportsโ (โWORKPLACE SAFETYโ). Except for sports with โHigher riskโ, which include football, wrestling, rugby, basketball, and ice hockey, other types of sports will not be too dangerous. To sum up, not all types of sports and physical activities are hazardous. If people properly abide by the social rule, which is a physical distance, going outside and having time to exercise will be much safer and beneficial for their mental health.
Writer: Youngjun Kim (Mark)
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