Major depressive disorder (MDD) is one of the most prevalent mental illnesses in America. According to the World Health Organization, there are more than 300 million individuals with MDD in the world. It is estimated that 16.2 million US citizens aged 18 or above had at least one major depressive episode in 2016 (6.7% of all American adults). Late-life depression (LLD) is also common and debilitating, with less frequent remission and more frequent recurrence after first-line antidepressant treatments than depression experienced earlier in life.
With the population aging rapidly, there is an increased need to identify the factors that will increase resilience to developing depression. Psychological resilience in LDD is defined as “the capacity to maintain or regain, psychological well-being in the face of challenge.” However, in MDD, it refers to the net effect of a variety of psychosocial and biological variables, which decrease the risk of onset or relapse, severity of illness, or recovery speed.
Usual treatments are psychotherapy and pharmacotherapy. However, current treatments are unsatisfactory due to high non-response rates, high drop out rates, high relapse rates, undesirable side effects and low remission rates. Because of the drawbacks of current treatments, alternative and complementary therapies are needed to treat MDD. Evidence indicates that Tai Chi (also called movement Qigong) can significantly regulate emotion and relieve symptoms of mood disorders. Recent studies also show that it may reduce stress and modulate inflammation.
Tai Chi, Qigong, and Yoga (meditative movements) are recognized as complementary approaches to relieving musculoskeletal pain, improving sleep, and reducing blood pressure, but not much focus has been on their effect on MDD. In 2018, a group of researchers performed a systematic review and meta-analysis of random controlled studies on the effect of meditative movements on MDD. Meta-analysis showed a significant benefit on depression severity and significantly improved remission rates when compared to non-meditative exercises. Movement-based interventions (especially Tai Chi) have been shown to “outperform convention physical exercise” regarding mood, cognitive functioning and depressive symptoms.
When doing Tai Chi, attention is focused on body, posture, movement, and breathing. Focus is taken away from stressors, and repeating movements in a mindful way can change the attention and relieve the depressive symptoms. It can also modulate brain structures in the area related to mood regulation through safe and easily accessible lessons.
Clinicians may consider recommending meditative movements for symptomatic management of patients with MDD. One concern is that some Tai Chi movements are complex and don’t work well for clinical intervention, therefore, some researchers feel that there is a need to develop a simplified Tai Chi protocol tailored specifically for depression. Others feel that more randomized controlled trials are warranted. The good news is that Tai Chi (and other meditative movements exercises) may provide a useful alternative to, or augment existing mainstream treatments for MDD without significant adverse effects.
Yet another reason to continue your Tai Chi journey!