Is exercise as effective as treatments for depression and anxiety?
文本难度：六级
刘立军供稿
Is exercise as effective as treatments for depression and anxiety? Some big studies say yes. Many experts have reservations.
运动对抗抑郁、抗焦虑的疗效，能和正规治疗相媲美吗？一些大型研究给出了肯定的答案，但许多专家对此仍持保留意见。
For those in the doldrums, few things are more tiresome than being told to exercise. But unwelcome advice is not necessarily wrong. Study after study has found that exercise boosts mood and reduces anxiety. Two large analyses published earlier this year go further, suggesting it works about as well as therapy or antidepressants.
对于那些正处于情绪低谷的人来说，几乎没有比听到别人劝自己“去运动”更让人心烦的了。但不中听的建议未必就是错的。一项又一项的研究发现，运动能够提振情绪，缓解焦虑。今年早些时候发表的两项大型分析进一步表明，运动的治疗效果与心理治疗、抗抑郁药物不相上下。
The first, published in January by researchers based across Britain and Ireland, took the form of a Cochrane review — a well-regarded meta-analysis of health-care research. It pooled the results of 69 randomized-controlled trials (RCTs) conducted to measure the effects of exercise on depression. The second paper, published in February in the British Journal of Sports Medicine, was a so-called meta-meta-analysis. It drew on more than 1,000 trials involving nearly 80,000 participants. Both concluded that exercise reduces symptoms of depression and anxiety by roughly as much as conventional treatments.
第一项研究由英国和爱尔兰的研究人员完成，于今年1月发表，采用了备受推崇的科克伦（Cochrane）系统评价形式——这是医疗领域广受认可的一种荟萃分析。该研究汇总了69项随机对照试验（RCTs）的数据，这些试验专门用来评估运动对抑郁症的作用。第二篇论文于2月发表在《英国运动医学杂志》上，采用了所谓的“二次荟萃分析”。研究参考了1000余项试验，受试者近8万名。两项研究均得出结论：运动在缓解抑郁、焦虑症状方面的效果，与常规治疗方法大致相当。
There are important caveats. Meta-analyses are only as good as the studies they include, and exercise trials are prone to being skewed. For one thing, participants cannot be blinded — they know if they are doing kettlebell swings or not — which makes their self-reported mood vulnerable to any favorable expectations they might have. For this and other reasons, the Cochrane review judged all the studies it included to be at “high risk” of bias.
但该结论存在重要的限定条件。荟萃分析的可靠性完全取决于所纳入的原始研究，而运动类试验往往容易出现结果偏倚。首先，参与者无法实施“盲法”——自己是否完成壶铃摇摆这类运动，参与者心知肚明。这就导致参与者主动上报的情绪，很容易受到内心积极预期的影响。出于上述及其他因素，这份科克伦系统评价判定，其纳入的所有研究均存在“高偏倚风险”。
What’s more, the meta-meta-analysis did not include any studies that tested exercise against other interventions. The findings from the exercise trials were, instead, compared against those from separate trials of antidepressants or therapy. But unlike exercise studies, RCTs of antidepressants are typically well blinded and have strong placebo effects, making it harder for them to achieve similarly impressive results. “I don’t think it’s a fair comparison,” says Jonathan Roiser, a professor of neuroscience at University College London.
此外，这项“二次荟萃分析”并未纳入任何将运动与其他干预措施进行直接对比的研究。它是把运动试验的结果，与另外独立开展的抗抑郁药、心理治疗试验的数据做比对。但与运动研究不同，抗抑郁药物的随机对照试验通常盲法设计完善，且安慰剂效应显著，这使得药物想要取得同样令人瞩目的疗效数据难度更大。伦敦大学学院的神经科学教授乔纳森·罗伊泽（Jonathan Roiser）表示：“我认为这样对比并不客观。”
All the same, most researchers are confident that exercise helps improve mood. Aerobic workouts, such as running, walking or cycling, seem to be particularly beneficial across the board. For depression, group-based or supervised exercise is more effective than sweating alone, and the benefits of exercise accrue over several months. For anxiety, the best results seem to come from lower-intensity activity.
尽管如此，绝大多数研究人员仍认可运动有助于改善情绪。跑步、散步或骑车等有氧运动，总体来看大有裨益。针对抑郁症，团体运动或在专业人员指导下开展的运动，效果优于独自锻炼，且运动带来的益处会数月里不断累积。而对于焦虑症，低强度运动似乎能带来最佳效果。
Why exercise works is less clear. The popular idea that exercise generates a “high” by causing the release of endorphins, a form of opioid, has little scientific support. A study published in 2021 found that blocking runners’ opioid receptors reduced neither the euphoria they reported after a session nor the drop in anxiety. Researchers instead think that endocannabinoids — chemicals produced by the body and brain that activate the same receptors as the active molecules in cannabis — might be responsible for these short-term boosts.
Other pathways are also being triggered. Exercise seems to reduce inflammation and improve brain plasticity, as well as increasing the transmission of dopamine in the brain. Dopamine is involved in the process of weighing effort against reward, and so increasing transmission may help reverse the loss of motivation associated with depression.
运动还会激活其他生理机制：它能够减轻炎症，提升大脑可塑性，并增加大脑内多巴胺的传递。多巴胺参与了“权衡付出与回报”这一心理过程，因此，增加多巴胺的传递有助于改善抑郁症患者典型的动力缺失问题。
There are purely psychological benefits, too: exercise can provide people with a sense of achievement, agency and eventually mastery, all of which are known to lift mood. Plenty of reasons, then, to work up a sweat.
此外，运动还能带来纯粹的心理益处：它能给人带来成就感、自主感，最终获得一种掌控感，而这些都能够提振情绪。如此看来，我们完全有理由动起来，好好出一身汗。
【词汇】
1. in the doldrums 情绪低落
2. meta-analysis n. 荟萃分析（一种循证医学研究方法，把多个独立的同类研究的数据汇总、合并分析，得到一个综合性结论，研究说服力高于单一试验）
3. caveat n. 警告；提醒
4. skew v. 使……有偏差；影响……的准确性
5. placebo n. 安慰剂
6. neuroscience n. 神经科学
7. aerobic adj. 有氧的
8. accrue v. 积累；增加
9. endorphin n. 内啡肽
10. opioid n. 阿片样物质（既可来源于外界毒品，也包含人体自身合成的内啡肽，能够起到镇痛、产生欣快感的作用）
11. receptor n. 受体；感受器
12. euphoria n. 欣快感；极度愉快
13. cannabis n. 大麻
14. inflammation n. 炎症
15. dopamine n. 多巴胺
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