Exercise may be just as crucial to a depression patient's good health as finding an effective antidepressant, say scientists who found that the high fitness level at middle-age can protect the heart from the negative effects of the mental disorder. Researchers University of Texas in the US has brought into focus multiple ways in which depression can affect health and mortality. It has also explored the most common dilemma among patients - How does one cope with hopelessness and still find motivation to exercise? "Maintaining a healthy dose of exercise is difficult, but it can be done. It just requires more effort and addressing unique barriers to regular exercise," said Madhukar Trivedi, the study published in Journal of the American Medical Association. Depression has been linked to several other chronic medical conditions such as diabetes, obesity, and chronic kidney disease, in which anti-depressants are less likely to help. For patients with these conditions, the more appropriate treatment may be exercise. "The reasons behind this may partly be connected to the general health effects of physical activity, including the fact that exercise decreases inflammation that may cause depression. By reducing inflammation, the risk for depression and heart disease are lowered," Trivedi said. "The findings are just as relevant to younger age groups, in particular college-age adults who are just entering the workforce. This is the age where we typically see physical activity drop off because they're not involved in school activities and sports," he said. "Being active and getting psychotherapy are sometimes the best prescription, especially in younger patients who don't have severe depression," researchers said. They worked on a database of participants who had their cardio-respiratory fitness measured at an average age of 50 years. They used Medicare administrative data to establish correlations between the participants' fitness at midlife to rates of depression and heart disease in older age. Among the findings, participants with high fitness were 56 per cent less likely to eventually die from heart disease following a depression diagnosis. Trivedi recommended the people diagnosed with depression to set aside a consistent time to exercise every day, keep a log to track progress, to exercise with a friend, or to assign someone to hold them accountable for maintaining the exercise regimen.