Let Them Play Ball! Teenagers and Depression

When the No Child Left Behind Act arrived in 2001, followed by the Common Core State Standards in 2009, districts scrambled to make room for more core academic instruction. State-mandated testing and the remediation work that comes with it ate into the school day, and the hours had to come from somewhere. Often they came from physical education and recess. Some schools now run Academic Intervention Services during the slots once reserved for gym or free play. Others have dropped recess entirely. That choice runs against guidance from the American Academy of Pediatrics and other children's health groups, and it may carry a steeper cost than a few lost minutes of play.

The AAP calls recess "a vital and necessary component of a child's development." A good deal of research backs that up. Physical fitness does more than hold off obesity and the physical problems that follow it; it appears to help kids do better in class. A broad study out of Michigan State University found that fit students generally earn higher teacher-assigned grades and score better on standardized tests than their less-fit classmates. Exercise sends more blood to the brain and takes the edge off stress. Fit children also miss fewer days, since they are less prone to the illnesses, and some of the other troubles, that keep kids home.

Depression is one of those troubles. Roughly 11% of adolescents will go through a depressive disorder before they turn 18. The signs look different in young people than in adults. A young child might fixate on the idea of a parent dying, cling to caregivers, complain of feeling sick, or simply refuse to go to school. A depressed teenager may turn brooding and become hard to manage in the classroom. Left alone, depression in a young person can open the door to substance abuse, overlapping health problems, resistance to treatment, and falling behind academically.

Middle school is a rough stretch, and girls tend to carry more of the weight of depression than boys do. Researchers at the University of North Texas looked at this directly and found that sixth graders who were physically fit reported fewer depressive symptoms by seventh grade. Girls showed the biggest gains, which is the most hopeful part of the finding. The team surveyed 437 sixth graders in a large North Texas city, asking them about their fitness and their depressive symptoms. Girls reported depression more often. Having depression in sixth grade turned out to predict depression in seventh grade. Once the researchers stripped out other predictors, fitness still stood out as something that protected kids.

That matters, because it hints that fitness may actually head off depressive disorders, and because whether a child is depressed in sixth grade tells you something about the years ahead. "Depression that begins at this time can lead to chronic or recurring depression in later years," said Camilo Ruggero, PhD, who presented the work at the American Psychological Association's 122nd Annual Convention. "Fitness programs are one way to help prevent depression in middle-schoolers." Ruggero makes a point of saying it is overall fitness that does the protecting, not activity by itself. The trouble is that kids are not moving enough to get there.

The numbers are not encouraging. The Centers for Disease Control and Prevention reported that in 2013 only 27.1% of high school students got 60 minutes or more of exercise on a daily basis. Just 29% said they attended a physical education class at school. Among children ages 9 to 13, 77% reported some unstructured physical activity, so the pattern is clear: the older kids get, the fewer chances they have to move. Given how much of their waking life happens inside a school building, that should give people pause.

Children who are fit usually carry the habit into adulthood. Fitness here means body fat, muscular strength, flexibility, and endurance, and it reflects how a person chooses to live. A separate study from West Virginia University in Morgantown found that the range of a child's fitness predicts both academic performance and the odds of being a fit adult. Beyond warding off obesity and disease, movement raises serotonin and other chemicals tied to mood, which may bring benefits for mental health.

The AAP, the U.S. Department of Health and Human Services, and the National Association for Sport and Physical Education all put the recommendation at a minimum of 20 minutes of unstructured play each day plus 60 minutes of physical activity for kids ages 6 to 17. Some efforts are pushing in that direction, like the National Wildlife Federation's campaign to get 10 million more children playing outside. Parents and neighbors can add their voices by writing to legislators about the Fitness Integrated with Teaching Kids Act (the FIT Kids Act) or by asking local school board members to protect PE and recess. Guard the chance to be active, and you help guard kids against depression.

- Melissa Lavery, M.S.