Exercise should be ‘core treatment’ for depression – study
Exercise should be ‘core treatment’ for depression – study
Researchers found that exercise was just as good as therapy and even better than antidepressants.
Exercise should be a “core treatment” for people with depression, academics have said, after a new study suggested that some forms of exercise were just as good as therapy and even better than anti-depressants.
Walking, jogging, yoga and strength training appeared to be more effective than other types of exercises, according to a major new analysis.
And the more vigorous the exercise, the better, according to a research team led by academics in Australia.
But even low intensity exercises such as walking and yoga had meaningful benefit.
The effect of exercise appeared superior to antidepressants, according to the study which has been published in The BMJ.
But when exercise was combined with antidepressants, this improved the effect of the drugs.
After a couple of decades of people telling me exercise would help, I finally decided to try it last year. For 6 months, I did at least some form of exercise at least every other day which, coming from years of being completely sedentary, was quite a change. And at the end of all of that...nothing. I was in better shape of course, but I didn't feel any better, didn't have any more energy, and wasn't any less depressed. That's just one anecdote of course, but my point is that it really sucks seeing studies continually say exercise is the best thing we've got because if that's true then I am well and truly screwed lol
44I'm in the same boat. I've tried almost everything; hiking, running, biking, swimming, climbing... All it ever gives me is sore muscles the days after, but apart from that it doesn't change my mood in any way. In fact, it usually frustrates me since I don't feel any perceived benefits, but it still costs me time, effort and pain. Doesn't help that I'm very sport-averse because of negative expeiences in my youth.
20I've been clinically diagnosed with depression and other fun stuff for nearly two decades now. Exercise is great as a stimulant to your emotional fortitude but it hasn't "fixed" shit for me like they said it would. "Here's a bottle of 60mg pills, give it a month to feel better". If I had a plank of wood every time I heard that after trying their holistic idea, I'd have built my own house to get away from this fucking dismal housing market.
However, I think our problems paint the picture for us: Mental health issues are treated more like chronic staph infections than the psychological trauma they are. Everyone's damage is so acutely unique to them, because it happened to them, so treatments need to be equally as personal. I don't have the source on me, so take my statement how you wish, but nearly half of all diagnosed Depressives are given drug-only treatments.
The solution is to expand therapeutic services to help more people (i.e. government programs to subsidize the cost of services to the psych practice) and only use medications as a short-term supplement during treatment. This would help those afflicted to reach the point they can do the more holistic approaches and wean off the drugs.
Then again, that doesn't get the pharmaceutical corporations paid... ¯\_(ツ)_/¯
On a more personal note, we also need better therapists. The ones I have must've had some shit they're dealing with of their own because my sessions were typically abysmal and fruitless. Maybe if I had someone who cared a titch more my brain wouldn't hate me so much. It's probably just another pay-to-win scheme; I'm poor so I'm doomed to shitty service. Idk. I just work here, man.
16I'm so sorry. I am chroniclly depressed myself. Lexapro helps a bit but I struggle to get myself to keep taking it. Long endurance exercise like running helps my mood but in my depressed state I cannot get myself to actually do it.
I wish they could just fix our fucking brains so we could be "normal"
3
What were you doing for exercise? The key is getting your heart rate up to like 90% for your age and weight and keeping it there for like fifteen minutes.
2
That's lovely but as the article tucks away at the end pretty unrealistic.
When people experience more severe forms of depression simply offering exercise may not be completely helpful, for example, when someone is struggling to get out of bed let alone get to the gym.
36Depression is a spectrum. When I was suffering I was still able to go to work and school, I was just in a sort of behavioral rut where that's all I did. Every experience I had felt like eating unseasoned food. There was no joy to it, it was just "if I don't do this I'll die and I guess I don't want that...". I tried Effexor and not only did it not help, it destabilized me pretty badly. Getting into the habit of exercising first thing in the morning every day has really turned that around.
11Effexor
Absolutely everyone I have talked to/seen who has taken effexor has horror stories about it. That drug should not be prescribed.
For me it caused multiple manic episodes. One where I had a seizure. One where I didn't sleep for a week and was hearing voices by the end(and some worse stuff I don't want to mention). Also weird sensory effects. It's been 4 years since I have taken it and I still don't feel like I have recovered from the trauma of that drug.
Exercise has been helping a lot lately tho. I cant say I do it every day but I do a moderately intense exercise session about 1-3 times a week. Intense enough my legs hurt the next day. Tho I do forget to do it some weeks.
I was in the "struggles to get out of bed" category of depression. For me what helped was just doing the absolute minimum amount of exercise I could muster, like jog in place for a min while I waited for my hot pocket to nuke. Just did that every once in a while when I remembered. Having a baseline of occasionally doing it let me build on that over many months to more intense exercises. I'm not going to say my depression is cured but it has very objectively improved. Getting out of bed is not nearly as hard now, and my ability to take care of myself and my environment has improved as well. Looking for work again too.
2
That's on them. They'd no different than them being to depressed to get up and take their medicine.
If exercise is the best treatment for depression, and someone refuses to exercise.... well, enjoy depression I guess.
-57I hope you never experience crippling depression where it takes all your mental energy just to get out of bed and shower, where, the thought of doing anything more is just too much.
Exercise is wonderful, and yes helps massively. But depression is a feedback loop. You know exercise (or going to therapy) will make you feel better, but depression stops you, so you start beating yourself up about how much of a worthless piece of shit stain person you are because yes, you're right it is, on you and you're making your depression worse you can't even fucking help yourself you lazy fucking cunt arse piece of shit fucker. And society thinks you're a lazy fat useless slob who is no good to anyone and what's the point of it anyway. What's the point of trying to help yourself when you'll just fuck it up anyway like you fuck up everything because you're a useless waste of oxygen.
22One of the problems with depression is that it's corrosive to your internal drive. "Just" getting up and exercising takes the same level of will as "just" getting up and running an ultra-marathon.
Depression isn't just feeling sad. Its depression of the synapses in the brain. This means it takes FAR more effort just to do simple things. One of the areas affected is the executive functioning. This is the part that enables the shift from thinking "I want to exercise" to actually doing it. Effectively it translates will power into action. When this area is depressed it's akin to a car with a damaged gearbox, no amount of revving the engine will just make it work.
11Mental illness is illness. If someone had a physical disability that made even going to physical therapy difficult, we'd expect more resources to be directed to help them get there to improve their lives. Or at the very least, we'd have enough empathy to say "damn, that sucks, and it isn't your fault alone."
I genuinely hope you never have to experience a mental health that gives you a real perspective on how that deep depression feels. But I also hope you show basic empathy to people struggling. It's a boomer mindset that's trickled down to us.
8
Since the study wasn’t actually linked (as far as I can tell on mobile), here’s a link to it.
https://www.bmj.com/content/384/bmj-2023-075847
From the conclusion: “Depression imposes a considerable global burden. Many exercise modalities appear to be effective treatments, particularly walking or jogging, strength training, and yoga, but confidence in many of the findings was low”
I always worry about studies like this because it always seems to me like it might be difficult to determine if exercise is the catalyst to better mental health or if someone’s bettering mental health through any number of other kinds of treatments or even changes in a persons social life was the catalyst for exercising more. When I’m feeling particularly depressed, I absolutely don’t feel like exercising, and when I start to feel hopeful for the future, I find myself wanting to exercise more. Same with “just go outside and walk through the woods”. I only feel like doing that on days my depression isn’t particularly bad.
29Thanks for the link.
I think the authors shared your concern as well.
Our review did not uncover clear causal mechanisms, but the trends in the data are useful for generating hypotheses. It is unlikely that any single causal mechanism explains all the findings in the review. Instead, we hypothesise that a combination of social interaction,61 mindfulness or experiential acceptance,62 increased self-efficacy,33 immersion in green spaces,63 neurobiological mechanisms,64 and acute positive affect65 combine to generate outcomes. Meta-analyses have found each of these factors to be associated with decreases in depressive symptoms, but no single treatment covers all mechanisms.
3
In my years of depression, I was also in peak fitness. Like, hours of cardio a day level of fitness. Maybe it helped (I sure couldn't tell, but I would probably have been worse without it), and I imagine it helps a lot of people. But a lot of these reductive headlines are going to encourage the "just go outside or something" crowd to be even more dismissive of people with depression. Or people will see "core treatment" and think "instant cure treatment".
14I am the same. I mean... Not anymore because I'm older and kind of lazy, but like.. Even when I was doing a ton, depression still existed.
BUT... different strokes for different folks, as they say. If it helps anyone at all, then good. Give it a go.
I actually just absolutely fucking hate exercising. I'd rather wash dishes for 2 hrs than run for 30 min.
2
how about just like
MAKE THE WORLD LESS DEPRESSING
maybe that might help
13Chicken and egg. Both things need to be done. The world is increasingly dangerous to human nature. We have built a system that is detrimental to our existence. That said, everyone needs to get off their asses and go outside and touch grass.
-2i live in the city, the grass has cigarette buds in it
7
I hate when people tell depressed people to "just go work out." When I was struggling with depression, I could hardly get out of bed and put on a fresh change of clothes, and somehow, they thought that I'm going to go outside and go for a walk! They really need to start with something more realistic like telling them to finally go and brush their teeth, because that is a lot more doable for them, and that still feels good too.
I do recognize that exercise does help. I'm in a lot better place now and I exercise daily, but if you're asking a depressed person to do that, you might as well be talking to a rock. Also sometimes people are just really depressed, and even if they do exercise, it hardly helps, since exercise probably isn't fixing the root issue.
11During my deepest depression I would go to the gym to lift weights because it was an invisible way to punish myself.
4I'm curious, did that make you feel better or worse? I used to punish myself by slicing up my forearm and it did make me feel happy even though it was a terrible way to go about doing that.
4
Jokes on them! I can't get myself to exercise because I am depressed.
10Right, I wonder if there's just a misunderstanding here and they're just asking people exercising if they're less depressed than when they weren't exercising and it's like, no shit they're feeling better if they weren't they wouldn't be out there exercising.
2This is a meta analysis of 218 clinical trials, they would have been more controlled than that.
7
With anti depressants to help keep it under control, adding exercise has helped me for sure. Ymmv of course.
9This has been known for quite sometime, it’s amazing to me that it’s not one of the first recommendations for treatment
6Have you ever tried exercising when depressed? I'm overweight and depressed. I know exercise could make me feel better.
But how the fuck can I do it? I can barely muster the motivation to shower more than once a fortnight.
It's not ignorance. I used to be a runner and know the Ashtanga yoga first series by heart. Also did judo.
But actually doing anything is way fucking beyond my reach.
So no. It's not a panacea.
It's just another "smile and you'll feel happy" comment.
26I think this study suffers from confirmation bias. The people who actually got themselves to do excercise were already intrinsically motivated enough to actually do it. That way you self-select for a positive result.
I didn't read the actual study btw, it's possible they already adjusted the results due to this.
10I’m aware that depression causes major lack of motivation, nothing in my comment insinuated the opposite. That doesn’t mean it shouldn’t be the first avenue for treatment, ahead of medication.
3Assuming exercise is a valid treatment.....
It's not just another smile and be happy. You CAN exercise. It's not impossible, but you're making a choice not to.
You want someone to snap their fingers and make you better, apparently. But that's never going to happen. You can accept/engage with the treatment, or you can continue to be depressed. That's just reality.
-6
Not one time have my doctor's recommended it for me. Just a new pill or nothing. Guess I'll buy some running shoes.
7I've been doing aports and exercising my whole life, but it does nothing for my depression.
1Like every single treatment for all ailments that have ever and will ever exist, some will not work for certain people.
-1
Cosigning this, getting into the habit of working out every day has changed everything about my life for the better. I'm happier, more productive at work, more present for my friends and family at home and, counterintuitively, have a lot more energy with which to attack the day.
6This is the "just decide to be happy" of treatments but with extra steps (like a jog).
1It won't be implemented, because personal trainers are more expensive than (most) antidepressants.
-9Most forms of exercise do not require a personal trainer.
18Rec centers are all over the place. They are cheap and they have decent equipment. They also have people who help. You don’t need a personal trainer to go for a walk or lift weights.
5You can get an exercise prescription in the UK. It's basically a pass to use the local (public) leisure centre. Your don't get a trainer but you do get to use the equipment.
3You don't need a personal trainer anymore than you need a mechanic to change your wheel/tire. A little research and/or just a decently competent fitness-minded individual to mentor you for a few sessions is all you need.
2