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- Hacker News
- > Start with brisk walking three times a week for 20-30 minutes at an intensity where you can still talk.
When people talk about exercise as a treatment for depression, i never imagined they meant such small amounts.
by bawolff - And yet even that little exercise produces significant differences in outcome compared to doing less.by mcherm
- You have to start somewhere. A full on daily HIIT routine for someone who's struggling to get out of bed is not going to help them much (setting aside risk of injury, they're going to be frustrated and that will set them back too).by Jtsummers
- >Exercise works for depression. So why isn't it treated like real medicine?
Clinical depression is a serious mental illness, it causes great suffering, broken relationships, and far too frequently, death by suicide.
A person suffering to such an extent frequently will seek treatment (if they don't, well we don't generally pursue people with medical conditions) from a trained, licensed professional for evaluation, and the extent to which the patient gets out of the house and interacts with people is part of the assessment. Exercise will be among the suggestions that will be encouraged.
However, you don't need a prescription to exercise, so it's not treated like medicine, but it is recommended. If you are prescribed medication or exercise, if you don't take it or do it, there generally isn't a compliance system that kicks in (unless the courts have become involved)
by fsckboy - One day, my psychiatrist had brought her new dachshund puppy to work, and she invited me to pick him up. He promptly licked all over my face and then fell asleep in my arms.
I joked to her that puppies beat SSRIs any day of the week, that she should write prescriptions to take to the animal shelter. And it's probably true! Unfortunately, I don't live the kind of life that's compatible with a pet.
Personally, I'm grateful that doctors mostly stay in their lane, although I would hope a good therapist might recommend physical activity to someone who needs it.
And as to what kind of exercise to recommend -- the advice I've heard is that the best kind of exercise to do is what you enjoy and will therefore stick to. Brisk walking three times a week for 20-30 minutes might work great for some people. But if someone finds that a tedious chore, they're probably not going to stick to it.
by impendia - Exercise really is a wonder drug. The best of the best!
If only doctors could prescribe it and have people adhere to the prescription.
If only American culture weren't so car-centric and our daily lives involved some natural amount of exercising. We've built a society where only the privileged few can walk or bike to work. It's just too easy these days to barely move in our normal life. Drive to work, drive to the store, drive the kids places... you literally have to specifically schedule exercise (and ironically, many people will drive to the gym to walk on a treadmill).
by scottious - There are simple things that add up:
Skip the elevator and take the stairs.
Park at the far end of the parking lot, not next to the door.
When I run errands, I park at a central location and walk to the various destinations.
When I meet a friend or associate, instead of meeting at a restaurant, I propose meeting at a nice area and have a walk & talk.
It adds up.
by WalterBright - Exercise helps my ADHD, but it requires quite a bit of sequential cognitive processing to actually get to the point of starting it. Adderall makes this initial part much easier. I expect something parallel is happening in those with depression.by geye1234
- For me exercising regularly is about as effective as the medication. Eating well and cutting out sugar and coffee helped a bit too.by wao0uuno
- You will find your answer in DJ Shadow's "Why Hip Hop Sucks In '96":by 01284a7e
- "It's the money."by js2
- What do you mean exercise isn't treated like real medicine? Doctors have been trying to advocate for people to be more active to help with basically every major health issue for decades. People complain about "ThEy JuSt WaNt To SeLl YoU pIlLs" as if it's not the people who want to solve their health issues by just taking the correct combination of magic pills.
You can be sold exercise too. Physical therapy exists. Personal trainers exist. Gym memberships, gym influencers, gym culture, and gym products all exist. It's not the inability to sell you a product that stops people from exercising.
by xboxnolifes - > What do you mean exercise isn't treated like real medicine?
It's in the article. How doctors actually recommend it (the complaint of many patients that they are only told, or only hear, "exercise more") versus how medical treatments usually provide plans and guidance. Telling people to exercise more (mostly) doesn't help (especially for people already dealing with reduced motivation from a disorder like depression). Clear, actionable guidance, possibly with a monitored program, that's something patients have more chance of following through on.
by Jtsummers - It should be encouraged but even accounting for side-effects, taking a pill is easy. From personal experience, when I'm heavily depressed, I can barely get out of bed or eat. Forget exercise.
- Personal experience: Exercise did not help with my severe depression. Out of sheer desperation, I started exercising and eating way better. My health improved significantly, dropping 75 pounds.. but the depression still remains. I was just as depressed after 6 months of daily walking (3-5mi/day) as I was before. Left the house depressed, returned home depressed.
All that to say, I think IMO exercise can help improve general daily mood, but it did not really do anything for my overall depression.
by Molitor5901 - The article addresses this.by Maxatar
- Aren't depressions coming with side-effects like inability to do anything at all? The block is somewhere else to overcome before even thinking about exercise and the brain might have a good reason to block it (e.g. some local energetic/metabolic failure and the brain forcing a "safe mode" to prevent further damage). It's like telling to people with endothelial damage that exercise would do them good when in fact it would cripple them further (e.g. from long covid).by storus
- Any non hack psych will tell you to go outside and take a walk. Meds are a minimal solutionby tekla
- > Aren't depressions coming with side-effects like inability to do anything at all?
Severe depression, absolutely. That's also discussed in the article.
by Jtsummers - I have depression, clinically treated with SSRIs. My exercise regimen now is 8-10 hours a week of swimming, cycling, and running. I find that the exercise helps lift my mood a lot, but also if I lose my ability to exercise it is far less catastropic to my mental health than if I stop taking the SSRIs.
My exercise volume varies throughout the year because of physical health concerns (sickness, injury, combination of the two), and I notice it and will become mopey, but it's far from the crippling anxiety and depression that sets in if I miss my SSRIs for a few days.
But this is just anecdata, treat accordingly.
- Just because a thing is true doesn't mean you can apply it. There are vast numbers of active ingredients discovered or developed that are effective in curing many deceases but there aren't "drugs"/pills with it because we haven't found a delivery mechanism for them to be effective where they should in the human body.
Going back to the subject: Have you ever been clinically depressed or dealt with people in that predicament? Getting up from the bed is already a huge win for that day, let alone exercising and doing it consistently and regularly. Even taking medication regularly can be a hit or miss.
So, yeah the prescription is easy to write and thank god it's real and effective, but that's only ~5% of the work.
by PedroBatista - The article says that 41% of mental health professionals never recommend exercise. Is it really the case that these 41% have only patients with the severest forms of depression who struggle to get out of bed at all? Or do they have many patients who get out of bed for work and such, and could force themselves to exercise, but don't know that it's worth the hurdle because they haven't been told about the mental health benefits?
- Hear, hear. I've fortunately not had to personally deal with depression, but have been around those who have, and "just go to the gym" is right up there with "have you just tried not being sad?" on the list of unactionable plans.
See also: "Why don't more people with ADHD get treatment?" "Because if they were able to initiate and follow through a complex plan of meeting with care providers, arguing with insurance, and having prescriptions filled, they probably wouldn't need it."
by kstrauser - Exercise is great on the days I can do it, I love going for a walk. But sometimes when I hear that suggestion - I wonder if those people have ever lain in a totally uncomfortable position in bed for 45 minutes because they felt paralyzed, unable to will their muscles to reposition themselves into something more comfortable. From that perspective, even light exercise seems like walking on the moon; merely a thought, not real.by arcfour