Exercise can be nearly as effective as therapy for depression

https://www.sciencedaily.com/releases/2026/01/260107225516.htm

by mustaphah • 6 months ago

402 392 6 months ago

cheald5• 6 months ago

This is a finding that keeps coming up, and I've certainly found it true in my life, but there's a significant chicken-and-egg problem in that depression frequently precludes the motivation to exercise, and if you don't already have a deeply-disciplined routine to overcome the lack of motivation, people won't do it.

Exhortation to develop those good habits in the good times, I suppose.

zaptheimpaler• 6 months ago

It doesn't have to take deep discipline. I started my routine by just going for short walk after dinner everyday and it built up from there. It's intimidating to have to start at gym for 60 minutes 3x/week. Just do whatever little you like - a few pushups, a walk, a dance and stop when its not enjoyable. It tends to naturally build up.

WackyFighter4• 6 months ago

Much like the sibling comment I started walking around the local park before spending more time hiking. I live semi rurally though and wouldn't want to walk in an urban environment.

I normally feel much better after walking and cycling. Also I think doing something repetitive like walking allows you to think, tune out of other things.

wk_end2• 6 months ago

Everyone is different, so I say this not to tell you how to feel but just to offer a different perspective:

Walking in urban environments can be its own sort of joy. Cities (well, good ones anyway) are full of life and energy and humanity, have unexpected nooks and crannies, and a rich sense of dynamism and excitement. Even late at night (as long as you're safe), a quiet city can be a source of serenity and melancholic beauty. Writers like Baudelaire and Benjamin described at great lengths the pleasures of flânerie.

Nature is wonderful too, of course! I love a good hike through the forests and mountains...but I also love a good stroll downtown.

HauntingPin3• 6 months ago

I also question the universality of it. No amount of exercise changed my depression or made life any less miserable. Anti-depressants finally helped me get past the trauma I was unable to properly process otherwise.

2muchcoffeeman2• 6 months ago

And you think the effects of drugs is universal?

Exercise is a side effect free treatment that works for some people so it’s worth a shot because it sometimes works.

abraxas• 6 months ago

And I'm the counter anecdotal case of your anecdotal case.

I have a page long list of failed psychiatric regimens that included drugs alone and drugs combined with talk therapy. None of them effective.

I won't say that I'm cured of depression now or will ever be. But a strict and persistent exercise routine lessened it to the point where I can function day to day. This was never achieved with presrciption drugs or therapy (of which I have developed a dim opinion).

Jtsummers4• 6 months ago

I also question the universality of it.

The article doesn't claim exercise is a universally effective treatment, so whose statements are you questioning?

antonymoose• 6 months ago

I don’t think depression is a universal root-cause diagnosis so I’m inclined to agree.

I’ve been diagnosed clinically several times in life with depression and the pills never did anything for me. Sometimes exercise worked, sometimes it was of little or no use.

With retrospect, all of my episodes of depression were a function of environment. As a child, growing up in a broken home situation and bad school environment, of course there is going to be depression. Life sucks. Further, no pill or weight lifting schedule is going to fix that either. Only breaking out of that situation will.

As an adult, I’ve absolutely had and broken out of a long episode of depression with exercise. Bad breakup, startup failure, then introduce chronic drinking and subsequent weight gain. Guess what, cutting back on drinking, bicycling to work 30 minutes each way, doing martial arts in the evenings, it was a great fix. It enhanced self image, added a new community of positive people, and broke a cycle of depression.

marcosdumay• 6 months ago

There's no universality on anything linked to mental health.

cheald5• 6 months ago

Depression isn't monocausal so it'd be far too simple for it to have a single solution.

But in general, humans just work better when we're regularly putting our bodies under reasonable physical load.

heavyset_go3• 6 months ago

I'm a non-competitive athlete, and yes exercise can help depression, but no, it will not be sufficient for anything but your mild to average case of it.

Exercise is a crucial part of dealing with it, but it is not a panacea.

resumenext4• 6 months ago

I hesitate to ask but what is your gender? I think there may be very gender specific effects in this comparison. I would also be very curious the type and intensity of exercise and whether you had comorbidities that impact ability to train (obesity, low testosterone, etc).

skywhopper5• 6 months ago

Yeah, any of these studies that show “X works better than Y” are inevitably operating on averages. Not everyone will respond the same way. Not to mention that the very existence of the structure and human interaction required for these studies makes a huge difference in their outcomes.

4fterd4rk• 6 months ago

Well... sure. I've had trouble with anxiety and it's actually an incredibly anxiety provoking thing for me to go to therapy. But I read enough information telling me that therapy is good for anxiety so I finally went. I think there's people out there who need to know that exercise is helpful for depression, even if the depression makes it difficult.

boplicity2• 6 months ago

We have a certain amount of "willpower" that can overcome motivational barriers. This willpower is limited, though. It's very helpful to have clear guidance on where to allocate this very limited resources, especially in situations where people are otherwise struggling.

All of which is to say -- these exhortations can play a useful role. :)

LorenPechtel3• 6 months ago

Yup, which is why diets fail. People who are fat generally do not have enough available willpower to lose weight.

ToucanLoucan• 6 months ago

It's also worth noting that willpower in general is constantly being whittled down by how stressful and, for lack of better term, fucking annoying modern life is. I'm reminded of a quote from my favorite article from Ed Zitron:

In plain terms, everybody is being fucked with constantly in tiny little ways by most apps and services, and I believe that billions of people being fucked with at once in all of these ways has profound psychological and social consequences that we’re not meaningfully discussing.

And I think one of those psycho-social consequences we're not discussing is everyone is just... fucking annoyed now, constantly, about shit that it doesn't feel right to really complain about. Like, you plus or minus live on your phone, and I'm very much including myself in that statement. Every time you get logged out of an app you use every day to, for example, board your morning train, or park your car, or have to reset a password to pay your power bill, just like, all of that? Every time your day is interrupted with stupid bullshit from Modern Life takes a tiny bit of that energy, and I dunno about everyone reading this, I have a quite well managed and streamlined life, and I still have just... dozens of these. Every single day. I can't fathom being one of the folks who ISN'T as well versed in tech as I am, existing for them must be utter HELL.

And that's the essentials, that's not even going into how most tech products now are constantly begging for your attention, for your engagement, trying to pluck the strings of your psyche into making you angry, or horny, or whatever. Engage with platforms, buy these products, watch 9 TV shows so you're not out of the loop, you've been added to an SMS spam group, and everyone is replying to it saying they're not interested, on and on and on.

Sorry this turned into more of a rant than I really envisioned but yeah. I can easily comprehend a day where I try and go to my gym, and the fucking app doesn't work right and I can't get in, and I just quit because I've already solved 20 fucking captchas today and I simply lack the energy to do another, to help train some goddamned AI, for a company I don't know, you know?

hn_acc12• 6 months ago

AIUI, the whole "certain amount of willpower" was a misunderstanding / exaggeration / bullshit claim that's not really held to be true anymore.

refulgentis2• 6 months ago

This is 100% true, and what I'm about to describe isn't an attempt to falsify it: took me 11 years and 3 cities to figure it out.

You don't have to exercise so much as get moving.

I'm the best I've been in 37 years, and it's because in August I started forcing myself to just keep walking whenever I went out to have a cigarette. I was in Boston, and would end up ~nowhere and exhausted.

Then started doing random stuff: "might as well walk to Harvard Square instead of the bike path again" "might as well go to a bookstore instead of somewhere random" "I should use the skate park, I don't fit in*, but I miss rollerblading from middle school"

Then my dog died, 2 days later I severely sprained my ankle at the skate park and couldn't walk anywhere substantive for a couple weeks. By the time I'm able to do a sustained 10m+ walk it's winter.

Went to visit California as a not-tech-employee for the first time, so I saw San Luis Obispo and Los Angeles for the first time. And the same habit kicked in, in SLO I ended up hiking for the first time on what I find out later was not a real trail, end up hiking every day that week.

Get to LA and it's nothing like I would have thought. Egalitarian, tons of stuff to do, and Waymo is a godsend. Whenever I get antsy there's somewhere to go and a way to get there.

2 weeks later, I got an apartment in LA, moving away from Northeast for the first time in my life. I could see me just spending another 4 months decaying in Boston until its barely warm enough out to take a 30m walk, and I'm tired of that cycle..

All that to say, I'm fit, I had a great career in high school sports, I played basketball occasionally, but couldn't really get active consistently. Treadmill was never stimulating enough to keep my attention on anything other than being bored. In retrospect, I really wish I heard this old saw ~all of us know and heard it as "moving around" instead of exercise.

(n.b. this was all under active mental health care x medications spanning a decade+. It's not that the mental health care was useless, I don't think I could have done what I did without it. But it couldn't "fix" me on it's lonesome, only enable me to get moving.)

* in retrospect this was wrong, plenty of newbies, and one of the most welcoming social environments I've been in. just people out there all trying to do the same thing and supporting each other.

cheald5• 6 months ago

That's a great way to think about it. "Get moving" is a lot less intimidating and feels more achievable than "exercise" which conjures images of marathons and four-plate squats.

LorenPechtel3• 6 months ago

Getting moving *is* exercise.

No way could I do a gym and these days most things in a gym would be just begging for joint pain. But the wilderness is a great gym (assuming you know what you're doing safety-wise, I see too many idiots out there.)

burningChrome2• 6 months ago

get moving is the key.

Some of my best friends are personal trainers and they say the same thing. When you tell people just moving essentially gives you what they refer to as "free exercise". The kind that doesn't make people feel like they have to get up off the couch, change their clothes, go to the gym, get on the treadmill, lift their weights, etc.

Just walking around the block. Just walking up a few flights of stairs. Just doing something that doesn't feel like you have to have a huge investment is sometimes the best way to start - then transition into more structured stuff like wight lifting or running or anything else. And you still get the benefits for almost nothing. Walk a few flights of stairs and your legs start to burn, your lungs open up, you increase your blood flow, and you release endorphins. And it didn't cost anything if you can just include it in your day-to-day activities.

Not sure how many times I make extra trips to my basement just to get in a few more stairs. lol

Insanity• 6 months ago

Nail on the head. I know that exercise will make me feel better, but during a period of depression/grief I could not even get out the house.

AnthonBerg• 6 months ago

To my surprise, it has been my experience that this turns out to be pulmonary. It was always the chicken-and-egg of... breathing.

Seems like this has been my story:

Severe prolonged stress floored me. Turns out that the autonomous control of bronchoconstriction and dilation had gone out of wack, into dysregulation. My lungs were basically clamped shut. (Muscular tension and sundry dysregulation from severe prolonged stress makes sense, right? Applies to the lungs too!)

Exercise worked when I could get myself to do it... because exercise forces lungs to open.

And the nervous system and brain, well it requires lots of oxygen. In order to learn. And unlearn.

—

edit: Also interesting: Ketamine therapy worked. And... ketamine is a bronchodilator!

cultofmetatron• 6 months ago

its amazing that we haven't found anyone dualwielding the skill of therapist and personal trainer. we already have things like sex surrogacy (https://www.webmd.com/sex/what-is-sexual-surrogacy) so its not like it would be that weird by comparison.

KellyCriterion2• 6 months ago

You can also have a "deeply-disciplined routine" and get thrown out of it and hit depression because exactly by that one impact.

Source: Myself.

gloxkiqcza• 6 months ago

I’m not sure if you need to hear this but in case you do: There’s only one way to get back to it and the sooner you do it, the easier it is. First week is hardest, then the positive feedback loop starts kicking in. Do not to think about it, just get it done.

heavyset_go3• 6 months ago

Exhortation to develop those good habits in the good times, I suppose.

This is what medication for more severe cases of things like depression is supposed to offer: an opportunity to learn, usually through therapy, to cope with the condition in a healthy way.

hu32• 6 months ago

Yup!

Same thing for ADHD.

Medication helps having willpower/focus to develop better habits and realize you are not a useless dumb human. It's just that your brain is a little finicky to get going sometimes.

In fact the few diagnosed ADHD people I know are wicked smart. It's just that their brain overclocks to unproductive levels without medication.

yomismoaqui• 6 months ago

Motivation is fleeting but routine persists.

When there is something that you want to do regularly (exercise, doing the final boring part of some sideproject, cleaning the house...) you remove willpower from the equation and set a day and a time.

For example, everyday from 18 to 19 I work on my sideprojects, or saturdays from 16 to 18 is house cleaning time. There is no question if I want to do it, it is set at that time and I have to do it, period.

The nice thing about routine is that the first times it is hard, but after some repetitions your mind (and body) begin to get used and it transforms into a routine and then it's like it's written in stone. That time period of that day X is for Y and it is what it is.

Routine can be used for bad things but also for good things.

jjtheblunt4• 6 months ago

I bet simply having a dog needing walking tips the scales into an exercise routine at some level.

smeej16• 6 months ago

There is no question if I want to do it, it is set at that time and I have to do it, period.

Gosh it must be nice to have at least an ordinary amount of executive function skills. Is it really this easy for neurotypical people to build routines? That's really all it takes?

I don't see how this removes willpower at all. It just determines what time you have to use it.

RickJWagner• 6 months ago

I subscribe to Arnold Schwarzenegger’s newsletter, which has a surprising amount of great, well researched content.

Right after New Year’s Day, he said pretty much what you said. Discipline beats Herculean effort that’s sporadic.

shevy-java2• 6 months ago

saturdays from 16 to 18 is house cleaning time.
Routine can be used for bad things but also for good things.

So your willpower causes such routines to work. Not everyone works that way. And not everyone not working that way has depression. I don't think one can generalise this to "routines will fix your depression".

but after some repetitions your mind (and body) begin to get used

I also don't buy into that. A good counter-example is tobacco smokers. Some manage to quit the moment they decide they want to quit, with no substitutes. Others try with substitute and interestingly for many who try, that also works, but for some it does not. And some can barely ever quit smoking. And a lot of this has to do with how their brain works.

Matthew Perry spoke about that with regard to his alcohol addiction. People are different. I personally never started with smoking, for instance, because I never trusted myself to be able to (want to) quit again - so at the least I was consistent in this regard (plus also, because in our youth, so many others started to smoke suddenly, and I always felt it was a very stupid reason to smoke merely because others would do so, even at an early age. Their rationales would not be mine and I failed to see the point in adopting their positions and make them my position).

trueismywork• 6 months ago

The same routine for good things can turn into being a bad thing. Brcause it can make you inflexible. So there's a trade off there.

For me, it was when I was in a situation where I had to work 80 hours a week to keep my job. I had to get rid of my routine for 8 months and I am happy I did it otherwise I would he poor today.

skywhopper5• 6 months ago

Glad that works for you, but please know if you are giving advice to individuals, that not everyone can work this way. In fact, for some people, this sort of artificial structure actually makes it harder to get the stuff done, and just makes things worse.

WalterBright5• 6 months ago

Motivation is fleeting but routine persists.

Ahnold Schwarzenegger said that the gains in an exercise program happen when you really don't want to do it, but do it anyway.

ericmcer• 6 months ago

It is really easy to have a routine when you are single and healthy in your 20s. It stops working so well later on. If you have friends, partner, kids, parents, pets, work, health issues etc. the routine is going to be challenged. If that only happens once every few months no big deal, but now that I am in my late 30s with a partner, kid, 3 pets and elderly parents. I literally have something derail my day almost every single day. Carefully planning my week would be a recipe for misery.

I think really successful people are ones that just don't give a shit, like full on narcissism. Like my dream is X, I need to do Y today. The dog is sick? My kid needs a ride? My parents need help? Not my problem I am doing Y full stop.

parpfish2• 6 months ago

An easier routine for me to manage house cleaning is to set up a calendar with one little chore each day.

List out what needs to be done every week, every month, every season, and set them up to repeat.

Every day you do your little two minute task (clean the bathroom mirrors; vacuum a single room), so you get a little win. And they’re each so small that it never feels like you need to switch into a long “cleaning binge” that you need to dread.

darrenf3• 6 months ago

I found this to be true, and that it perfectly dovetailed with TFA.

When I was at my absolute depth (so far…) back in 2013, I would see my counsellor at 1130 on a Saturday. I’d be able to recount the darkness of the previous 7 days in stark vivid detail, yet cheerfully and not feeling at all depressed in the moment. The counsellor asked what I did on Saturday morning except the session and my answer was, well I do Parkrun[0] of course. I always do Parkrun. It’s in my calendar, it’s not really negotiable. It might have been the only time I managed to get out of bed all week, but, I mean, how can I possibly skip Parkrun?

I never actually linked the exercise to the boost in my mental health until I had it pointed out to me at that moment. I go for a run and I feel better because of the run. I would spend the whole 5km stewing and ruminating and maybe in tears but half hour after getting home I could function! it’s stuck with me ever since, and I’ve never (yet) been so down again.

Tomorrow will be my 429th Parkrun :)

[0] https://www.parkrun.com/

Terr_• 6 months ago

Motivation is fleeting but routine persists.

That makes me think of a philosophical comic on quitting smoking. [0] Rather than cerebral willpower, a lot of value comes from indirectly shaping what your animal-brain does or doesn't encounter/expect every day.

[0] https://existentialcomics.com/comic/13

bicepjai• 6 months ago

This is a great quote

> Motivation is fleeting but routine persists.

taeric5• 6 months ago

As someone that is unable to keep any sort of routine, I have objections here. :D Without some sort of obligating circumstance, it is incredibly easy to forego what would have otherwise been today's routine.

mnky9800n2• 6 months ago

thats right. a year ago i decided, fuck this going to the gym randomly and not having a plan and only kind of committing. im going to do it. so i got a trainer, committed to 4 days a week, and so far ive kept that up for a year. and now, if i find myself running out of time in the day i make time for the gym. it is such a part of my routine that i simply do it without much questioning. because i know if i dont go i will no longer be able to do the things in the gym the way i do them today. i enjoy that feeling and wish to continue. i think the point of life, at least partially, is to figure out things that you enjoy that don't take from you and do them consistently.

femto2• 6 months ago

The key I found was to avoid self flagellation.

Try your hardest to do each session, but if you miss a session don't try to make it up. Just get on and do a normal session the next time it falls due. You're in it for the long term, so long term it doesn't matter if you were intermittent when building the habit, or the occasional session gets missed for a reason.

mancerayder• 6 months ago

Motivation is fleeting but routine persists. When there is something that you want to do regularly (exercise, doing the final boring part of some sideproject, cleaning the house...) you remove willpower from the equation and set a day and a time.

Absolutely!! Don't wait to Feel Like It, or Be Motivated... and especially do not depend on another person/trainer/weather to motivate you!

Fitness is a to-do, like laundry or grocery shopping or going to work. Now where the nuance comes in is finding what you enjoy. But a nuance of this nuance is, you don't know what you like until you have done it for a while, at least one month. Don't do boot camps or hacky gimmicky things people try to trick themselves into doing.

For a while I was deep into photography and writing. In both, I read and listened to people who were experts - successful writers and photographers. I learned this - they don't wait for inspiration. They commit X time per day to doing their craft, as habit.

I write this after coming from the gym, on a chilly night, after a relatively annoying day, and I feel 80 percent better.

Now the joint soreness and constant tightness are a problem, cuz I'm getting older. But it must be done.

jimnotgym11• 6 months ago

I'm not even back from work at 18-19 every day, or even most days. It varies by hours. By the time I have had dinner I'm thinking about settling down to settle my mind so that I might sleep that night. I'm also mentally exhausted after a day in my job. How do I create a habit without a time gap?

46493168• 6 months ago

Motivation is fleeting but routine persists.

This is tautological: if the action doesnt persist, it isn’t routine.

fastasucan17• 6 months ago

Motivation is fleeting but routine persists

Dude, not when we are talking about mental health problems. A semi serious mental health problem can take you out of the routine of showering, eating and brushing yoir teeth.

There is no question if I want to do it, it is set at that time and I have to do it, period.

Again we talk about mental health here. Getting out of bed before dinner can be an impossible task. There is no "I have to do it, period". That period can cease to exist, and all you are left with is "i have to do it" over and over again without the ability to actually do it.

mustaphah• 6 months ago

Once exercise becomes a habit, it's very easy to do even on days when your mood is terrible. A strict routine (initially) is the trick to making things easier forever.

You definitely want to build that habit when you're at your best.

hannob• 6 months ago

True, but the same is true for therapy. Finding a good therapist isn't easy, and having depression certainly doesn't make it easier.

baincs• 6 months ago

That may be true if you're severely depressed, but I think it can save you if you're starting to get depressed. That's what happened to me at one point, and an online comment saved me.

I was like 60% depressed but on my way there. I just took my first computer science class in college but I was overly ambitious when I participated in an undergrad CS research. The stress and imposter syndrome was shoving me to the downward spiral.

I posted some gloomy thoughts on an online forum. It was long ago, but I remember the post contained how I could kind of relate to the villain while watching the movie The Dark Knight Rises.

Some online person advised me "lift weights". I had never tried seriously lifting weights, but I was living in a student apartment 10 minutes away from the student gym, so I decided to give it a try. I can't forget the sensation when I did a set of bench press. After a period of amassing so much stress, each rep felt like I was reaching my hand into my brain, directly scooping out the waste and tossing it away.

I became much more active after that, and successfully finished the research and the degree.

It's like how homelessness is more reversible for people who became homeless less than a year ago, and why organizations focus on those groups.

eudamoniac• 6 months ago

If psychiatrists could mind control their depressive patients into doing 2-3 weeks of heavy compound lifts, I'm certain more than half would be cured.

iamacyborg• 6 months ago

Motivation generally follows action, not the other way around.

javanissen2• 6 months ago

I think the real exhortation is to develop a multi-pronged strategy for managing depression. I didn't feel like my depressed life got durably better until I had both exercise and therapy, and there are still times where things aren't going well with no clear discernible reason. I suspect that adding a low dose of medication on top would help.

Every additional coping mechanism you add, that works well for you, provides defense in depth.

broof• 6 months ago

Also the bad times can be a great time to build good habits. I’ve tried and failed to develop an exercise routine many times, but it wasn’t until I was laid off for 6 months that it finally stuck. I had a friend who went to the gym every day in the middle of the day so I didn’t really have a reason not to go. 6 months was long enough for the habit to stick and fast forward years later and I still have the habit. It’s been so good that I regularly think about how good it was that I had the opportunity to be laid off.

econ• 6 months ago

I hear ice swimming also works.

lightbulbish• 6 months ago

That is true. And motivation is not a fixed variable. It is possible to get increased motivation by a better plan, resulting in increased self efficacy.

From studies like this, maybe more awareness and perhaps funding to solutions providing smaller steps

Shameless plug, I am building one: Low friction mini games, social, squats/situps/pushups. Feelgoodcrew.com

mnky9800n2• 6 months ago

i think what is missing from this narrative is not whether or not people have a routine, it is that exercise elevates your mood away from the depressed state, therapy encourages you to question your thoughts and decisions through out your day that might lead you away from a depressed state. to put it a different way, whats the point of exercising every day if you continue the thoughts and habits that are less than satisfactory to you without any self awareness?

darkhorse222• 6 months ago

My two cents on this topic is to create short term, superficial incentives to help create the practices that yield the long term incentives. For me this is paying extra for a gym with a hot tub, sauna, and cold plunge. Now I derive relaxation from the workout, but before that I also received a lot of support from the knowledge that the amenities afterwards were waiting for me.

I'm not a big believer in discipline.

is_true• 6 months ago

If you are or you know some that is depressed one of the best things you can do is start exercising with someone.

pinkmuffinere• 6 months ago

I really like this advice. When I'm sad I don't want to leave the house, and certainly won't have the motivation to do much exercise on my own. But having friends peer-pressure me into making good choices would (and has) helped a lot.

singpolyma32• 6 months ago

One thing that worked well for me is I switched my transportation to almost exclusively bicycle. Do I always want to exercise? Do I always want to get on my bike when it's below zero in active weather? No, not always. But if I want to get where I'm going that's my option and I get the exercise in the process (and save a buttload of money too)

baby• 6 months ago

I think we also approach exercise the wrong way. And IMO this is true with sleep too (which also impacts depression). We're using the wrong metrics.

The most important thing to get started with working out is just to start doing some exercise. You can start on one push up a day or something. It's all about creating momentum and habit.

Once you do it, then you can increase the time and the intensity and optimize exercise and all. But doing sport should be about doing one push up a day and thats it. About starting as slow as you can.

Sleep is the same in that we try to sleep as much as we can, and get as much REM and deep sleep, and these are not the right metrics for most people. The most important is just to go to bed and wake up at the same time everyday. That's it.

People are obsessed with trying to go to sleep at some point in time. Don't. Go to sleep when you're tired, wake up sleep deprived at the right time, the next evening it'll be easier to sleep at the right time

jimnotgym11• 6 months ago

I always wondered if this kind of research was just finding that depressed people motivated to exercise are already in a recovery mindset

vlod• 6 months ago

“Action precedes motivation.” ― Robert McKain

This seems to work for me at least. If I start trying to reason with myself why I should get out of bed at 5am to go to the gym rather than excuse XYZ, I will talk myself out of it.

If I simply start "moving" and start doing "stuff" without engaging my brain, things happen and within a short space of time, I'm pumping iron and feeling great.

_DeadFred_• 6 months ago

Fun fact, people suffering from loss of quality of life issues don't lack motivation. Lots of these people are in great pain, constantly, every day. My mother had a hip issue where the pain could instantly shoot up so bad she couldn't move (from just the normal, constant, almost in tears pain). She couldn't risk going somewhere to exercise, she would be stuck. She couldn't risk exercising on days where she needed to work the next day. Some days she would break down crying going to the grocery store because she had gotten stuck there the previous time she went.

A LOT of quiet unassuming people are INSPIRINGLY motivated to push through INCREDIBLE pain and obstacles, every day. Many that prevent them from 'just exercising until life gets better'. It is bullshit to say they lack motivation/character/willpower.

unsupp0rted• 6 months ago

I take this to mean therapy for depression (particularly for men) is barely effective at all and exercise is not quite as barely effective at all.

If therapy for depression were a pill, I'm not sure it'd demonstrate enough efficacy to get approved.

EA-3167• 6 months ago

The problem is that the same is true for many medications and other treatments, but if you're in the "lucky" minority (a pretty large one) for whom there's some relief... it's worth the try. It's not like choosing bleeding and emetics instead of chemotherapy for cancer, it's just the best we have right now to treat a complex system that we barely have the earliest understanding of.

pfisherman• 6 months ago

Adding to this, the molecular mechanisms of psychiatric disorders such as depression, bipolar disorder, and schizophrenia are not well understood. People prefer their brains and skulls intact so taking brain samples for study is not possible.

Diagnosis and grading is fuzzy - a cluster behavioral symptoms observed and reported by patients, family members, and clinicians.

Based on some of the genetic evidence, which can also be fraught, it is likely that something like depression is in fact a grouping of a bunch of separate underlying disorders / causes that all result in the same (easily) observable symptoms. Hence why some treatments work on a subset of patients, but are ineffective in others.

derbOac• 6 months ago

Psychotherapy is similar to pharmacotherapy in effect size but longer lasting after discontinuation. Given that the latter has been approved, it's safe to assume psychotherapy would be approved if it were a pill.

throw1282• 6 months ago

Anecdotal obviously, but from my experiences and those in my friend-group, therapy seems actively harmful in many circumstances. Therapy can be an enabler of bad behavior, helping to build a new fancy framework of excuses just as easily as it can help you land somewhere better. How long has it been since you've seen something bad (maybe it was just slightly selfish, maybe it was something worse and chronic) waved away as "self-care"? Or if you've lost faith in people or communication generally, then you're not going to feel better by going through many rounds of therapist mismatch and at some point you've aggravated problems rather than fixing them. Fortunately for the industry, measuring the harm is just as difficult as measuring the benefits. The advice to "just exercise more" may not help, but at least it really can't hurt.

chrneu• 6 months ago

Therapy can be an enabler of bad behavior

Be aware that a lot of therapists are aware of this and actively try not to do this.

Unfortunately, services like BetterHealth allow clients to select their therapists in ways which results in people doctor shopping to get what they want. Doctors want to get paid so they'll say/do whatever to keep clients.

It's like the antibiotic issue with internal medicine. People will see a bunch of doctors until they get what they want.

ebiester• 6 months ago

I think the major problem we have is we are lumping depression and anxiety into the same category.

Some people probably do have issues quickly resolved by SSRIs. Others are magically fixed by bupropion while it spikes anxiety in others. Others have major trauma that they have to work through and many therapies (like internal family systems therapy, as one example) are great at handling that. Others are stuck in cognitive distortions and merely learning about them and handling them (through cognitive behavioral therapy) can be life changing.

But if you have major trauma in your past, exercise is probably not going to do much. If you are heavily overwhelmed and your body is stuck in perpetual flight or fight) exercise and meditation might be a giant help.

But right now the practitioners are aware of this, but it's really hard to double blind test these divisions until people can do the analysis first. And at that point, you've basically already started therapy.

aswegs8• 6 months ago

I don’t think that conclusion follows. These results don’t mean “barely effective.” They mean that, on average, people who get therapy or exercise end up noticeably better off than people who don’t. When researchers translate the results into intuitive terms, therapy typically moves the average person from the middle of the pack to around the top 30 percent, and exercise to roughly the top 35 percent. That’s the same general magnitude of benefit seen with many approved medications, including antidepressants themselves. Depression trials have large placebo effects, which makes the numbers look smaller, but that doesn’t mean the treatments are doing almost nothing.

emsign• 6 months ago

It's almost as if humans were optimized to constantly move around all day by evolution. Huh. Who would have thought.

srameshc• 6 months ago

I will speak from my experience. I have diabetes and I try to manage it well, with workout. But sometimes when the sugars are high for a while, I can feel it, the sadness, the hopelessness. It took me a while to understand that is high sugar levels and a mild form of depression. Now I will do some workout when I feel that and after a little workout, I can see how my mind also start to feel better. This is not a solution for everyone who is experiencing depression probably but might help some who are experiencing because of high sugar levels.

hu32• 6 months ago

hey friend, I'm glad to hear you found a way to improve things. It's not easy.

I also notice my mind better after workouts.

gehsty6• 6 months ago

If it helps anyone I take antidepressants and have had a positive experience with them. Depression can be caused by a chemical imbalance and no amount of exercise or talking about it will fix it.

One of the most frustrating things when your really low is people giving advice like do exercise to feel better - please don’t do this.

ge962• 6 months ago

that $5K deductible though...

gehsty6• 6 months ago

Apologies - one of the very few great things left in UK is the NHS and my diagnosis was free and my prescription is £9/month.

I take sertraline (Zoloft in the US I think) and that is cheap - $20/30 month.

scosman• 6 months ago

Exercising can help. It's not bad advice or inappropriate to suggest it. People shouldn't suggest it as if it's a cure all and certainly shouldn't suggest you just need to buck up, but the study is showing it can really help.

Context: I'm "using" SSRIs, talk therapy, psychotherapy, strength training and endurance training -- all in parallel right now.

gehsty6• 6 months ago

It can be inappropriate depending on where the person is, when I was diagnosed I could barely get out of bed. Feels a bit like telling an anorexic person to eat something.

altruios• 6 months ago

Depression can be caused by a chemical imbalance and no amount of exercise or talking about it will fix it.

This is a debatable. As far as I understand things: 'chemical imbalance' has no tests to confirm that's actually true, That's just a story they tell to relax people.

Which is orthogonal to the point that antidepressants can work for some people.

We don't know how depression works. It very well may be many little things dressed in a trench coat.

https://www.sciencedirect.com/science/article/pii/S266656032...

https://www.nature.com/articles/s41380-022-01661-0

https://www.neurocaregroup.com/news-insights/the-death-of-ch...

javier1234543212• 6 months ago

Jim Carey had the best way to think about this: “I believe depression is legitimate. But I also believe that if you don’t exercise, eat nutritious food, get sunlight, get enough sleep, consume positive material, surround yourself with support, then you aren’t giving yourself a fighting chance.”

gehsty6• 6 months ago

I wonder what his thoughts are on post natal depression? Of course those things help but there can be factors outside of people’s control that can lead them down this path…

BeetleB• 6 months ago

If you say that to a depressed person, they are going to sink deeper into despair. Most people (even those who are not depressed), are not meeting that bar.

Always remember, being true is not the same as being helpful.

evanjrowley2• 6 months ago

Another quote from Jim Carey:

  People talk about depression all the time.

  The difference between depression and sadness is sadness is just, you know, from happen stance. Whatever happened or didn't happen for you...

  ... and depression is your body saying fuck you, I don't want to be this character anymore, I don't want to hold up this avatar that you've created in the world. It's too much for me.

  So, a friend of mine who's a spiritual teacher has a really good take. His name is Jeff Foster, and his take on it is that they should change [how we think of] the word "depressed" as "deep rest"

  deep rest - your body needs to be depressed, It needs deep rest from the character that you've been trying to play.

Link: https://youtube.com/shorts/lMQJ2bHeP4c?si=UPRHV8DVWZ77nXCM

achierius• 6 months ago

Depression can be caused by a chemical imbalance

And yet many other times, it can be caused or exacerbated by situational and psychological factors, including "being stuck at home all day".

One of the most frustrating things when your really low is people giving advice like do exercise to feel better - please don’t do this.

Worse, antidepressants actually cause significant harm to many people who take them, often without even improving their depressive symptoms. This is very bad, and I would say significantly worse than giving general advice that might be inapplicable to some people.

There's no one-size-fits-all solution, and some people probably are legitimately just in need of more motivation to go running or biking or whatever else will get them the exercise they need.

D-Machine7• 6 months ago

"Chemical imbalance" theories of depression (e.g. "serotonin hypothesis") have been scientifically discredited for well over a decade now.

EDIT: For a recent overview, see https://www.nature.com/articles/s41380-022-01661-0

joe_the_user• 6 months ago

I support people taking antidepressants if it helps them.

But I have to say the "chemical imbalance" theory either means no more than "depression responds to an antidepressant (sometimes)" or it is false/meaningless. Neither neurologists nor psychologists have a sufficiently detailed understanding of the workings of the brain to make such a claim.

Again, I'm glad drugs work for you. I would note that there three ways drugs can go for people; working with few problems, not working, working but with significant physical and/or psychological side-effects. Especially, taking any substance daily for the rest of one's life can stress the organs responsible for digesting/processing regardless of whether than substance is otherwise a great fix.

So I think we need to look beyond a glib "this fixes it for everyone" rhetoric even if this fixes it for you (and yeah, some of my friends should at least drugs, I'll admit).

lifetimerubyist• 6 months ago

The hypothesis of chemical imbalance causing depression is mostly discredited.

https://www.ucl.ac.uk/news/2022/jul/analysis-depression-prob...

diob• 6 months ago

Yes, exactly. I have exercised daily (either weight training or cardio) for nearly 20 years. I've also had anxiety and depression for that entire stretch of time.

Exercise was how I stayed mildly sane for a good majority of those years, but when I started taking medication it was like the entire world changed. I wish I had started earlier in life. It helped me to become a lot more introspective as well, being able to better examine why I was feeling the way I did.

There are some things that no amount of exercise or "healthy living" can fix, that's unfortunately just the human condition. It's nothing to be ashamed of.

tsoukase3• 6 months ago

Usual antidepressants (reuptake inhibitors) have specific chemical and clinical effects. Some forms of depression, mostly with stress, respond heavily, others, like refractory and bipolar, show no effect. It's like saying a knife cannot cut an arbitrary material. It depends. Studies of ADs must start to differentiate at least a few subtypes of depression.

fastasucan17• 6 months ago

Some times its almost like telling a person in the middle of a heart attack that they ought to change their diet and start exercising more.

stormed2• 6 months ago

I decided to go unmedicated from SSRIs/mood stabilizers in 2024 and it changed my life for the better. Prior to stopping, I thought I was physically unhealthy until I found out excessive overheating & exhaustion was a common side effect of Zoloft. Since then, I've lost around 40 pounds and have been able to regularly exercise without issues. My mental health also improved with forcing myself to get vitamin D outside. It can be the simplest of things to improve your life, but it can be easy to forget (especially WFH).

PeterStuer2• 6 months ago

Did you get the "brain zaps" when coming off the SSRIs? How long did it take?

stormed2• 6 months ago

Definitely. It wasn’t too bad, but it took roughly a month for the brain zaps to completely stop with Zoloft & Wellbutrin. I had worse brain zaps in the past from Lexapro, that was bad enough I’d lose focus on whatever task I was doing.

cung• 6 months ago

Nearly as effective? It’s significantly more effective!

imzadi• 6 months ago

This is only talking about therapy and not medication. The original study is a bit light on details https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

For the 57 trials (2189 participants) comparing exercise with no treatment or a control intervention, the pooled SMD for depressive symptoms at the end of treatment was −0.67 (95% confidence interval (CI) −0.82 to −0.52; low‐certainty evidence), showing that exercise may result in a reduction in depressive symptoms. When we included only the seven trials (447 participants) with adequate allocation concealment, intention‐to‐treat analysis and blinded outcome assessment, the pooled SMD was smaller (SMD −0.46, 95% CI −0.88 to −0.04). Pooled data from the nine trials (405 participants) with long‐term follow‐up provided very uncertain evidence about the effect of exercise on depressive symptoms (SMD −0.53, 95% CI −1.11 to 0.06; very low certainty evidence).

Like, what does -0.67 really mean in this context. I read the study and it is not really explained. Maybe I'm too dumb to get it, though.

verteu2• 6 months ago

It's a standardized mean difference, which I believe can roughly be interpreted as: "treated groups had 0.67 stddev lower depression score than control groups."

That's a pretty substantial improvement - consider someone who's more depressed than 75% of the population becoming completely average. (Because the 75th percentile is about 0.67stddev above the median.)

D-Machine7• 6 months ago

You cannot say if this is a substantial change or not, because you need to know by how much the groups actually differ on average, i.e. you need the unstandardized effect size, expressed as a mean difference in the scale sum scores, or as an actual percentage of symptoms reduced, or etc. In general, there are monstrous issues with standardized mean differences, even setting aside the interpretability issues [1-3].

See also my response to GP.

[1] https://journals.plos.org/mentalhealth/article?id=10.1371/jo...

[2] https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1348/0...).

[3] https://www.tandfonline.com/doi/abs/10.1080/00031305.2018.15...

D-Machine7• 6 months ago

It means nothing, standardized effect sizes have no clinical meaning here, they are purely statistical. To measure if these kinds of changes matter, you need to determine the Minimal (Clinically) Important Difference [1-2]. I.e. can clinicians (or patients) even notice the observed statistical difference.

In practice, this is a change of about 3-5 points on most 20+ item rating scales, or a relative reduction of 20-30% of the total (sum) score of the scale [1-2]. Unfortunately, anti-depressants are under or just barely reach this threshold [3-4], and so should be widely to be considered ineffective or only borderline effective, on average. Of course this is complicated by the fact that some people get worse on these treatments, and some people experience dramatic improvements, but, still, the point is, depression is extremely hard to treat.

Unfortunately, this also means that if exercise is only nearly as effective as therapy for depression, it may mean that the benefits of exercise are not actually really clinically observable, if measured properly and not just based on arbitrary statistical significance.

EDIT: There is less data on MCIDs for therapy, but at least one review suggests therapy effects can be in the 10+ point range [5]. But the way the exercise study is presented, with standardized effect sizes, we have no idea if the results matter at all [6].

[1] Button, et al. (2015). Minimal clinically important difference on the Beck Depression Inventory - II according to the patient’s perspective. Psychological Medicine, 45(15), 3269–3279. https://doi.org/10.1017/S0033291715001270 [https://www.cambridge.org/core/journals/psychological-medici...]

[2] Masson, S. C., & Tejani, A. M. (2013). Minimum clinically important differences identified for commonly used depression rating scales. Journal of clinical epidemiology, 66(7), 805-807. [https://www.jclinepi.com/article/S0895-4356(13)00056-5/fullt...]

[3] Hengartner, M. P., & Plöderl, M. (2022). Estimates of the minimal important difference to evaluate the clinical significance of antidepressants in the acute treatment of moderate-to-severe depression. BMJ Evidence-Based Medicine, 27(2), 69-73. https://doi.org/10.1136/bmjebm-2020-111600 [https://ebm.bmj.com/content/27/2/69.abstract]

[4] Jakobsen, J. C., Gluud, C., & Kirsch, I. (2020). Should antidepressants be used for major depressive disorder?. BMJ evidence-based medicine, 25(4), 130-130. https://doi.org/10.1136/bmjebm-2019-111238 [https://ebm.bmj.com/content/25/4/130.abstract]

[5] Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. Journal of affective disorders, 159, 118–126. https://doi.org/10.1016/j.jad.2014.02.026 [https://pubmed.ncbi.nlm.nih.gov/24679399/]

[6] Pogrow, S. (2019). How Effect Size (Practical Significance) Misleads Clinical Practice: The Case for Switching to Practical Benefit to Assess Applied Research Findings. The American Statistician, 73(sup1), 223–234. https://doi.org/10.1080/00031305.2018.1549101

unparagoned3• 6 months ago

Other metas show exercise is more effective than both therapy and drugs.

ssri don’t fix any underlying condition and barely work long term, that if they really work at all.

fastasucan17• 6 months ago

What if medication helps people being able to exercise?

commiepatrol• 6 months ago

I read the title as "Exorcise". I'll show myself out.

Simulacra• 6 months ago

I found this to be contradictory with my mental health period even after losing nearly 100 pounds, and going from zero to walking 8 to 10 miles a day, my mental health did not improve. It felt good to accomplish goals, two life-changing goals, really, but my overall disposition and deep depression did not change. I have no explanation for this.

nineteen9992• 6 months ago

It may be worth looking into childhood trauma if that's something that may be applicable. I had a similar experience, after losing 35kg over 3 years I felt and looked great on the onsite, even having to overcome back surgery during that period as well, felt like I'd conquerered the world. I thought I'd "done enough work", but as I found out, sometimes there is work to be done on the inside as well.

jimmar• 6 months ago

I took meds for depression a few years ago. I don't know that they did anything other than signal to myself that I wasn't ready to give up. They may have served as a kind of "dumbo's feather" that helped me get through a rough patch. Exercise might be similar. People who choose to exercise make the statement to themselves that they are worth doing something positive for. Some mental health problems resolve with time and without medication, and in those cases, exercise might be a great way to address them. But if you're struggling, call your doctor and make and appointment. Medication is sometimes the answer.

jokoon• 6 months ago

I tried intensive workout

It's unhelpful because I got tired, and then I stopped workout entirely

Now I just do fast walking and it's nice

cpursley• 6 months ago

Have you tried lifting weights (different pace than HIT)?

bunnybomb29• 6 months ago

You sound like a couch potato, like me.

Try HIIT 1 minute walking, 1 minute running

stimulating for the brain, safe, fun and an easy way to ease into running.

denim_vampire• 6 months ago

I think one of the tricky things about depression is how unique each person's experience with it can be. I can only speak from my own history. For me, medication was indispensable in getting me to a point where lifestyle changes could occur.

That being said, I do believe that exercising, eating right, maintaining a healthy sleep schedule, etc., all the boring lifestyle things have been key to preventing myself from slipping back into that depressed state, years after stopping medication.

einsteinx2• 6 months ago

It’s also fantastic for anxiety, or at least it has been for me. Though I’ve heard anxiety and depression are often linked so I wonder if there’s some common underlying mechanism by which it helps either both.

taeric5• 6 months ago

I would assume that "doing something" is the key here? Successfully doing exercise probably has add on benefits that you can more successfully do other things afterward. But successfully reading a book can help me get out of depression. Successfully cleaning the kitchen. Really, just successfully doing anything is a huge cure against depression.

yoyoma1234• 6 months ago

No, it’s more specific - doing something physical.

Cleaning dishes yes, reading a book no

taeric5• 6 months ago

My point in including both is that both can be surprisingly effective and turning my mood around. Despite them being very different. Included the dishes because that is physical and a chore that most people actively dislike.

Edit: Just to be clear, per my other post sibling to this, I should say that they can both seem to be very effective at turning my mood around. I do not, necessarily, think either is causal on their own.

filchermcurr• 6 months ago

I'm not sure this is the type of depression being talked about here. It's unfortunate that we have conflated periods of being sad / down with clinical depression. I have no doubt that reading a book or cleaning the kitchen or accomplishing a goal can help with feeling down or general sadness, but clinical depression is a whole separate beast without such easy a fix.

taeric5• 6 months ago

Who said these were "easy" fixes, though? I am emphatically not claiming that "just doing something" will work. Though, fair that what I put there can seem that way.

I am more trying to claim that "just doing something" has an annoying track record of looking like "it" is what worked. I would fully believe that, in reality, the thing that worked was already at play before the success started happening. That is, fully depressed people don't succeed at any of these things.

fastasucan17• 6 months ago

Its also a huge sign you are already on your way out of the depression.

ElijahLynn• 6 months ago

The audiobook Spark by Dr. John Ratey, psychiatrist is a great listen with a bunch more evidence based arguments to support that exercise is better then drugs for depression.

I highly recommend the audiobook as it is read by him and he is very enthusiastic about his research.

The one quote I remember from the book is that he stopped prescribing Prozac and started prescribing treadmills...

chegra• 6 months ago

I did a summary here: https://www.chestergrant.com/highlights-from-spark-how-exerc...

It's in my top 15 books that changed my worldview.

Some key highlights:

1. In 2001 fit kids scored twice as well on academic tests as their unfit peers.

2. German researchers found that people learn vocabulary words 20 percent faster following exercise than they did before exercise, and that the rate of learning correlated directly with levels of BDNF.

3.Specifically, every fifty minutes of weekly exercise correlated to a 50 percent drop in the odds of being depressed.

D-Machine7• 6 months ago

Unfortunately, if exercise is only nearly as effective as therapy for depression, it may mean that the benefits of exercise are not actually really clinically observable, if measured properly and not just based on arbitrary statistical significance.

Standardized effect sizes like the ones reported here have no clinical meaning, they are purely statistical. To measure if these kinds of changes matter, you need to determine the Minimal (Clinically) Important Difference [1-2]. I.e. can clinicians (or patients) even notice the observed statistical difference.

EDIT: There is less data on MCIDs for therapy, but at least one review suggests therapy effects can be in the 10+ point range [5]. But the way the exercise study is presented, with a standardized effect size, we can have no idea if the results matter at all [6].

shevy-java2• 6 months ago

This kind of makes sense. Most forms of depression have to do with not wanting to do something or lacking motivation to do so. Whereas in sports, people get busy usually, they do something, even if it may just be soccer playing. Exercise is also usually good for one's physical well-being, blood circulation increases, muscles may improve, pain may go away (depends on the exercise, but usually say, two days after some heavy work out, most people may feel better than before, unless it was some extreme exercise that caused injury).

I don't think this works for all type of depression though.

cj• 6 months ago

I wonder if there’s some survivorship bias. E.g. did they only study people who started and maintained a routine vs. everyone who started a routine but couldn’t stick with it due to depression symptoms

eastbound• 6 months ago

Observation bias. Those who succeed to drive themselves to do an effort, are already out of the depression. Try doing 7hrs sports a week and falling into depression: You won’t have the energy. It’s not sports that gets you out of depression, but sure it’s a stage on the way back and you gotta constantly give it a chance.

fastasucan17• 6 months ago

This is spot on. "To stop being sick you just have to do all the stuff healthy people do, and not do the stuff sick people do! I have never seen a healthy person being sick, so it must work!".

resumenext4• 6 months ago

Therapy carries a huge risk, so maybe if you compare average outcomes exercise is only nearly as effective, but if you consider the 2 overall exercise comes out way, way ahead imho.

javanissen2• 6 months ago

Is the huge risk being involuntarily committed?

If so, that is a risk that is very dependent on local laws. I would be much more cautious about seeking mental health care in Florida, where the Baker Act makes it very easy, than in Connecticut [0]. The risk of being involuntarily committed also, of course, has to be balanced against the risk of forgoing mental health care when you need it and then injuring or killing yourself.

[0] https://psychiatryonline.org/doi/10.1176/appi.ps.201900477

resumenext4• 6 months ago

That seems like a minor concern. Therapeutic malpractice is a thing, misdiagnosis, iatrogenic treatments and so forth; not uncommon. Was a time when gay was in the dsm, the pendulum has swung back and forth on transgender children.

isk517• 6 months ago

Exercise is great, just make sure to take sometime to evaluate where you are at mentally. I was running about 40 miles and doing 5 hours of lifting per week to try and stay a head of my depression, and when I finally burnt out everything came crashing down all at once.

MikeNotThePope• 6 months ago

Exercise is great for addressing feelings related to being physically inactive. It won’t address other mental health issues, such as learning to control your emotions & fostering healthy relationships.

nerdsniper• 6 months ago

Exercise is great for addressing feelings related to being physically inactive.

That definition is probably too narrow.

https://en.wikipedia.org/wiki/Neurobiological_effects_of_phy...

observationist• 6 months ago

There's a deeper level to the way you calibrate your mental operation. If you're under a lot of mental stress, your body is evolved to prime you for physical effort, beyond the fight or flight responses. By engaging in exercise, you're resetting your physical condition, and that can put you in a much better position to mentally cope with whatever is happening.

This is something that has very deep evolutionary roots. A looming project deadline, a relationship crisis, feeling burned out, general malaise about your place in life - all of those stressors can bring about different neurochemical and hormonal changes that are in whole or in part dealt with in a healthy way by engaging in strenuous physical activities.

That puts you in a position to gain perspective without the immediacy of the negative emotion, so you don't have to feel anxious, or have subtle negative threat framing around everything.

You can abuse that, like anything else, and mask real negative factors in your life, or it can be a phenomenal and healthy way to deal with the negative framing of otherwise neutral or even positive circumstances in your life.

pedalpete• 6 months ago

There is a tri-lateral(?) relationship between exercise, sleep, diet, and how the three impact mental health.

A waste product of exercise is Adenosine. Adenosine build-up leads to increased sleep pressure, and improved Neural Function of Sleep, not just "being unconscious".

This is where things get a bit interesting when we look at depression. For many people, depression results in decreased Neural Function of Sleep (specifically slow-wave activity) even though sleep time often increases.

However there is also some evidence that restricting slow-wave activity can act as a "reset" button. The researchers I have spoken to about this are either in the "too dangerous to do the research" camp, or "distrupting slow-waves for a very short period, then increase slow-wave activity".

Of course, sleep and exercise would only be a single pathway to improving depression outcomes. Exercise alone, and the dopamine, oxygenation, and many other outcomes are also likely to come into play.

Comparing this to pharmaceutical or behavioural therapies, I can see why they'd be as effective. You're treating the entire system, not just trying to change a single chemical in the brain, specifically when we aren't even measuring the chemical before or after treatment.

lifeisstillgood• 6 months ago

This leads to a fairly obvious conjecture :

That since for 100,000 years humans were roaming the landscape gathering or hunting, and for 10,000 years engaged in heavy agricultural work, is the modern day rise in depression not just correlated but caused by the modern day reduction in daily heavy exercise?

It’s such an obvious idea I am wondering if folks know of any research / studies on it?

yousif_123123• 6 months ago

Don't underestimate the meaning and relationships people had in those times, hunting together to feed your family, farming with your community and interacting with animals etc.

I think physical activity, even just going on walks makes one feel change is possible. If something sucks and I sit home all day on YouTube, then it continues to suck. If I can change my environment, do things outside, see new people and find myself if different situations, then the thing that sucks starts feeling like maybe it also could change.

For example I doubt exercising in a basement just by yourself on 1 machine is likely to materially help with depression. At least not as much as going out doing a variety of things, or playing a game of basketball at the local gym/community center.

kayo_20211030• 6 months ago

Yeah. I think the communitarian point is valid, and valuable. Also, even if you only do that 1 machine thing in the basement, you can regard it as an achievement that's worth something. At least I did that thing. It makes me feel kinda ok too, or just better.

fastasucan17• 6 months ago

is the modern day rise in depression

I think it was quite hard to get an appointment for a depression diagnosis 100,000 years ago.

bradlys• 6 months ago

I exercised for years. I’m talking multiple hours a day. It was a part time job. It never improved my mood.

Some people don’t suffer from chemical imbalances, unhealthy habits ruining their mood, or whatever your snake oil will magically cure. There’s a term called Shit Life Syndrome and some people just have that as their long term situation.

owenpalmer• 6 months ago

Extremely disappointing analysis in the article and also the cited paper's abstract [0]. The only way this data could possibly hold any value is if they found a way to control for how depression might influence an individual's likelihood of choosing to participate in the trial in the first place, as well as trial completion rates.

Even an amateur could read the headline and instantly understand this critical point the experiment's design, and yet it's not even acknowledged under the "Risk of bias" section.

[0] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

znpy• 6 months ago

I’m here ti add my own anecdotal two cents:

2024 has been a rough year. I didn’t begin any real recover until around march-may 2025… when i started going yo the gym and lifting weights. Yeah sure i’m doing therapy and all that jazz but the real improvements started with weight lifting.

Geee• 6 months ago

I've found out that running outside just for 10 minutes with quite high intensity is really effective for anxiety / depression with instant effect. Also, specifically lactic acid producing exercises, such as doing free squats quickly works too. It might have something to do with how the brain uses lactic acid for some functions, but this is just my guess.

Found out that there's some research on this: https://www.biotechniques.com/biochemistry/exercise-lactate-...

lazarus012• 6 months ago

I can see how therapy can be helpful for some people. But I find it to be a big scam from my own personal experience.

What incentive do they have to give you immediate and durable results? Why do most only take cash?

I did some ML work with an addiction psychiatrist at the peak of the opioid crisis. He said,”To pay my bills, I have to treat rich people.”

I find taking long walks and speaking candidly about how I’m feeling is always the most effective way to deal with tough emotions.

sizzle2• 6 months ago

You are assuming everyone has someone to take long walks with and speak their innermost vulnerable thoughts/feelings with. A therapist is a paid person to achieve this same outcome.

lazarus012• 6 months ago

No I’m not. Please read the first sentence of my post.

I agree, it’s tough to be honest when you’re vulnerable. Expressing vulnerability exposes how people really feel about you.

Aeglaecia3• 6 months ago

and people wonder why i call psychiatrists legal drug dealers - what incentive does a psychiatrist have to fix someone , when they could make 10x more money keeping that person dependant forever

azan_• 6 months ago

If we had effective treatment, then psychiatrists that are effective would quickly displace ones that keep you hooked on non-effective ones.

tsoukase3• 6 months ago

Any psychotherapist, and mainly psychiatrists, tries to create a heavy dependence to their patents, not so chemical but behavioral and psychological, which they call patient bonding. They don't want to instruct the patient and make them independent. It's shown that this causes a consistent improvement and simultaneously establishes their dominance long-term.

getnormality• 6 months ago

I'm sure the result is in some sense valid, but it's like saying that radiation therapy can be nearly as effective as antibiotics for a sore throat. The conditions under which it works, the method of action, and what is accomplished are all different.

evanjrowley2• 6 months ago

I've had many exercise regimens throughout my life but never has it ever helped me with mental health in any way.

Exercise has always been a mental drain for me. A day when I go to the gym is a day when I give up mental capacity that could have been used for something else. I'll be less effective at work and less organized at home. It's like my IQ's dropped by double digits.

I drink enough water and electrolytes, in case anybody's wondering.

wiether• 6 months ago

Sorry if I'm stating something obvious for some, but, exercise doesn't HAVE to be something pushed by the industry like running or going to the gym.

I got great success converting friends and coworkers to... walking.

Not going on a multi-hours hike on the weekend, but just walking around the block or in a park for half an hour at mid-day, and going through the same routes so you don't have to think about finding your way.

By doing so, not only you are physically active, which is a big positive overall for most of office workers, but it requires so little of focus to achieve it that your mind is now free to wander as it please.

During this free period, you can come up with a solution to an issue you've been stuck on during the morning or for days, or you'll think about plans for the future, or you'll just get back to work with a clear mind, ready to tackle the issues of the afternoon.

I give up mental capacity that could have been used for something else

That's the beauty of _just walking_, it requires no mental capacity, it frees it actually. Don't overthink things, like where should I walk, when, do I have the right gear... Just get outside, put the appropriate clothing depending on the weather and, enjoy your free mind compute credits!

Once you see how it works, it feels like cheating.

Afterwards you'll feel better physically and mentally.

All the gym/running/zone 2 stuff is something different altogether that could come up once you're converted to the light exercise/big effects of _just walking_.

tsoukase3• 6 months ago

Physical exercise, like diet, and mood are complicated bio-psycho-social functions that are depended on dozens of overlapping factors in each person. Most meta-analyses and their underlying studies ignore most of these dimensions and come to a binary yes-no conclusion based on a mere p-value. Huge confounding effects persist that the studies should heavily take into account. At least examining such popular functions provide large samples cheaply.

bfrog• 6 months ago

Nothing has solved sadness for me as well as lifting weights, long fast bike rides, and team sports. Nothing.

rcarr• 6 months ago

For a long time I used to be able to manage my exercise with depression. Eventually, it stopped working. I literally climbed a mountain, got to the top and felt nothing.

What got me out of that place was improv comedy lessons. Highly recommend to anyone. Improv schools and theatres should be as ubiquitous as gyms.

rkomorn• 6 months ago

Did you mean manage your depression with exercise?

unparagoned3• 6 months ago

This is complete bullshit. Exercise has been show to be more effective than therapy and drugs.

Exercise improves the biological health of the brain which can be fixing the underlying condition.

If you are depressed because your brain is biologically unhealthy, therapy isn’t going to do anything

artyom• 6 months ago

May rampant depression everywhere be caused by not the lack of exercise, but because of life becoming overly sedentary?

30 years ago moving your body wasn't going to the gym, it was part of everyday life. Staying 2 hours nonstop in front on the screen was to watch a movie, and maybe done a couple times a week, tops.

Now we just deliver 3 tomatoes to our doorstep to avoid going out.

Exercise can be nearly as effective as therapy for depression

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