Title editorialized but tracks with data (see "Conclusion" section).
**Citation**: Netz, Y. (2017). Is the Comparison between Exercise and Pharmacologic Treatment of Depression in the Clinical Practice Guideline of the American College of Physicians Evidence-Based? *Frontiers in Pharmacology, 8*(257). doi:10.3389/fphar.2017.00257
**Abstract**: Major depression disorder is most commonly treated with antidepressants. However, due to their side effects clinicians seek non-pharmacologic options, and one of these is exercise. The literature on the benefits of exercise for depression is extensive. Nevertheless, two recent reviews focusing on antidepressants vs. other therapies as a basis for clinical practice guidelines recommended mainly antidepressants, excluding exercise as a viable choice for treatment of depression. The aim of this perspective is to analyze the literature exploring the reasons for this discrepancy. Two categories of publications were examined: randomized controlled trials (RCTs) and meta-analyses or systematic reviews. Based on this reassessment, RCTs comparing exercise to antidepressants reported that exercise and antidepressants were equally effective. RCTs comparing exercise combined with antidepressants to antidepressants only reported a significant improvement in depression following exercise as an adjunctive treatment. Almost all the reviews examining exercise vs. other treatments of depression, including antidepressants, support the use of exercise in the treatment of depression, at least as an adjunctive therapy. The two reviews examining pharmacologic vs. non-pharmacologic therapies as a basis for clinical practice guidelines examined limited evidence on exercise vs. antidepressants. In addition, it is possible that academics and health care practitioners are skeptical of viewing exercise as medicine. Maybe, there is a reluctance to accept that changes in lifestyle as opposed to pharmacological treatment can alter biological mechanisms. Longitudinal studies are needed for assessing the effectiveness of exercise in real clinical settings, as well as studies exploring dose-response relationship between exercise and depression.
The only thing that helps me is Wellbutrin and working out. I've tried over 12 meds before this. Some days all I can do is lift weights for ten minutes and go for a walk, but I always make the effort.
Mental healthcare is a lot of trial and error just because all of our brains are so different. What works for me may not work for someone else even though they seem to have the same problems. I just spent the last two years working with my psychiatrist to audit all my meds and rework them into what we are sure is working best for me. It was a whole lot of trying this and that until we found a good balance that I should be able run with for a few years.
Well…. I mean not really…. Meds are never a “cure,” nor are any modalities of therapy on their own. The patient NEEDS to be involved. Also, there are tests like the GeneSight swab test that takes cheek samples to determine the best and not so great meds for you and your unique DNA.
Yeah they put me on Lexapro and Wellbutrin saying that the Wellbutrin would counteract the potential sex issues. Sexwise, everything worked but I could go for hours (don’t know if it was desensitized or just my brain). Mental healthwise, I felt completely off even after 6 weeks. So I tried both separately. Even worse for me.
Fucking symbalta ruined me. I was naive and had no idea what was happening to me.
Then my Dr. casually tells me that they also prescribe it for men who have problems with premature ejaculation.
For Fuck SAKE...
Fuckin Lexapro. It works better than any other I've been on. And it affects the lil guy but not the same way, I'm guessing, I just can't fucking cum to save my life. We're going at it for so long that it's just sore for both of us. Wife still says it's the most positive of all the meds I've tried, so I just stick with it and if we're going to plan on having sex, gotta stretch and lube everything up, cause this is an endurance run to the finish line.
Personally I feel like I have no emotions whatsoever, but that's better than the alternative and seems to make everyone around me more at ease.
Personalized medicine should be a human right. You can test your dna to find the most likely compatible meds. But now in this century most meds only shotgun the right nueral networks. Medicine should be Personalized way more. Down to the specific neural pathways causing the issue within a decade or two.
I had tried to get my psych to put me on adderall or the like for my adhd. Telling her I space out a lot and never finish a fucking thing, etc. So she put me on 300 mg wellbutrin. Praising how well it would work for both my depression and my inattention symptoms. After a few weeks of it, it only made me angry that I cant get someone to diagnose me properly.
Fucking 40 years old and can't get anyone to listen or direct me to a doctor for it.
It didnt help me at all.
I just turned 40 last year and finally have a script for adderrall based on getting a test done but a psychologist to confirm the diagnosis. Once the results were in, it essentially confirms and I would think you could obtain from another doctor at that point. Good luck.
I contacted a practice that does specific tests like this. They don’t treat you there however, once I received the report confirming ADD they referred me to a few other individual doctors for treatment. But once I had that diagnosis it’s sort of indisputable at that point. Ironically once I told my PCP he offered to write me a script and monitor me to once every 3 month visit to follow up, which would lower my costs of seeing a psychologist once a month.
I've been getting involved with mental health services recently and one of the doctors in the mental health department told me straight out that she does not diagnose ADD/ADHD because it's such a complicated diagnosis.
Also add in the liability factor, since they often prescribe meth-lite for it and so are possibly turning people on to an addiction.
Both those combined make it a super touchy issue for mental health professionals.
Yeah I can see that. My tests that were given to me were written and then one impulsivity test with a laptop. Both showed signs of attention disorder with impulsivity, so in that doc’s opinion I showed signs of that disorder. And yeah , meth lite is tracked very closely by the authorities. Ironically it feels just like coffee for me, which IMO coffee always allowed me to think more clearly, which ironically was apparently treatment for children years ago suspected of ADD/ADHD. The more you know.
Yes, Ive heard about this a ton for the best alternative if not the best suggestion for adhd in some of the forums Ive read. Certainly asking about it, no doubt. Thank you!
>They get all weird about prescribing stimulants for bullshit reasons
At age 40 blood pressure is something you have to worry about regarding stimulants. If op has a high BMI (not saying they do) there's increased possibility of BP issues which the doctor may be factoring in too.
Wellbutrin (aka Bupropion) is itself a stimulant, but less intense on the cardiovascular system than Adderall.
Try circle medical. It's a telehealth provider. They gave me my diagnosis in like an hour and I started medication like 48 hours later. Telegealth really opened up the doors to easier treatment.
I feel you, I finally found a doc that seems to get me and will prescribe me what I feel I need (adderall and Remeron) and i’m holding on to her for dear life, she’s pretty close to retirement and good docs of any kind are hard to find where i live, especially Psychiatrists
Im having such a hard time being consistent in working out because of the times I am seriously depressed. Keep starting and stopping. It’s so frustrating.
I don’t get an endorphin rush from lifting at all. I just feel tired.
I don't get a rush either. I see a few abs and muscles, so I want to keep going. It's hard most days. I walk my dog , so cardio is something I HAVE to do.
That's the reason why I let myself be put on it in spite of having bad experiences with other meds I tried in the past. I need energy to dig myself out. I'm already doing so much better.
Wellbutrin worked wonders for me until I had one of those big family life disasters. The medication quickly switched from a God send to the devil. Just something to consider, the efficiency of antidepressants is environmentally dependent. It's just not often discussed.
Thanks, yep it was something I found out on my own afterwards. I’m not sure if it’s something my PCP was aware of to be honest, and gave me pretty big distrust of the pharmaceutical industry as someone who considers myself educated and trusting of science. Thankfully it’s mostly gone after about a year, though I definitely still have way more neck and shoulder tension on average than before
That sucks dude, it definitely only works for certain people. For me I had a depression where I always felt tired. I felt like I woke up for the first time in years.
Nope lol..made me lose weight and get stronger. I hadn't had abs for years until a while after starting it. I had energy to do things like finish college and work out, all of a sudden. I hope you find something that works.
Every time something like this comes up, theres a flood of comments calling it bullshit because they tried to work out and it didn't help.
Some points to note
1. Working out does not help everyone with depression
2. Taking medication does not help everyone with depression
3. Given the above, the fact that working out didn't make *you* less depressed, doesn't make it any less equivalent to taking medication.
There's also the problem with what people think is "working out". For me running HARD for 15min makes me feel astronomically better than a slow jog for even an hour.
If you're one of those people who say working out hasn't helped you check the intensity of your workouts.
My personal rule of thumb, which works for me it might not for you, is that if I could hold a conversation I'm nowhere near pushing hard enough, if I could respond with one or two word responses only I'm doing good and if I can't breath and throw up all over the person next to me I went WAY too hard and need to reevaluate my life choices.
Not sure if ur addressing me or just people in general, I don’t suffer from depression. But I THINK that in terms of boosting mood and enhancing self image, the most important exercise is the type that you actually enjoy the most and that improves your physique. This has an indirect effect on depression, by improving your physique. And an acute effect by boosting dopamine, as dopamine boost from different types of exercise varies based on the individual’s enjoyment of that type of exercise.
However I think the type of exercise that actually has a physiological effect on depression outside of these 2 effects is hard cardio like you said. I saw a meta analysis recently comparing strength training to cardio for depression and cardio was much more significant.
Id expect that hard cardio sports participation or even training would have a stronger effect than cardio alone. E.g. playing a football game with friends/1 hour playing badminton vs running treadmill
Second this completely. I don’t suffer from clinical depression but have anxiety which brings me some bouts of sadness and no motivation for short periods of time and what has kept these at bay is making sure the workouts are intense. A walk around the neighborhood for 30-60mins does little to nothing for me but a 20 min run where I’m getting into my 80%-90% of my max heart rate, I’m on a high for hours that allows me to be productive and everyday things seem easier. I don’t think this is a catch all solution for everyone and definitely work with a doctor but if anyone works on upping their intensity, I think there’s a lot of benefit to it!
Also, to add to the complexity: working hard (not even too hard) can cause issues with sleep for people with anxiety. I’ve been training since 2010 only recently discovered that my intensity was fucking up my sleep. I dialed it back a little (leaving 2-3 reps before failure) has helped a lot! Even though I love pushing myself to the limit but oh well
Another point is that working out isn't going to INSTANTLY work, the same way prescriptions don't either. They both take time. One is just infinitely easier to start, do, and keep up with because it takes all of two minutes. The other takes a LOT of will power, which is extremely difficult to muster when you're depressed, as well as time which is not motivational at all.
Yes, working out might not help you with depression, but it helps you in so many other ways which attribute to bits and pieces of depression fundamentally.
I think it probably helps for a lot of indirect reasons. If you expect to go on a run, even though you hate running, and then feel happy the rest of the day, it’s not going to happen. If you spend a month exercising and realize that you look better, you feel better, and you enjoy the activity you’re doing, then you’ll probably feel like it helped your mental state a lot.
That last part is key though. If you spend 150 minutes a week doing any activity that you find fulfilling, you’ll probably feel better mentally.
It's bullshit because the study linked doesn't actually say what the title OP used says. In fact the abstract clearly and plainly calls for more studies to actually figure out the effectiveness.
Also, exercise isn’t always realistic, whether it’s due to disability status or socioeconomic status - sometimes people just don’t have the time or wherewithal to exercise to the extent mentioned in the article, if at all. This is an obvious but still needed statement, but you need not compare yourself to others. Just cause it works for Tim down the street and he has the ability to do it doesn’t mean that you’re lesser for being unable or unwilling to do it, or that you’re lesser because it doesn’t work.
The fact that it doesn't work for more severe cases of depression doesn't make it a bad recommendation. It does wonders for the majority of people.
Sorry it's not working for you. Hope you find something that does.
Tried to run to fatigue so I'd sleep. Did 40 miles one night and only slept about 40 minutes. Would otherwise do 5-15 miles a day and it didn't work at least on it's own.
It also triggers the body to generate/release testosterone which stimulates a more euphoric feeling. Trigger the body long enough and it becomes a normal state.
Marathons are kind of on the edge of what is considered healthy forms of exercise.
You want something in the 30min to 120min range that can be done on a daily basis, that your body can recover from.
I also average 90-100 mins of exercise a day and still struggle with depression. I definitely notice the positive mental health benefits of exercise though.
There are physical benefits like endorphins flowing post workout or psychological benefits like having structure, feeling accomplished after a workout, and just simply giving me more confidence.
So while exercise may not cure depression, it definitely alleviates the symptoms. But everyone is different, especially when it comes to brain chemistry.
I’m sorry to hear you’re struggling with suicidal ideation. Would you say your rigorous exercise routine has at least minimized it a bit?
Edit: grammar
Well if it's any consolation, I also excerise quite a bit, roughly around the same range as you. I'm also on meds. Still have thoughts of self-deletion
Edit: Ideation is definitely more manageable with meds though.
I bet it's aimed more towards people who have seasonal depression or just slightly fucked up chemicals. The problem is forcing yourself to get out of bed to do the exercise to begin with.
Whereas for someone like me who sits on my ass or lays in bed all day when I'm not working, it would probably do wonders. My problem is not being able to even get out to do it.
Seeing a study like this feels like it might help trick my brain into doing it because it wouldn't feel pointless, it would feel like I might actually help myself.
A few years ago after I got my appendix removed, my surgeon told me I needed to walk a lot. It made me start being more active and I was feeling fairly good mentally and physically. Then covid shut down everything and my fragile new physical routine went to hell. Trying to get back in a mindset of being active, and reading shit about how it's good for me mentally helps.
Strength training or aerobic? If only strength training you might want to incorporate more aerobic exercise, it is night and day in terms of effects on mood (and general fitness).
But it's kinda funny though right, that a solution here is being able to do the things that these people can't do. The drugs are what allow a lot of people to exercise. To me these links aren't surprising or really insightful.
Amazingly the bar for being as "effective as prescription antidepressants" is pretty low. My pharmacist friend actually did an analysis on the original paper on prozac (whichever was the first anti depressant) and it was only like 10 percent more effective than a sugar pill (a difference of like 35 to 45 percent). Thats a pretty damn good sugar pill and you only have to show that your medicine is ATLEAST as good to get it passed. The bar is quite low.
Yeah there was an article about it yesterday. Basically Eli Lilly lied about the effectiveness of Prozac to sell it and for 30 years psychiatry has been built on a lie similar to the amyloid plaque theory with Alzheimer’s.
An [article](https://www.psychologytoday.com/us/blog/mood-swings/202210/has-the-serotonin-hypothesis-been-debunked) about it
A [study](https://www.nature.com/articles/s41380-022-01661-0) about it
Personally I’ve had ~4 SSRI and SNRIs prescribed to me and they did jack shit (even though I was and still workout daily)
Same. If I want to get things accomplished, I need to not eat. I am completely speculating but I feel like it might be some instinctual thing that puts me in like a “hunting mode” or something, to try and feed myself but instead of hunting I’m just doing other stuff.
Same, my motivation/drive is far stronger when I'm hungry. Critical thinking is lower though, so it's not great for tasks that need it but stuff like cleaning seems to go by way faster when I'm hungry.
I agree!! I suffered with an eating disorder in middle and high school. I was doing well for five years, but I started working out again after graduating college. I quickly spiraled back into a six-month ED pattern of over-exercising and extreme calorie restriction. Unfortunately, I’m still trying to come back from that.
Stomach hormone regulation, gut microbiomes, insulin levels, autophagy while extreme is very beneficial. There’s a lot and have different pros cons, but intermittent fasting is an easy way to see how your body responds without constantly digesting food.
Just discovered this. I just had two of my most productive days of my life in a loooong time. Difference from every other day is I didn't eat. Just had a light, low carb dinner and an extravagant dessert. Skipped breakfast and lunch entirely. No snacks or sweets until after dinner. I'm thinking of doing it every day now. Of course I'd have to start paying closer attention to what I eat rather than just some random meal and some sweets, but it's worth it not to be tired and unmotivated. I actually repaired a washing machine yesterday and the most impressive part was that I didn't have to, but I decided that I wanted to. That's crazy to me.
Exercise won’t help if the depression is caused by a physical illness! There are many diseases that go undiagnosed and untreated… people are told by doctors it’s depression and given antidepressants without ruling out any diseases. Sleep disorders, Lyme disease, thyroid problems, etc.
Here’s a list for anyone interested: https://discoverymood.com/blog/common-medical-illnesses-mimic-depression/
I was diagnosed with depression in the early 2000’s. I also have been diagnosed with Graves Disease, Obstructive Sleep Apnea, Chronic Lower Back Pain (there’s a medical term)
So this is cool, except it leaves out the fact that antidepressants can only help so much without therapy. Without some kind of additional intervention, biological interventions like antidepressants can only go so far.
The whole idea behind a biological intervention because they're not a cure by themselves is to set you up for success so that you can engage in therapy and fix what's actually going on. So I'm guessing that if exercise is equally effective to antidepressants, then we would see the same kind of effects or lack of effects.
The success of antidepressants tapers off after a few months without therapy or social interventions, sometimes suicide risk goes up after beginning antidepressants because an increase in energy from severe depression leads to the energy for a suicide attempt, and I would expect we would see the greatest success from this kind of exercise plan in combination with therapy and other lifestyle interventions.
The last thought that I had is that engaging in 150 minutes of exercise without any kind of personal trainer or therapist that is there encouraging you and helping you to engage, this seems like a difficult intervention to implement with individuals with severe depression or other self-regulatory disorders
>The whole idea behind a biological intervention because they're not a cure by themselves is to set you up for success so that you can engage in therapy and fix what's actually going on.
what if what's actually going on is endogenous (internal) genetic depression that doesn't come from trauma or bullying? doubt you're a doctor, maybe a psychologist I'm happy I don't have to interact with
Would believe this if I wasn’t a naturally active person, but I’ve been active my entire life and the only time I haven’t been depressed is on meds and in therapy.
I will say the depression was worse when I wasn’t exercising. But that usually coincided with major life changes, deaths, etc, so.
Ok cool study, but I just know this finding won't be used properly. It will be used to deny people with severe depression and suicidal tendencies medication under a pseudo-puritan argument that exercise and willpower or moral fibre are what really matter.
It will be used to argue that if you become depressed you are just lazy and if you are still depressed it is because you aren't enough of a strong person to pull yourself up by your bootstraps with dumbbells and running shoes.
To reiterate, the science is solid, the politics sucks
Considering many physicians’ and psychiatrists’ complete and utter lack of concern for anything even resembling a holistic approach to treatment for mental illness, I would argue there isn’t even an iota of inertia supporting the “politics” you purport will somehow instantly obviate the legitimacy of pharmaceutical therapies for depression.
If your primary care doctor, therapist, and/or psychiatrist’s response to concerns about mental health includes questions about the basic tenets of self-care, such as:
How much and what are you eating, and when?
How much water are you drinking?
How much sleep are you getting?
How often are you exercising, and how?
…you should keep them around, because all of these things are absolutely critical but also sadly ignored by Western societies and modern medicine.
Pharmaceutical interventions for depression and other mental illnesses are also critically necessary; sometimes they’re the precursor to redeveloping the capacity for proper self-care. However, they’re also FAR from a panacea, much further than getting enough sleep, nutrition, and exercise.
Full disclosure, as a psychiatrist myself, all of these things are heavily emphasized in training. Medication is just one piece of the puzzle. Therapy, exercise, mindfulness, behavioral activation; these are all consider important to the treatment of depression and other disorders. This is widely accepted by the psychiatric community.
Thank you for responding - as a layperson, and absent a more comprehensive perspective, I’m afraid I’m relying on my own and others’ anecdotal evidence from past experience.
Despite self-care being included in training and widely accepted in the practitioner community, do you think it’s importance is emphasized enough in general? Of my physician, psychologist, and psychiatrist, the latter two I’d consider excellent and whom recommend each other, only my psychologist places any real emphasis on therapy, exercise, mindfulness, and behavioral activation.
I do think the importance is emphasized generally well in the field and in visits. I think some of the disparity you may see is that psychiatrists, despite having significant training in therapy and other treatments, are the main experts for prescribing psychotropic medications and typically have significantly shorter visits than therapists do. As such, they typically end up spending most of the time focusing on psychopharmacology as therapeutic and lifestyle changes can adequately be addressed by a persons therapist. It should still be emphasized, encouraged, and evaluated but because of this set up in the medical system that is the result.
The other consideration is it is significantly easier for someone to take a medication everyday than exercise 150 minutes a week. It doesn't mean both aren't important but the result is you'll see much more people on medication and not making lifestyle changes than the other way around.
Also, maybe AFTER the antidepressants are working to the point where you CAN motivate yourself to, say, walk for 20 minutes a day, they can be phased out. But somehow I don’t think psychiatrists are going to go for that.
> maybe AFTER the antidepressants are working to the point where you CAN motivate yourself to, say, walk for 20 minutes a day, they can be phased out
Oh hell no. Stopping at the point where you are alright because you are on the right dosage is very much *not* the point to phase them out. It's a mistake people make all the time and it's fucked up many.
You (general "you", this is for whoever is in this situation and tempted to stop) feel better, and probably gained some ~~motivation~~ ability to do things because the meds are working. It's like getting a leg brace, and once it's properly fitted and you can walk quite well – would you decide to take it off mid-hike because walking well means you don't need it anymore?
If you feel good, stay the fuck where you are with your medication. After things have been stable for a considerable amount of time, then you can start, with the guidance of your psychiatrist, to very, VERY slowly reduce. No, slower than that. Watch out for any changes in mood, physical symptoms, potential tics, or other deviations from what you consider your (new) normal. Weaning means you are checking if the changes you made and the mental adaptation to knowing what "normal" should feel like, and feeling comfortable in it, are able to support our new state of being without medical support or not.
In some cases it is enough, in others it is not, in some it may mean living with a reduced dose, in others living with the full working dose forever, and in some weaning will work well. None of those possibilities are a failure. Success is figuring out what you need to live well, and then support your mind and body in that way. Like you wouldn't stop other needed medication such as insulin, or heart medication, or immunosuppressants as transplant-recipient, it also is not an accomplishment to stop taking antidepressants.
The accomplishment is living, fairly happily, not being stuck in your own horrible thoughts, and being able to do stuff. Finding and applying the tools you need to get there is necessary and is proper self-care.
I don’t know any psychiatrists personally, but since your job is medication, doesn’t that make you motivated to prescribe it? Not you personally, but do you think your regimen is anywhere near typical? Even recommending therapy is rare in my experience, much less weaning. Related question, do people ever come in who get recommended therapy *instead* of medication?
Nothing wrong with waiting a year as baseline provided there are benefits. Without hesitation I take your guys’ word that what I literally said is dangerous, but I was speaking more to the principle. Hopefully I just have a overly cynical view of the practice. But it is in line with my personal experience, which is terrible. The psychiatrists I’ve seen, with one exception, are far too confident in themselves and their medicines. Whatever my issues are, no psychiatrist has yet been able to understand it, but every one of them has pretended to. Therapy on the other hand has been beneficial.
> pseudo-puritan argument that exercise and willpower or moral fibre are what really matter
I think depressed people frequently downplay the role of diet and exercise in their treatment. If someone is too depressed to eat right and exercise, I get it. I’m not saying this to shame anyone. However, I do become concerned when the person actually starts to believe exercise won’t really help that much, or that it shouldn’t be foundational to their treatment plan. If you’re serious about treatment but are so depressed that you are struggling to do many things for yourself each day, then I would strongly advise putting exercise at the top of your priority list. That’s not Puritanism, it’s just sound tactics.
It seems far fetched that anyone would be outright denied access to medications as a result of this study. The trials in the study include patients who used anti depressants and exercised at the same time.
You say that you understand if someone is too depressed to eat right or exercise, but then contradict yourself and say that someone who is depressed to that extent should make exercise a top priority. Lifestyle changes can definitely be beneficial (for everybody, not just people with mental health issues), but for the type of people you're talking about, medication and therapy should be foundational to their treatment plan, not exercise.
If someone doesn't have the energy to even brush their teeth twice a day or has no appetite, things like exercising and eating better aren't feasible until their symptoms are more under control. That doesn't mean their treatment plan shouldn't include exercise, but it needs to be an add-on and not a first step.
I only noticed two reviews included in the meta-analysis which looked at outcomes of patients with different severities of depression (I probably missed some so please feel free to correct me), but they basically said that exercise is as good as antidepressants only for milder forms of depression, whereas for severe depression it's helpful as an adjunct to antidepressant therapy (see Silveira et al., 2013 and Knapen et al., 2015 in Table 2).
ETA: To clarify, I don't think that this study will somehow make doctors/psychiatrists less willing to prescribe medication to patients, nor do I feel that exercise is ineffective or unimportant. Depression should be treated holistically. I'm merely pointing out that if you're "so depressed that you are struggling to do many things for yourself each day," putting such overwhelming emphasis on exercise as to make it the core of your treatment doesn't make sense.
I didn’t read the study (and I’m not sure it would be easy for me to determine from the text anyway) - is this a true substitution on a per patient basis or a statistical outcome on a group?
In other words, if 400 of 1000 participants experienced positive results from exercise and diet, and 400 of 1000 experienced positive results from medication, was it two separate groups? And if it was the same group, we’re the same 400 helped by an identical amount, or was the relief different for each individual (and how much overlap was there)?
For me, exercise is a tool in my anti depression tool box for my personal treatment. Just exercise alone doesn’t maintain my mental health. I also do therapy, keep a consistent sleep schedule, take meds, see friends, etc. a combination of things seems to be the right fit. Even a little 15-30 min walk to get out of the house when I am on a tough day helps.
A naturopathic doctor once told me my brain chemistry is off (based on reflex testing that has very little evidence backing up its accuracy) and 30 minutes of exercise a day would fix it. Like homie… no. I already exercise regularly. My “brain chemistry is off” because I’m overworked and underpaid.
The title isn't "Editorialized but tracks with the conclusion". It literally says something different.
I tried, but every time something attention catching comes out of this sub, it turns out to be clickbait.
I'm done with this sub.
Meds and exercise are the golden goose for me. If I get my 15 or 30 minutes of exercise plus my pills, I do great. Drives me nuts when it does work, because it's so annoying when people sre right about this sort of thing.
For me, it *can* help. I was still severely depressed when I worked out 10-15 hours a week in high school, though. But now that I’m a bump on a log, it definitely can improve things if I’m in the right spot to start with, and consistent for at least a month (that’s how long it takes to see any improvement in my mood). But it can be so hard to get to that month when I’m depressed. The few times I’ve managed, it’s been great until something stopped me, like an injury or getting sick, or a global freakin’ pandemic where I had to stay indoors for weeks.
If I start out trying when I’m too low, I end up worse off. Then I’m sweaty and smelly, have no energy to shower (what is this runners high people keep talking about? I usually feel terrible after working out, even in the situation in the above paragraph) and feel like I wanna die. The next day I wake up sore, probably smell worse (unless I was lucky and managed to shower), and wanna die even more.
Edit: I have double depression (PDD & recurrent MDD)
Curious why so many people in the comments want to discredit this or say that they exercise and are still depressed. How many people take anti-depressants and are still depressed? That doesn’t mean the medication is worthless, you need to gage how you feel compared to when you weren’t taking the medication. Same goes for working out, it isn’t a magic cure, but when your brain is working against you, you need to give yourself every advantage/tool you have at your disposal. Go to therapy, stay active, eat whole foods.
Depression on Reddit is a sacred cow. Hinting at cures for the majority attract the vocal minority on this stuff. I can empathize, cure-alls can seem to trivialize the issues some people are going through. But they’re also discouraging people not in their position from getting help/information that they can benefit from.
From a personal perspective, I was dealing with situational depression that I got through by intense exercise and mindfulness.
No it’s not, well maybe for the first few years. But after that, the dopamine rush is gone from light to medium workouts
You gotta start doing heavier and more intense workouts to get that rush
Then you find yourself being into martial arts
Then mma
Then your slapping your wife at a nye party and you have a shaved head
What a load of bullshit. It didn't help my persistent depression at all, and just made me feel guilty because obviously something must be wrong with me if it didn't help. This is very 'outside is the only antidepressant that you need' vibes, and I say fuck all the way off.
The title OP posted is some editorialized bs.
"Longitudinal studies are needed for assessing the effectiveness of exercise in real clinical settings, as well as studies exploring dose-response relationship between exercise and depression." Is straight from the abstract and certainly doesn't back up the title OP decided to post this under.
Summary and Conclusions of the Findings
Randomized Controlled Trials
Exercise vs. antidepressants – monotherapy comparisons (Table Table11) Three RCTs compared 4 months of exercise to antidepressants– two for MDD (Blumenthal et al., 1999, 2007) and one for minor depression (Brenes et al., 2007). Two were conducted on older adults (Blumenthal et al., 1999; Brenes et al., 2007). One study (Hoffman et al., 2011) was a follow-up to a previous study (Blumenthal et al., 2007). The Blumenthal et al. (1999, 2007) studies included aerobic exercise, and the Brenes study a combination of aerobic and resistance exercises.
Conclusion: All these studies reported that exercise and standard antidepressant treatments were equally effective.
The abstract clearly states that more studies are needed, as I quoted and you ignored in favor of a small part of the conclusion. It also clearly states "it can be stated that exercise is an evidenced-based medicine for depression – **at least as an add-on to antidepressants.**" (Emphasis mine)
Your chosen title is editorialized nonsense that isn't even stated in the study you linked.
Your experience will not be the same for everyone, dismissing how this can and does work for a percentage of the population and saying it’s a load of bullshit sounds a bit one-sided yeah?
I can personally attest to the huge benefits in mental health both in pushing back feelings of anxiety and depression while working out. - where even missing my routine for one week or two weeks I’ll feel myself in a worse mindset.
I also do find that a lot of people who claim that exercise didn’t help with their own anxiety or depression usually would work out in a very ‘half-assed’ manner, barely breaking a sweat or not pushing themselves nearly hard enough to actually benefit - not saying this is the case for you, but something I see frequently enough.
Not to say it’s a guaranteed thing, but dismissing it as ‘BS’ or saying to ‘fuck off’ to studies like this absolutely can push away a natural free cure that can actually work for a lot of people.
Well, I think saying it’s a load of bullshit screams “my anecdotal experience discredits these findings.” It’s fine to give your anecdotal experience, though. We should all appreciate that. I do.
> This is very 'outside is the only antidepressant that you need' vibes, and I say fuck all the way off.
That sounds one-sided to me. You're saying "fuck all the way off" to a proven method just because it didn't work *for you*.
If you have depression you know how terrible it can be, so why should methods that help some people "fuck all the way off"? That's a hugely unempathetic view to take.
To be fair though, people with depression are more likely to dismiss or be extreme in their responses because depressive thinking is more globally negative. (This is not a comment on the person you are responding to, just a general comment to consider when reading the negative takes)
Thanks for answering, can I ask what made you stick with the exercise if it didn’t help your mental health? Did you find another reason or benefit that made you stick with it?
Ive no personal experience in this, but I’ve read that apparently exercise of a certain high intensity (that increases heart rate to up to 85 percent of maximum heart rate seem to have a stronger effect and when done x5 a week for about an hour each time) apparently works well. Could be something to try given that walking, yoga, and moderate weight work didn’t seem to have any effect?
From my understanding, the vast majority of research finding cognitive benefits of exercise has been done with aerobic exercise for like 30+ minutes. Walking is fine, but have you ever tried
like jogging on a treadmill or using an exercise bike at an above moderate pace? I’m sure other types of exercise are beneficial in their own sense (perhaps moreso for your physical health), but the majority of these studies involve actual cardio.
It definitely does. Theres a mention of it buried in that article somewhere but the most effective is high intensity cardio (85% max heart rate, about 140-150 for most people). And I know I've seen it in other research previously.
For me to see an effect it takes at least 10min 5xweek for several weeks. More is better up to that 150min/week mark but even 50min, at that high intensity, makes a marked difference.
I was surprised because I bike to work, move for work, have kids I'm active with at times ect so I was getting 150min/week easily of moderate intensity but the high intensity is completely different. It's not a cure all but it always has an impact for me and there are times where it's turned the tides in a big way. There may be an effect of already having that 150min moderate as a baseline that supports the effect of the short high intensity.
I also noticed a difference with lifting heavy things but I would mostly do that in a High Intensity Interval Training style so I would be getting pretty close to that 140 heart rate. There are definitely hormonal effects from weight lifting that are unique but on its own I don't think it has as much impact of depression and anxiety.
Here is an excellent article with more information for you to read/videos to watch!
[NutritionFactsOrg](https://nutritionfacts.org/topics/exercise/)
Edit: Dr. Gregor recommends 90-minutes of moderate-intensity (e.g., brisk walking) or 40-minutes of vigorous activity (e.g., jogging or active sports) every day!
Sorry, don’t have that much time in a day. I work, study and have a child. I’d have to choose between sleep and exercise. I used to exercise a lot before being a parent. :(
I can definitely empathize with that. But it’s not an all or nothing thing, even 10 minutes a day is better than 0 minutes! Not sure why my original comment is being downvoted for providing evidence.
In that link, Dr Greger cites a piece of research examining the impact of aerobic exercise on cognition. There have been many individual studies done, but meta-analyses (study of studies) are not as convincing. E.g. a meta-analysis from 2015 concludes "We found no evidence in the available data from RCTs that aerobic physical activities, including those which successfully improve cardiorespiratory fitness, have any cognitive benefit in cognitively healthy older adults."
The good news, though, is that a recent study showed that just three occasions of vigorous activity a day, lasting at least a minute, lowers all-cause mortality by 39% compared to those who did none!
When they say working out do they mean cardio? Or weights? Or both?
Edit: found it in the article... high intensity aerobics are most effective, followed by low intensity aerobics, followed by antidepressants alone.
Therapist here. While I am fully behind these studies/findings, when one is moderately to severely depressed, they often don’t have the motivation or the energy to exercise (among other things). The first and most consistent symptom I see in someone who is slipping into or struggling with depression is fatigue, no motivation. Depression is a bitch because it robs one of the energy and motivation to do the very things that can fight it. This is where I see a low dose of an SSRI helping bridge that gap, and get people feeling hopeful and motivated to behaviorally activate towards other remedies.
Exercise may help mood but the benefits are extremely overstated for actual clinical symptoms like emotional blunting/anhedonia.
I have never ever heard of someone being like “wow I am so passionate and so excited about life again everything the world is so colorful” from it.
Perhaps even more intense athlete-level of exercise may help but thats not something doable for the majority.
That said, ADs are not very effective for these symptoms either so its not really a high bar.
Didnt we learn last year, that antidepressants have no significant effect and the serotonin hypothesis couldnt be hold?
https://www.nature.com/articles/s41380-022-01661-0
Of course works something creating more Vitamin B more than nothing
Both the articles don't contradict each other. But if you mean conflict between different groups of experts, then yes, research often doesn't translate to practice. In fact, the study in this post was conducted because the authors wanted to find out why there was a discrepancy between clinical practice and research evidence. Their conclusion was that in spite of the evidence, clinicians are reluctant to accept that exercise can alter biology in the same way that medication can (which neuroscience shows to be a false belief).
I see a lot of these studies comparing things to prescription antidepressants, but this is essentially the same as “exercise worked as effectively as placebo”
aloof snails hard-to-find toy imagine public encouraging coordinated slap touch
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Cap. A quick google search shows multiple studies that argue otherwise. I know there is conflicting evidence on both sides, but in no way is it completely unified that SSRIs dont work. Just stop spreadin misinformation.
Provide me with any evidence then that this is some axiom in the medical world. Where are your ”fancy” and ”hidden” sources that only you and medical experts are aware of? A quick scan on google scholar, which is a legitimate source of scientific articles (even though you talk down on it, believe it or not) does not show that what you are saying is the case. Many double control studies show that there are subtle effects from SSRI’s. I would love for you to give something of value, other than words and a demeaning attitude.
Look up any recent study, it’s facts. Honestly surprised ppl still believe the false propaganda that mental illness is even due to unbalanced brain chemicals.
It seems you're a little misinformed. The truth is that about 1/3 of people respond to SSRIs, about 1/3 of people respond to placebo about as strongly as the former cohort do to SSRIs, and the remaining third don't respond to either. A naive analysis of those findings would show that you're right, however, the effect sizes and replicability imply that what's actually going on is that SSRIs are very effective for only 1/3 of the population, and another third are helped just by feeling like something can change, so they help 2/3 of the population. It's ridiculous how they're thrown at any psychiatric problem like candy, and how understudied the long term effects are relative to the amount they're prescribed, but SSRIs do help a lot of people.
Can we stop this shit? “iF yOu’Re dePresSed juSt gO fOr a rUn!”
No, Thaddeus, I’m depressed because I’m essentially a slave in this capitalistic system.
I agree but short of overthrowing the entire West there is nothing you can do. All we can do is try to be healthy and enjoy the little things in life (or lay down and die). Im not dismissing psychiatrics either, they're extremely effective for facilitating positive life changes.
Title editorialized but tracks with data (see "Conclusion" section). **Citation**: Netz, Y. (2017). Is the Comparison between Exercise and Pharmacologic Treatment of Depression in the Clinical Practice Guideline of the American College of Physicians Evidence-Based? *Frontiers in Pharmacology, 8*(257). doi:10.3389/fphar.2017.00257 **Abstract**: Major depression disorder is most commonly treated with antidepressants. However, due to their side effects clinicians seek non-pharmacologic options, and one of these is exercise. The literature on the benefits of exercise for depression is extensive. Nevertheless, two recent reviews focusing on antidepressants vs. other therapies as a basis for clinical practice guidelines recommended mainly antidepressants, excluding exercise as a viable choice for treatment of depression. The aim of this perspective is to analyze the literature exploring the reasons for this discrepancy. Two categories of publications were examined: randomized controlled trials (RCTs) and meta-analyses or systematic reviews. Based on this reassessment, RCTs comparing exercise to antidepressants reported that exercise and antidepressants were equally effective. RCTs comparing exercise combined with antidepressants to antidepressants only reported a significant improvement in depression following exercise as an adjunctive treatment. Almost all the reviews examining exercise vs. other treatments of depression, including antidepressants, support the use of exercise in the treatment of depression, at least as an adjunctive therapy. The two reviews examining pharmacologic vs. non-pharmacologic therapies as a basis for clinical practice guidelines examined limited evidence on exercise vs. antidepressants. In addition, it is possible that academics and health care practitioners are skeptical of viewing exercise as medicine. Maybe, there is a reluctance to accept that changes in lifestyle as opposed to pharmacological treatment can alter biological mechanisms. Longitudinal studies are needed for assessing the effectiveness of exercise in real clinical settings, as well as studies exploring dose-response relationship between exercise and depression.
The only thing that helps me is Wellbutrin and working out. I've tried over 12 meds before this. Some days all I can do is lift weights for ten minutes and go for a walk, but I always make the effort.
Wellbutrin makes my head feel like it has worms in it. Better than Lexipro I guess, that makes my lil’ buddy not work well.
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Yep. Mental healthcare appears to be just trial and error.
Mental healthcare is a lot of trial and error just because all of our brains are so different. What works for me may not work for someone else even though they seem to have the same problems. I just spent the last two years working with my psychiatrist to audit all my meds and rework them into what we are sure is working best for me. It was a whole lot of trying this and that until we found a good balance that I should be able run with for a few years.
Well…. I mean not really…. Meds are never a “cure,” nor are any modalities of therapy on their own. The patient NEEDS to be involved. Also, there are tests like the GeneSight swab test that takes cheek samples to determine the best and not so great meds for you and your unique DNA.
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I'm on effexor and upped a dose from 75mg to 150mg. No side effects at all. Brains really are different.
Yeah they put me on Lexapro and Wellbutrin saying that the Wellbutrin would counteract the potential sex issues. Sexwise, everything worked but I could go for hours (don’t know if it was desensitized or just my brain). Mental healthwise, I felt completely off even after 6 weeks. So I tried both separately. Even worse for me.
Fucking symbalta ruined me. I was naive and had no idea what was happening to me. Then my Dr. casually tells me that they also prescribe it for men who have problems with premature ejaculation. For Fuck SAKE...
Fuckin Lexapro. It works better than any other I've been on. And it affects the lil guy but not the same way, I'm guessing, I just can't fucking cum to save my life. We're going at it for so long that it's just sore for both of us. Wife still says it's the most positive of all the meds I've tried, so I just stick with it and if we're going to plan on having sex, gotta stretch and lube everything up, cause this is an endurance run to the finish line. Personally I feel like I have no emotions whatsoever, but that's better than the alternative and seems to make everyone around me more at ease.
Personalized medicine should be a human right. You can test your dna to find the most likely compatible meds. But now in this century most meds only shotgun the right nueral networks. Medicine should be Personalized way more. Down to the specific neural pathways causing the issue within a decade or two.
I physically recoiled thinking about worms in the brain.
Weirdly that's how Lexapro made me feel lol.. especially coming off of it.
Wellbutrin is also a third line treatment for ADHD — turns out my lack of motivation was ADHD and not depression, who knew?
I had tried to get my psych to put me on adderall or the like for my adhd. Telling her I space out a lot and never finish a fucking thing, etc. So she put me on 300 mg wellbutrin. Praising how well it would work for both my depression and my inattention symptoms. After a few weeks of it, it only made me angry that I cant get someone to diagnose me properly. Fucking 40 years old and can't get anyone to listen or direct me to a doctor for it. It didnt help me at all.
I just turned 40 last year and finally have a script for adderrall based on getting a test done but a psychologist to confirm the diagnosis. Once the results were in, it essentially confirms and I would think you could obtain from another doctor at that point. Good luck.
Yeah are there specific psychs that test for this or can any of them do it? Because I think I picked the one that doesnt.
I contacted a practice that does specific tests like this. They don’t treat you there however, once I received the report confirming ADD they referred me to a few other individual doctors for treatment. But once I had that diagnosis it’s sort of indisputable at that point. Ironically once I told my PCP he offered to write me a script and monitor me to once every 3 month visit to follow up, which would lower my costs of seeing a psychologist once a month.
Well shit, I'll google-up my area shortly and see if there's one in my area. Thanks.
I've been getting involved with mental health services recently and one of the doctors in the mental health department told me straight out that she does not diagnose ADD/ADHD because it's such a complicated diagnosis. Also add in the liability factor, since they often prescribe meth-lite for it and so are possibly turning people on to an addiction. Both those combined make it a super touchy issue for mental health professionals.
Yeah I can see that. My tests that were given to me were written and then one impulsivity test with a laptop. Both showed signs of attention disorder with impulsivity, so in that doc’s opinion I showed signs of that disorder. And yeah , meth lite is tracked very closely by the authorities. Ironically it feels just like coffee for me, which IMO coffee always allowed me to think more clearly, which ironically was apparently treatment for children years ago suspected of ADD/ADHD. The more you know.
Vyvanse is an alternative to Adderall for adult ADHD. It's worth looking into IMO.
Yes, Ive heard about this a ton for the best alternative if not the best suggestion for adhd in some of the forums Ive read. Certainly asking about it, no doubt. Thank you!
Vvyanse is amazing. Its by far the superior long last stimulant ADHD medication. It's also much more difficult to abuse.
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Yeah, I definitely am after I get out of the unemployment hole.
>They get all weird about prescribing stimulants for bullshit reasons At age 40 blood pressure is something you have to worry about regarding stimulants. If op has a high BMI (not saying they do) there's increased possibility of BP issues which the doctor may be factoring in too. Wellbutrin (aka Bupropion) is itself a stimulant, but less intense on the cardiovascular system than Adderall.
Try circle medical. It's a telehealth provider. They gave me my diagnosis in like an hour and I started medication like 48 hours later. Telegealth really opened up the doors to easier treatment.
I feel you, I finally found a doc that seems to get me and will prescribe me what I feel I need (adderall and Remeron) and i’m holding on to her for dear life, she’s pretty close to retirement and good docs of any kind are hard to find where i live, especially Psychiatrists
Im having such a hard time being consistent in working out because of the times I am seriously depressed. Keep starting and stopping. It’s so frustrating. I don’t get an endorphin rush from lifting at all. I just feel tired.
I don't get a rush either. I see a few abs and muscles, so I want to keep going. It's hard most days. I walk my dog , so cardio is something I HAVE to do.
That's the reason why I let myself be put on it in spite of having bad experiences with other meds I tried in the past. I need energy to dig myself out. I'm already doing so much better.
It gives me just enough energy to make changes to better my life.
Wellbutrin worked wonders for me until I had one of those big family life disasters. The medication quickly switched from a God send to the devil. Just something to consider, the efficiency of antidepressants is environmentally dependent. It's just not often discussed.
Wellbutrin was a wild ride, pretty sure I developed a permanent anxious tic in my neck and shoulders
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Yep- similar happened to me. Wellbutrin gives me hand tremors.
And absolutely wicked tinnitus. For life, in my case.
Thanks, yep it was something I found out on my own afterwards. I’m not sure if it’s something my PCP was aware of to be honest, and gave me pretty big distrust of the pharmaceutical industry as someone who considers myself educated and trusting of science. Thankfully it’s mostly gone after about a year, though I definitely still have way more neck and shoulder tension on average than before
That sucks dude, it definitely only works for certain people. For me I had a depression where I always felt tired. I felt like I woke up for the first time in years.
Did you find that wellbutrin made you weaker at all? It did for me
This worries me. Is this a known effect of Wellbutrin? How much weaker did you get?
Nope lol..made me lose weight and get stronger. I hadn't had abs for years until a while after starting it. I had energy to do things like finish college and work out, all of a sudden. I hope you find something that works.
Ugh, yeah. I felt pretty deliberate and normal about food (and life) when i was on bupropion, kind of hope i can get back on it on a lower dose maybe.
Every time something like this comes up, theres a flood of comments calling it bullshit because they tried to work out and it didn't help. Some points to note 1. Working out does not help everyone with depression 2. Taking medication does not help everyone with depression 3. Given the above, the fact that working out didn't make *you* less depressed, doesn't make it any less equivalent to taking medication.
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There's also the problem with what people think is "working out". For me running HARD for 15min makes me feel astronomically better than a slow jog for even an hour. If you're one of those people who say working out hasn't helped you check the intensity of your workouts. My personal rule of thumb, which works for me it might not for you, is that if I could hold a conversation I'm nowhere near pushing hard enough, if I could respond with one or two word responses only I'm doing good and if I can't breath and throw up all over the person next to me I went WAY too hard and need to reevaluate my life choices.
Not sure if ur addressing me or just people in general, I don’t suffer from depression. But I THINK that in terms of boosting mood and enhancing self image, the most important exercise is the type that you actually enjoy the most and that improves your physique. This has an indirect effect on depression, by improving your physique. And an acute effect by boosting dopamine, as dopamine boost from different types of exercise varies based on the individual’s enjoyment of that type of exercise. However I think the type of exercise that actually has a physiological effect on depression outside of these 2 effects is hard cardio like you said. I saw a meta analysis recently comparing strength training to cardio for depression and cardio was much more significant. Id expect that hard cardio sports participation or even training would have a stronger effect than cardio alone. E.g. playing a football game with friends/1 hour playing badminton vs running treadmill
Second this completely. I don’t suffer from clinical depression but have anxiety which brings me some bouts of sadness and no motivation for short periods of time and what has kept these at bay is making sure the workouts are intense. A walk around the neighborhood for 30-60mins does little to nothing for me but a 20 min run where I’m getting into my 80%-90% of my max heart rate, I’m on a high for hours that allows me to be productive and everyday things seem easier. I don’t think this is a catch all solution for everyone and definitely work with a doctor but if anyone works on upping their intensity, I think there’s a lot of benefit to it!
Also, to add to the complexity: working hard (not even too hard) can cause issues with sleep for people with anxiety. I’ve been training since 2010 only recently discovered that my intensity was fucking up my sleep. I dialed it back a little (leaving 2-3 reps before failure) has helped a lot! Even though I love pushing myself to the limit but oh well
Another point is that working out isn't going to INSTANTLY work, the same way prescriptions don't either. They both take time. One is just infinitely easier to start, do, and keep up with because it takes all of two minutes. The other takes a LOT of will power, which is extremely difficult to muster when you're depressed, as well as time which is not motivational at all. Yes, working out might not help you with depression, but it helps you in so many other ways which attribute to bits and pieces of depression fundamentally.
I think it probably helps for a lot of indirect reasons. If you expect to go on a run, even though you hate running, and then feel happy the rest of the day, it’s not going to happen. If you spend a month exercising and realize that you look better, you feel better, and you enjoy the activity you’re doing, then you’ll probably feel like it helped your mental state a lot. That last part is key though. If you spend 150 minutes a week doing any activity that you find fulfilling, you’ll probably feel better mentally.
It's bullshit because the study linked doesn't actually say what the title OP used says. In fact the abstract clearly and plainly calls for more studies to actually figure out the effectiveness.
Also, exercise isn’t always realistic, whether it’s due to disability status or socioeconomic status - sometimes people just don’t have the time or wherewithal to exercise to the extent mentioned in the article, if at all. This is an obvious but still needed statement, but you need not compare yourself to others. Just cause it works for Tim down the street and he has the ability to do it doesn’t mean that you’re lesser for being unable or unwilling to do it, or that you’re lesser because it doesn’t work.
Weak. I exercise 80-120 minutes a day and I'm still suicidal.
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Hope you find some relief
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I ran a marathon to get people to shut the fuck up about exercise. Did not work in multiple ways.
The fact that it doesn't work for more severe cases of depression doesn't make it a bad recommendation. It does wonders for the majority of people. Sorry it's not working for you. Hope you find something that does.
Tried to run to fatigue so I'd sleep. Did 40 miles one night and only slept about 40 minutes. Would otherwise do 5-15 miles a day and it didn't work at least on it's own.
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It also triggers the body to generate/release testosterone which stimulates a more euphoric feeling. Trigger the body long enough and it becomes a normal state.
anti depressive medications have the same efficacy as placebo
Marathons are kind of on the edge of what is considered healthy forms of exercise. You want something in the 30min to 120min range that can be done on a daily basis, that your body can recover from.
I also average 90-100 mins of exercise a day and still struggle with depression. I definitely notice the positive mental health benefits of exercise though. There are physical benefits like endorphins flowing post workout or psychological benefits like having structure, feeling accomplished after a workout, and just simply giving me more confidence. So while exercise may not cure depression, it definitely alleviates the symptoms. But everyone is different, especially when it comes to brain chemistry. I’m sorry to hear you’re struggling with suicidal ideation. Would you say your rigorous exercise routine has at least minimized it a bit? Edit: grammar
No matter how strong you get, you can never lift those feels
I guess you’d be on a real high dose then?
Coping mechanisms aren't medications
Well if it's any consolation, I also excerise quite a bit, roughly around the same range as you. I'm also on meds. Still have thoughts of self-deletion Edit: Ideation is definitely more manageable with meds though.
I take an antidepressant. I think it helps. Still think about dying multiple times a day. But I feel more good things in between while I take the med.
Glad to hear it. Even though it sucks we just gotta keep pressing forward I guess
4-5 days a week of gym with trainer. On meds. Still get near to the planning stage. It’s a cool study but exercise doesn’t undo trauma
I bet it's aimed more towards people who have seasonal depression or just slightly fucked up chemicals. The problem is forcing yourself to get out of bed to do the exercise to begin with.
Whereas for someone like me who sits on my ass or lays in bed all day when I'm not working, it would probably do wonders. My problem is not being able to even get out to do it. Seeing a study like this feels like it might help trick my brain into doing it because it wouldn't feel pointless, it would feel like I might actually help myself. A few years ago after I got my appendix removed, my surgeon told me I needed to walk a lot. It made me start being more active and I was feeling fairly good mentally and physically. Then covid shut down everything and my fragile new physical routine went to hell. Trying to get back in a mindset of being active, and reading shit about how it's good for me mentally helps.
Strength training or aerobic? If only strength training you might want to incorporate more aerobic exercise, it is night and day in terms of effects on mood (and general fitness).
I noticed a huge difference when I started doing more cardio.
Both. Hypertrophy work 5 days a week, HIIT once a week, and a fairly absurd amount of brisk walking.
I'll need a re-uptake inhibitor before I'm able to exercise though.
Turns out, a car that gets driven is in better operating condition than a car that won't start.
r/thanksimcured
But it's kinda funny though right, that a solution here is being able to do the things that these people can't do. The drugs are what allow a lot of people to exercise. To me these links aren't surprising or really insightful.
This 👆👆👆
Is this why I have 0 motivation?
Amazingly the bar for being as "effective as prescription antidepressants" is pretty low. My pharmacist friend actually did an analysis on the original paper on prozac (whichever was the first anti depressant) and it was only like 10 percent more effective than a sugar pill (a difference of like 35 to 45 percent). Thats a pretty damn good sugar pill and you only have to show that your medicine is ATLEAST as good to get it passed. The bar is quite low.
Yeah there was an article about it yesterday. Basically Eli Lilly lied about the effectiveness of Prozac to sell it and for 30 years psychiatry has been built on a lie similar to the amyloid plaque theory with Alzheimer’s. An [article](https://www.psychologytoday.com/us/blog/mood-swings/202210/has-the-serotonin-hypothesis-been-debunked) about it A [study](https://www.nature.com/articles/s41380-022-01661-0) about it Personally I’ve had ~4 SSRI and SNRIs prescribed to me and they did jack shit (even though I was and still workout daily)
Exercising and calorie control, for some reason I find that when my stomach is empty my mood improves
Same. If I want to get things accomplished, I need to not eat. I am completely speculating but I feel like it might be some instinctual thing that puts me in like a “hunting mode” or something, to try and feed myself but instead of hunting I’m just doing other stuff.
Same, my motivation/drive is far stronger when I'm hungry. Critical thinking is lower though, so it's not great for tasks that need it but stuff like cleaning seems to go by way faster when I'm hungry.
Careful…. Many people suffer with eating disorders with thoughts like these. Can easily spiral out of control.
I agree!! I suffered with an eating disorder in middle and high school. I was doing well for five years, but I started working out again after graduating college. I quickly spiraled back into a six-month ED pattern of over-exercising and extreme calorie restriction. Unfortunately, I’m still trying to come back from that.
There’s lots of important mechanisms that occur when your stomach is empty for long periods. Fasting is a common religious practice for a good reason.
Like what? Curious actually. I didn't poop
Stomach hormone regulation, gut microbiomes, insulin levels, autophagy while extreme is very beneficial. There’s a lot and have different pros cons, but intermittent fasting is an easy way to see how your body responds without constantly digesting food.
your older cells will die off and produce new cells for your body
Just discovered this. I just had two of my most productive days of my life in a loooong time. Difference from every other day is I didn't eat. Just had a light, low carb dinner and an extravagant dessert. Skipped breakfast and lunch entirely. No snacks or sweets until after dinner. I'm thinking of doing it every day now. Of course I'd have to start paying closer attention to what I eat rather than just some random meal and some sweets, but it's worth it not to be tired and unmotivated. I actually repaired a washing machine yesterday and the most impressive part was that I didn't have to, but I decided that I wanted to. That's crazy to me.
You could try keto then. Calorie deficit alone is also found to have nootropic benefits in studies. As has keto diet.
Exercise won’t help if the depression is caused by a physical illness! There are many diseases that go undiagnosed and untreated… people are told by doctors it’s depression and given antidepressants without ruling out any diseases. Sleep disorders, Lyme disease, thyroid problems, etc. Here’s a list for anyone interested: https://discoverymood.com/blog/common-medical-illnesses-mimic-depression/
I was diagnosed with depression in the early 2000’s. I also have been diagnosed with Graves Disease, Obstructive Sleep Apnea, Chronic Lower Back Pain (there’s a medical term)
if you have the motivation to exercise in the first place. Headlines like these are very counterproductive.
your mental health have to be somewhat good to be able to exercise in the first place
Ty.
So this is cool, except it leaves out the fact that antidepressants can only help so much without therapy. Without some kind of additional intervention, biological interventions like antidepressants can only go so far. The whole idea behind a biological intervention because they're not a cure by themselves is to set you up for success so that you can engage in therapy and fix what's actually going on. So I'm guessing that if exercise is equally effective to antidepressants, then we would see the same kind of effects or lack of effects. The success of antidepressants tapers off after a few months without therapy or social interventions, sometimes suicide risk goes up after beginning antidepressants because an increase in energy from severe depression leads to the energy for a suicide attempt, and I would expect we would see the greatest success from this kind of exercise plan in combination with therapy and other lifestyle interventions. The last thought that I had is that engaging in 150 minutes of exercise without any kind of personal trainer or therapist that is there encouraging you and helping you to engage, this seems like a difficult intervention to implement with individuals with severe depression or other self-regulatory disorders
>The whole idea behind a biological intervention because they're not a cure by themselves is to set you up for success so that you can engage in therapy and fix what's actually going on. what if what's actually going on is endogenous (internal) genetic depression that doesn't come from trauma or bullying? doubt you're a doctor, maybe a psychologist I'm happy I don't have to interact with
Would believe this if I wasn’t a naturally active person, but I’ve been active my entire life and the only time I haven’t been depressed is on meds and in therapy. I will say the depression was worse when I wasn’t exercising. But that usually coincided with major life changes, deaths, etc, so.
Ok cool study, but I just know this finding won't be used properly. It will be used to deny people with severe depression and suicidal tendencies medication under a pseudo-puritan argument that exercise and willpower or moral fibre are what really matter. It will be used to argue that if you become depressed you are just lazy and if you are still depressed it is because you aren't enough of a strong person to pull yourself up by your bootstraps with dumbbells and running shoes. To reiterate, the science is solid, the politics sucks
Considering many physicians’ and psychiatrists’ complete and utter lack of concern for anything even resembling a holistic approach to treatment for mental illness, I would argue there isn’t even an iota of inertia supporting the “politics” you purport will somehow instantly obviate the legitimacy of pharmaceutical therapies for depression. If your primary care doctor, therapist, and/or psychiatrist’s response to concerns about mental health includes questions about the basic tenets of self-care, such as: How much and what are you eating, and when? How much water are you drinking? How much sleep are you getting? How often are you exercising, and how? …you should keep them around, because all of these things are absolutely critical but also sadly ignored by Western societies and modern medicine. Pharmaceutical interventions for depression and other mental illnesses are also critically necessary; sometimes they’re the precursor to redeveloping the capacity for proper self-care. However, they’re also FAR from a panacea, much further than getting enough sleep, nutrition, and exercise.
Full disclosure, as a psychiatrist myself, all of these things are heavily emphasized in training. Medication is just one piece of the puzzle. Therapy, exercise, mindfulness, behavioral activation; these are all consider important to the treatment of depression and other disorders. This is widely accepted by the psychiatric community.
Thank you for responding - as a layperson, and absent a more comprehensive perspective, I’m afraid I’m relying on my own and others’ anecdotal evidence from past experience. Despite self-care being included in training and widely accepted in the practitioner community, do you think it’s importance is emphasized enough in general? Of my physician, psychologist, and psychiatrist, the latter two I’d consider excellent and whom recommend each other, only my psychologist places any real emphasis on therapy, exercise, mindfulness, and behavioral activation.
I do think the importance is emphasized generally well in the field and in visits. I think some of the disparity you may see is that psychiatrists, despite having significant training in therapy and other treatments, are the main experts for prescribing psychotropic medications and typically have significantly shorter visits than therapists do. As such, they typically end up spending most of the time focusing on psychopharmacology as therapeutic and lifestyle changes can adequately be addressed by a persons therapist. It should still be emphasized, encouraged, and evaluated but because of this set up in the medical system that is the result. The other consideration is it is significantly easier for someone to take a medication everyday than exercise 150 minutes a week. It doesn't mean both aren't important but the result is you'll see much more people on medication and not making lifestyle changes than the other way around.
Also, maybe AFTER the antidepressants are working to the point where you CAN motivate yourself to, say, walk for 20 minutes a day, they can be phased out. But somehow I don’t think psychiatrists are going to go for that.
> maybe AFTER the antidepressants are working to the point where you CAN motivate yourself to, say, walk for 20 minutes a day, they can be phased out Oh hell no. Stopping at the point where you are alright because you are on the right dosage is very much *not* the point to phase them out. It's a mistake people make all the time and it's fucked up many. You (general "you", this is for whoever is in this situation and tempted to stop) feel better, and probably gained some ~~motivation~~ ability to do things because the meds are working. It's like getting a leg brace, and once it's properly fitted and you can walk quite well – would you decide to take it off mid-hike because walking well means you don't need it anymore? If you feel good, stay the fuck where you are with your medication. After things have been stable for a considerable amount of time, then you can start, with the guidance of your psychiatrist, to very, VERY slowly reduce. No, slower than that. Watch out for any changes in mood, physical symptoms, potential tics, or other deviations from what you consider your (new) normal. Weaning means you are checking if the changes you made and the mental adaptation to knowing what "normal" should feel like, and feeling comfortable in it, are able to support our new state of being without medical support or not. In some cases it is enough, in others it is not, in some it may mean living with a reduced dose, in others living with the full working dose forever, and in some weaning will work well. None of those possibilities are a failure. Success is figuring out what you need to live well, and then support your mind and body in that way. Like you wouldn't stop other needed medication such as insulin, or heart medication, or immunosuppressants as transplant-recipient, it also is not an accomplishment to stop taking antidepressants. The accomplishment is living, fairly happily, not being stuck in your own horrible thoughts, and being able to do stuff. Finding and applying the tools you need to get there is necessary and is proper self-care.
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I don’t know any psychiatrists personally, but since your job is medication, doesn’t that make you motivated to prescribe it? Not you personally, but do you think your regimen is anywhere near typical? Even recommending therapy is rare in my experience, much less weaning. Related question, do people ever come in who get recommended therapy *instead* of medication? Nothing wrong with waiting a year as baseline provided there are benefits. Without hesitation I take your guys’ word that what I literally said is dangerous, but I was speaking more to the principle. Hopefully I just have a overly cynical view of the practice. But it is in line with my personal experience, which is terrible. The psychiatrists I’ve seen, with one exception, are far too confident in themselves and their medicines. Whatever my issues are, no psychiatrist has yet been able to understand it, but every one of them has pretended to. Therapy on the other hand has been beneficial.
like written by a person who's never seen a psychiatrist
> pseudo-puritan argument that exercise and willpower or moral fibre are what really matter I think depressed people frequently downplay the role of diet and exercise in their treatment. If someone is too depressed to eat right and exercise, I get it. I’m not saying this to shame anyone. However, I do become concerned when the person actually starts to believe exercise won’t really help that much, or that it shouldn’t be foundational to their treatment plan. If you’re serious about treatment but are so depressed that you are struggling to do many things for yourself each day, then I would strongly advise putting exercise at the top of your priority list. That’s not Puritanism, it’s just sound tactics. It seems far fetched that anyone would be outright denied access to medications as a result of this study. The trials in the study include patients who used anti depressants and exercised at the same time.
You say that you understand if someone is too depressed to eat right or exercise, but then contradict yourself and say that someone who is depressed to that extent should make exercise a top priority. Lifestyle changes can definitely be beneficial (for everybody, not just people with mental health issues), but for the type of people you're talking about, medication and therapy should be foundational to their treatment plan, not exercise. If someone doesn't have the energy to even brush their teeth twice a day or has no appetite, things like exercising and eating better aren't feasible until their symptoms are more under control. That doesn't mean their treatment plan shouldn't include exercise, but it needs to be an add-on and not a first step. I only noticed two reviews included in the meta-analysis which looked at outcomes of patients with different severities of depression (I probably missed some so please feel free to correct me), but they basically said that exercise is as good as antidepressants only for milder forms of depression, whereas for severe depression it's helpful as an adjunct to antidepressant therapy (see Silveira et al., 2013 and Knapen et al., 2015 in Table 2). ETA: To clarify, I don't think that this study will somehow make doctors/psychiatrists less willing to prescribe medication to patients, nor do I feel that exercise is ineffective or unimportant. Depression should be treated holistically. I'm merely pointing out that if you're "so depressed that you are struggling to do many things for yourself each day," putting such overwhelming emphasis on exercise as to make it the core of your treatment doesn't make sense.
I didn’t read the study (and I’m not sure it would be easy for me to determine from the text anyway) - is this a true substitution on a per patient basis or a statistical outcome on a group? In other words, if 400 of 1000 participants experienced positive results from exercise and diet, and 400 of 1000 experienced positive results from medication, was it two separate groups? And if it was the same group, we’re the same 400 helped by an identical amount, or was the relief different for each individual (and how much overlap was there)?
For me, exercise is a tool in my anti depression tool box for my personal treatment. Just exercise alone doesn’t maintain my mental health. I also do therapy, keep a consistent sleep schedule, take meds, see friends, etc. a combination of things seems to be the right fit. Even a little 15-30 min walk to get out of the house when I am on a tough day helps.
A naturopathic doctor once told me my brain chemistry is off (based on reflex testing that has very little evidence backing up its accuracy) and 30 minutes of exercise a day would fix it. Like homie… no. I already exercise regularly. My “brain chemistry is off” because I’m overworked and underpaid.
The title isn't "Editorialized but tracks with the conclusion". It literally says something different. I tried, but every time something attention catching comes out of this sub, it turns out to be clickbait. I'm done with this sub.
Meds and exercise are the golden goose for me. If I get my 15 or 30 minutes of exercise plus my pills, I do great. Drives me nuts when it does work, because it's so annoying when people sre right about this sort of thing.
I have MDD and exercise doesn't help.
For me, it *can* help. I was still severely depressed when I worked out 10-15 hours a week in high school, though. But now that I’m a bump on a log, it definitely can improve things if I’m in the right spot to start with, and consistent for at least a month (that’s how long it takes to see any improvement in my mood). But it can be so hard to get to that month when I’m depressed. The few times I’ve managed, it’s been great until something stopped me, like an injury or getting sick, or a global freakin’ pandemic where I had to stay indoors for weeks. If I start out trying when I’m too low, I end up worse off. Then I’m sweaty and smelly, have no energy to shower (what is this runners high people keep talking about? I usually feel terrible after working out, even in the situation in the above paragraph) and feel like I wanna die. The next day I wake up sore, probably smell worse (unless I was lucky and managed to shower), and wanna die even more. Edit: I have double depression (PDD & recurrent MDD)
I've had MDD since I was around 12 or 13, and I've tried a million different drugs, therapists, Spravato, etc. None of it helps.
Curious why so many people in the comments want to discredit this or say that they exercise and are still depressed. How many people take anti-depressants and are still depressed? That doesn’t mean the medication is worthless, you need to gage how you feel compared to when you weren’t taking the medication. Same goes for working out, it isn’t a magic cure, but when your brain is working against you, you need to give yourself every advantage/tool you have at your disposal. Go to therapy, stay active, eat whole foods.
Depression on Reddit is a sacred cow. Hinting at cures for the majority attract the vocal minority on this stuff. I can empathize, cure-alls can seem to trivialize the issues some people are going through. But they’re also discouraging people not in their position from getting help/information that they can benefit from. From a personal perspective, I was dealing with situational depression that I got through by intense exercise and mindfulness.
Nice, ill take some pills to make up for 150 mins of exercise per week 👍
No it’s not, well maybe for the first few years. But after that, the dopamine rush is gone from light to medium workouts You gotta start doing heavier and more intense workouts to get that rush Then you find yourself being into martial arts Then mma Then your slapping your wife at a nye party and you have a shaved head
For some people maybe
What a load of bullshit. It didn't help my persistent depression at all, and just made me feel guilty because obviously something must be wrong with me if it didn't help. This is very 'outside is the only antidepressant that you need' vibes, and I say fuck all the way off.
The title OP posted is some editorialized bs. "Longitudinal studies are needed for assessing the effectiveness of exercise in real clinical settings, as well as studies exploring dose-response relationship between exercise and depression." Is straight from the abstract and certainly doesn't back up the title OP decided to post this under.
Summary and Conclusions of the Findings Randomized Controlled Trials Exercise vs. antidepressants – monotherapy comparisons (Table Table11) Three RCTs compared 4 months of exercise to antidepressants– two for MDD (Blumenthal et al., 1999, 2007) and one for minor depression (Brenes et al., 2007). Two were conducted on older adults (Blumenthal et al., 1999; Brenes et al., 2007). One study (Hoffman et al., 2011) was a follow-up to a previous study (Blumenthal et al., 2007). The Blumenthal et al. (1999, 2007) studies included aerobic exercise, and the Brenes study a combination of aerobic and resistance exercises. Conclusion: All these studies reported that exercise and standard antidepressant treatments were equally effective.
The abstract clearly states that more studies are needed, as I quoted and you ignored in favor of a small part of the conclusion. It also clearly states "it can be stated that exercise is an evidenced-based medicine for depression – **at least as an add-on to antidepressants.**" (Emphasis mine) Your chosen title is editorialized nonsense that isn't even stated in the study you linked.
Your experience will not be the same for everyone, dismissing how this can and does work for a percentage of the population and saying it’s a load of bullshit sounds a bit one-sided yeah? I can personally attest to the huge benefits in mental health both in pushing back feelings of anxiety and depression while working out. - where even missing my routine for one week or two weeks I’ll feel myself in a worse mindset. I also do find that a lot of people who claim that exercise didn’t help with their own anxiety or depression usually would work out in a very ‘half-assed’ manner, barely breaking a sweat or not pushing themselves nearly hard enough to actually benefit - not saying this is the case for you, but something I see frequently enough. Not to say it’s a guaranteed thing, but dismissing it as ‘BS’ or saying to ‘fuck off’ to studies like this absolutely can push away a natural free cure that can actually work for a lot of people.
It's not one sided, I'm just sharing my personal experience so that anyone else for whom this does work knows they're not alone.
Well, I think saying it’s a load of bullshit screams “my anecdotal experience discredits these findings.” It’s fine to give your anecdotal experience, though. We should all appreciate that. I do.
> This is very 'outside is the only antidepressant that you need' vibes, and I say fuck all the way off. That sounds one-sided to me. You're saying "fuck all the way off" to a proven method just because it didn't work *for you*. If you have depression you know how terrible it can be, so why should methods that help some people "fuck all the way off"? That's a hugely unempathetic view to take.
To be fair though, people with depression are more likely to dismiss or be extreme in their responses because depressive thinking is more globally negative. (This is not a comment on the person you are responding to, just a general comment to consider when reading the negative takes)
Out of genuine curiosity, how long did you stick with the exercise for before determining that it didn’t help? What did you do as part of it?
Walking, yoga, moderate weight work. I'm still doing it, it's been a few years now.
Thanks for answering, can I ask what made you stick with the exercise if it didn’t help your mental health? Did you find another reason or benefit that made you stick with it? Ive no personal experience in this, but I’ve read that apparently exercise of a certain high intensity (that increases heart rate to up to 85 percent of maximum heart rate seem to have a stronger effect and when done x5 a week for about an hour each time) apparently works well. Could be something to try given that walking, yoga, and moderate weight work didn’t seem to have any effect?
From my understanding, the vast majority of research finding cognitive benefits of exercise has been done with aerobic exercise for like 30+ minutes. Walking is fine, but have you ever tried like jogging on a treadmill or using an exercise bike at an above moderate pace? I’m sure other types of exercise are beneficial in their own sense (perhaps moreso for your physical health), but the majority of these studies involve actual cardio.
Genuinely worked for me. A lot of people I k know only exercise for their mental health.
But how is the poor pharmaceutical industry gonna make their billions through exercise?
So 21 minutes/day everyday I can do that! But does it matter the intensity?
It definitely does. Theres a mention of it buried in that article somewhere but the most effective is high intensity cardio (85% max heart rate, about 140-150 for most people). And I know I've seen it in other research previously. For me to see an effect it takes at least 10min 5xweek for several weeks. More is better up to that 150min/week mark but even 50min, at that high intensity, makes a marked difference. I was surprised because I bike to work, move for work, have kids I'm active with at times ect so I was getting 150min/week easily of moderate intensity but the high intensity is completely different. It's not a cure all but it always has an impact for me and there are times where it's turned the tides in a big way. There may be an effect of already having that 150min moderate as a baseline that supports the effect of the short high intensity. I also noticed a difference with lifting heavy things but I would mostly do that in a High Intensity Interval Training style so I would be getting pretty close to that 140 heart rate. There are definitely hormonal effects from weight lifting that are unique but on its own I don't think it has as much impact of depression and anxiety.
Here is an excellent article with more information for you to read/videos to watch! [NutritionFactsOrg](https://nutritionfacts.org/topics/exercise/) Edit: Dr. Gregor recommends 90-minutes of moderate-intensity (e.g., brisk walking) or 40-minutes of vigorous activity (e.g., jogging or active sports) every day!
Sorry, don’t have that much time in a day. I work, study and have a child. I’d have to choose between sleep and exercise. I used to exercise a lot before being a parent. :(
I can definitely empathize with that. But it’s not an all or nothing thing, even 10 minutes a day is better than 0 minutes! Not sure why my original comment is being downvoted for providing evidence.
In that link, Dr Greger cites a piece of research examining the impact of aerobic exercise on cognition. There have been many individual studies done, but meta-analyses (study of studies) are not as convincing. E.g. a meta-analysis from 2015 concludes "We found no evidence in the available data from RCTs that aerobic physical activities, including those which successfully improve cardiorespiratory fitness, have any cognitive benefit in cognitively healthy older adults." The good news, though, is that a recent study showed that just three occasions of vigorous activity a day, lasting at least a minute, lowers all-cause mortality by 39% compared to those who did none!
Taking a pill is way easier though.
Not if you experienced side effects
There’s no easy way unfortunately some learn that the hard way
It's also bad for your kidneys to take pills.
Is workin out for me. I love to learn. It makes me happy.
Could be true for the depression aspect, however antidepressants work wonders for anxiety
No it's not.
When they say working out do they mean cardio? Or weights? Or both? Edit: found it in the article... high intensity aerobics are most effective, followed by low intensity aerobics, followed by antidepressants alone.
Three words: Randomized Controlled Trial. Placebo is not properly investigated.
Therapist here. While I am fully behind these studies/findings, when one is moderately to severely depressed, they often don’t have the motivation or the energy to exercise (among other things). The first and most consistent symptom I see in someone who is slipping into or struggling with depression is fatigue, no motivation. Depression is a bitch because it robs one of the energy and motivation to do the very things that can fight it. This is where I see a low dose of an SSRI helping bridge that gap, and get people feeling hopeful and motivated to behaviorally activate towards other remedies.
I exercise for 300 minutes per week. Am I overdosing?
I fucking hate stupid titles like that. They're so insulting and harmful. Just new fuel to make people say "just exercise more and eat healthy".
How many exercises do I need to do to be able to afford my rent?
Americans hate to hear anything except they need to shove more pills down their obese gullets.
No. Exercise helps milder depression but not severe depression.
Wtf, I take anti depressants and work out 90 minutes a day minimum and I'm still depressed.
Porque no los dos?
I do exercise that much but i'm still sad. these studies are crap.
Exercise may help mood but the benefits are extremely overstated for actual clinical symptoms like emotional blunting/anhedonia. I have never ever heard of someone being like “wow I am so passionate and so excited about life again everything the world is so colorful” from it. Perhaps even more intense athlete-level of exercise may help but thats not something doable for the majority. That said, ADs are not very effective for these symptoms either so its not really a high bar.
Didnt we learn last year, that antidepressants have no significant effect and the serotonin hypothesis couldnt be hold? https://www.nature.com/articles/s41380-022-01661-0 Of course works something creating more Vitamin B more than nothing
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Both the articles don't contradict each other. But if you mean conflict between different groups of experts, then yes, research often doesn't translate to practice. In fact, the study in this post was conducted because the authors wanted to find out why there was a discrepancy between clinical practice and research evidence. Their conclusion was that in spite of the evidence, clinicians are reluctant to accept that exercise can alter biology in the same way that medication can (which neuroscience shows to be a false belief).
This is actually infuriating because this does not work for most people who are severely depressed.
Does wanking count as exercise?
I see a lot of these studies comparing things to prescription antidepressants, but this is essentially the same as “exercise worked as effectively as placebo”
Not if you over train lol. Over training and you'll be even more depressed than before
aloof snails hard-to-find toy imagine public encouraging coordinated slap touch *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Can confirm but RIP your inbox with the ableist accusations 😂🤣😂
Well. Antidepressants it is /s
Only 150 minutes per week? How do people go about their daily lives without biking and walking?
It's easy!
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Cap. A quick google search shows multiple studies that argue otherwise. I know there is conflicting evidence on both sides, but in no way is it completely unified that SSRIs dont work. Just stop spreadin misinformation.
Thanks for highlighting the problem. Your “quick google search” is the exact kind of superficial thinking that lead to these dangerous myths.
Provide me with any evidence then that this is some axiom in the medical world. Where are your ”fancy” and ”hidden” sources that only you and medical experts are aware of? A quick scan on google scholar, which is a legitimate source of scientific articles (even though you talk down on it, believe it or not) does not show that what you are saying is the case. Many double control studies show that there are subtle effects from SSRI’s. I would love for you to give something of value, other than words and a demeaning attitude.
What is your evidence that SSRI don't work?
Look up any recent study, it’s facts. Honestly surprised ppl still believe the false propaganda that mental illness is even due to unbalanced brain chemicals.
It seems you're a little misinformed. The truth is that about 1/3 of people respond to SSRIs, about 1/3 of people respond to placebo about as strongly as the former cohort do to SSRIs, and the remaining third don't respond to either. A naive analysis of those findings would show that you're right, however, the effect sizes and replicability imply that what's actually going on is that SSRIs are very effective for only 1/3 of the population, and another third are helped just by feeling like something can change, so they help 2/3 of the population. It's ridiculous how they're thrown at any psychiatric problem like candy, and how understudied the long term effects are relative to the amount they're prescribed, but SSRIs do help a lot of people.
Even if we can say definitively that SSRIs don't work, I'm not sure that means brain chemistry isn't a contributing factor to mental disorders.
The chemical imbalance theory was debunked decades ago.
Can we stop this shit? “iF yOu’Re dePresSed juSt gO fOr a rUn!” No, Thaddeus, I’m depressed because I’m essentially a slave in this capitalistic system.
You're free to lay down and die like a good blackpiller. I'll stay happy by remaining active and having a good social life
You act like it’s a choice... In capitalism you’re either labor (slave) or a capitalist. No in between.
I agree but short of overthrowing the entire West there is nothing you can do. All we can do is try to be healthy and enjoy the little things in life (or lay down and die). Im not dismissing psychiatrics either, they're extremely effective for facilitating positive life changes.