this post was submitted on 15 Feb 2024
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Exercise should be a “core treatment” for people with depression, academics have said, after a new study suggested that some forms of exercise were just as good as therapy and even better than anti-depressants.

Walking, jogging, yoga and strength training appeared to be more effective than other types of exercises, according to a major new analysis.

And the more vigorous the exercise, the better, according to a research team led by academics in Australia.

But even low intensity exercises such as walking and yoga had meaningful benefit.

The effect of exercise appeared superior to antidepressants, according to the study which has been published in The BMJ.

But when exercise was combined with antidepressants, this improved the effect of the drugs.

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[–] [email protected] 44 points 9 months ago (2 children)

After a couple of decades of people telling me exercise would help, I finally decided to try it last year. For 6 months, I did at least some form of exercise at least every other day which, coming from years of being completely sedentary, was quite a change. And at the end of all of that...nothing. I was in better shape of course, but I didn't feel any better, didn't have any more energy, and wasn't any less depressed. That's just one anecdote of course, but my point is that it really sucks seeing studies continually say exercise is the best thing we've got because if that's true then I am well and truly screwed lol

[–] [email protected] 20 points 9 months ago (2 children)

I'm in the same boat. I've tried almost everything; hiking, running, biking, swimming, climbing... All it ever gives me is sore muscles the days after, but apart from that it doesn't change my mood in any way. In fact, it usually frustrates me since I don't feel any perceived benefits, but it still costs me time, effort and pain. Doesn't help that I'm very sport-averse because of negative expeiences in my youth.

[–] [email protected] 16 points 9 months ago

I've been clinically diagnosed with depression and other fun stuff for nearly two decades now. Exercise is great as a stimulant to your emotional fortitude but it hasn't "fixed" shit for me like they said it would. "Here's a bottle of 60mg pills, give it a month to feel better". If I had a plank of wood every time I heard that after trying their holistic idea, I'd have built my own house to get away from this fucking dismal housing market.

However, I think our problems paint the picture for us: Mental health issues are treated more like chronic staph infections than the psychological trauma they are. Everyone's damage is so acutely unique to them, because it happened to them, so treatments need to be equally as personal. I don't have the source on me, so take my statement how you wish, but nearly half of all diagnosed Depressives are given drug-only treatments.

The solution is to expand therapeutic services to help more people (i.e. government programs to subsidize the cost of services to the psych practice) and only use medications as a short-term supplement during treatment. This would help those afflicted to reach the point they can do the more holistic approaches and wean off the drugs.

Then again, that doesn't get the pharmaceutical corporations paid... ¯\_(ツ)_/¯

On a more personal note, we also need better therapists. The ones I have must've had some shit they're dealing with of their own because my sessions were typically abysmal and fruitless. Maybe if I had someone who cared a titch more my brain wouldn't hate me so much. It's probably just another pay-to-win scheme; I'm poor so I'm doomed to shitty service. Idk. I just work here, man.

[–] [email protected] 3 points 9 months ago

I'm so sorry. I am chroniclly depressed myself. Lexapro helps a bit but I struggle to get myself to keep taking it. Long endurance exercise like running helps my mood but in my depressed state I cannot get myself to actually do it.

I wish they could just fix our fucking brains so we could be "normal"

[–] [email protected] 2 points 9 months ago

What were you doing for exercise? The key is getting your heart rate up to like 90% for your age and weight and keeping it there for like fifteen minutes.

[–] [email protected] 36 points 9 months ago* (last edited 9 months ago) (34 children)

That's lovely but as the article tucks away at the end pretty unrealistic.

When people experience more severe forms of depression simply offering exercise may not be completely helpful, for example, when someone is struggling to get out of bed let alone get to the gym.

[–] [email protected] 11 points 9 months ago (1 children)

Depression is a spectrum. When I was suffering I was still able to go to work and school, I was just in a sort of behavioral rut where that's all I did. Every experience I had felt like eating unseasoned food. There was no joy to it, it was just "if I don't do this I'll die and I guess I don't want that...". I tried Effexor and not only did it not help, it destabilized me pretty badly. Getting into the habit of exercising first thing in the morning every day has really turned that around.

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[–] [email protected] 29 points 9 months ago* (last edited 9 months ago) (1 children)

Since the study wasn’t actually linked (as far as I can tell on mobile), here’s a link to it.

https://www.bmj.com/content/384/bmj-2023-075847

From the conclusion: “Depression imposes a considerable global burden. Many exercise modalities appear to be effective treatments, particularly walking or jogging, strength training, and yoga, but confidence in many of the findings was low

I always worry about studies like this because it always seems to me like it might be difficult to determine if exercise is the catalyst to better mental health or if someone’s bettering mental health through any number of other kinds of treatments or even changes in a persons social life was the catalyst for exercising more. When I’m feeling particularly depressed, I absolutely don’t feel like exercising, and when I start to feel hopeful for the future, I find myself wanting to exercise more. Same with “just go outside and walk through the woods”. I only feel like doing that on days my depression isn’t particularly bad.

[–] [email protected] 3 points 9 months ago

Thanks for the link.

I think the authors shared your concern as well.

Our review did not uncover clear causal mechanisms, but the trends in the data are useful for generating hypotheses. It is unlikely that any single causal mechanism explains all the findings in the review. Instead, we hypothesise that a combination of social interaction,61 mindfulness or experiential acceptance,62 increased self-efficacy,33 immersion in green spaces,63 neurobiological mechanisms,64 and acute positive affect65 combine to generate outcomes. Meta-analyses have found each of these factors to be associated with decreases in depressive symptoms, but no single treatment covers all mechanisms.

[–] [email protected] 14 points 9 months ago (1 children)

In my years of depression, I was also in peak fitness. Like, hours of cardio a day level of fitness. Maybe it helped (I sure couldn't tell, but I would probably have been worse without it), and I imagine it helps a lot of people. But a lot of these reductive headlines are going to encourage the "just go outside or something" crowd to be even more dismissive of people with depression. Or people will see "core treatment" and think "instant cure treatment".

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[–] [email protected] 13 points 9 months ago (2 children)

how about just like

MAKE THE WORLD LESS DEPRESSING

maybe that might help

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[–] [email protected] 11 points 9 months ago (1 children)

I hate when people tell depressed people to "just go work out." When I was struggling with depression, I could hardly get out of bed and put on a fresh change of clothes, and somehow, they thought that I'm going to go outside and go for a walk! They really need to start with something more realistic like telling them to finally go and brush their teeth, because that is a lot more doable for them, and that still feels good too.

I do recognize that exercise does help. I'm in a lot better place now and I exercise daily, but if you're asking a depressed person to do that, you might as well be talking to a rock. Also sometimes people are just really depressed, and even if they do exercise, it hardly helps, since exercise probably isn't fixing the root issue.

[–] [email protected] 4 points 9 months ago (1 children)

During my deepest depression I would go to the gym to lift weights because it was an invisible way to punish myself.

[–] [email protected] 4 points 9 months ago

I'm curious, did that make you feel better or worse? I used to punish myself by slicing up my forearm and it did make me feel happy even though it was a terrible way to go about doing that.

[–] [email protected] 10 points 9 months ago (1 children)

Jokes on them! I can't get myself to exercise because I am depressed.

[–] [email protected] 2 points 9 months ago (1 children)

Right, I wonder if there's just a misunderstanding here and they're just asking people exercising if they're less depressed than when they weren't exercising and it's like, no shit they're feeling better if they weren't they wouldn't be out there exercising.

[–] [email protected] 7 points 9 months ago

This is a meta analysis of 218 clinical trials, they would have been more controlled than that.

[–] [email protected] 9 points 9 months ago

With anti depressants to help keep it under control, adding exercise has helped me for sure. Ymmv of course.

[–] [email protected] 6 points 9 months ago (4 children)

This has been known for quite sometime, it’s amazing to me that it’s not one of the first recommendations for treatment

[–] [email protected] 26 points 9 months ago* (last edited 9 months ago) (6 children)

Have you ever tried exercising when depressed? I'm overweight and depressed. I know exercise could make me feel better.

But how the fuck can I do it? I can barely muster the motivation to shower more than once a fortnight.

It's not ignorance. I used to be a runner and know the Ashtanga yoga first series by heart. Also did judo.

But actually doing anything is way fucking beyond my reach.

So no. It's not a panacea.

It's just another "smile and you'll feel happy" comment.

[–] [email protected] 10 points 9 months ago

I think this study suffers from confirmation bias. The people who actually got themselves to do excercise were already intrinsically motivated enough to actually do it. That way you self-select for a positive result.

I didn't read the actual study btw, it's possible they already adjusted the results due to this.

[–] [email protected] 3 points 9 months ago

I’m aware that depression causes major lack of motivation, nothing in my comment insinuated the opposite. That doesn’t mean it shouldn’t be the first avenue for treatment, ahead of medication.

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[–] [email protected] 7 points 9 months ago

Not one time have my doctor's recommended it for me. Just a new pill or nothing. Guess I'll buy some running shoes.

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[–] [email protected] 6 points 9 months ago

Cosigning this, getting into the habit of working out every day has changed everything about my life for the better. I'm happier, more productive at work, more present for my friends and family at home and, counterintuitively, have a lot more energy with which to attack the day.

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