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Aerobic exercise is an effective treatment for depression

209 points by DanBC 8y ago

DanBC 8y ago
Exercise is often pushed as a treatment for depression on HN, but the evidence is surprisingly weak. Many of the studies aren't very good; most of the studies have inclusion criteria that exclude people with major depression or people who've had in-patient treatment. This means that the studies have included a bunch of people who had sponteneous remission, or who would have recovered no matter what intervention you gave them. This study only looked at people who were recruited from inpatient or outpatient MH services; it excluded people who had other long term physical problems; and it found similar effects for solo or group exercise, and for exercise that used or didn't use equipment.
- astazangasta 8y ago
  Look, the evidence is always surprisingly weak. This isn't necessarily because these things don't work, its because the epistemology used is terrible at evaluating these sorts of questions, when someone has bothered to look in the first place. See here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/ Anecdotally my life experience is that exercise is the best possible way to combat depression. The other day I was crushingly depressed and had been for a week. I went and hit my heavy bag for twenty minutes and came out feeling fine. The effect was profound and easily felt. I don't need a study to convince me further; my lived experience is a superior epistemic method here.
  - massivecali 8y ago
    Severe depression leads to isolating behaviors. If you're not so depressed that you are able to leave the house and go somewhere, you're ahead of the game and excercise is just icing on the cake.
    - astazangasta 8y ago
      The floor is always available for pushups, but the social benefits of exercise are also worthwhile in combatting depression. Severe depression is another story, but most depressed people are not severely depressed.
    - leib 8y ago
      When I was younger I think I was depressed. It got to the stage where people would talk to me and I wouldn't talk back, I'd just stare; I'd lie in bed doing nothing; I let my hair grow long because I didn't want to go outside or talk to a barber. I'm much better now, and I think exercise was one of the key things that improved my general mood. It was a constant sturggle though for a while. YMMV, of course, and I was never diagnosed or anything.
    - HeyLaughingBoy 8y ago
      That still doesn't mean that he wasn't depressed though. I've experienced the same thing. I struggled with depression in my 20's but I found that if I was able to drag myself out of the house and get on my bike, I'd feel better within minutes. However, the huge struggle was getting out of bed and walking outside in the first place.
  - astura 8y ago
    Anecdotally, for me, when I was in the mist of severe clinical depression exercise did absolutely nothing for me except make me feel much worse and made me vomit... a lot. Of course, I was suffering from severe clinical depression not "feeling terrible for a week" level "depression." That's really key, severe clinical depression profoundly affects your response to stimuli in pathological ways. Another example for me is severe clinical depression (of which I've suffered two episodes of in my life) makes me unable to taste food.
    - rleigh 8y ago
      If exercise is making you vomit, I think you're doing it wrong. What did you have to do to get that reaction? Did you try backing off the intensity to a level where you could simply cope and enjoy it?
      - tempguy9999 8y ago
        > If exercise is making you vomit, I think you're doing it wrong. Good point. I'm interested in their answer on that. > [...] and enjoy it? Fuck me :) That was amusing! No offence but you really don't get it. Exercise in that state we use as a coping mechanism. I guess he, like me, overdid it hence the vomiting (just a guess though - love to hear the answer). There is no enjoying it because there's little if anything to enjoy if you're hurting inside. To repeat: exercise is a coping mechanism. It's not 'fun'.
        astura 8y ago
        Didn't overdo it or anything, if anything I underdid it, my workouts, depressed or not depressed, are not particularity intense and the depression takes the intensity down, since I'm feeling so shitty. Vomiting is simply my body's response to stress while disfunctioned by severe depression. During that timeframe, I was sitting in a room with coworkers discussing specifics of a project and that was just so completely overwhelming to me that I had to run out of the room and go vomit. Later that week I had to take an extended leave of absence from work because I could just no longer function at work.
      - 8y ago
  - DanBC 8y ago
    The context is people being given treatment by the state, sometimes against their will, sometimes when they've been deprived of their liberty. Given that context it's important that we don't force people to do anything unless we know it works, and the previous evidence didn't tell us that. I'm glad exercise works for you, and I always support people finding out what works for them.
    - atomical 8y ago
      Is exercising harming them? Why apply such a high standard to something is healthy especially when western populations are sedentary? I think there should be a measured approach.
      - kaybe 8y ago
        Exercise usually hurts more that lying around, even when you're not depressed. So yes, I think it can harm.
        atomical 8y ago
        https://www.cnn.com/2017/05/15/politics/donald-trump-exercise/index.html https://www.cnn.com/2017/05/15/politics/donald-trump-exercis... > Trump believed the human body was like a battery, with a finite amount of energy, which exercise only depleted. So he didn't work out.
        chillwaves 8y ago
        The link only demonstrates the absurdity of your previous statement. Unless that's what you are going for?
        sctb 8y ago
        We've asked you countless times to stop posting unsubstantive, trollish, or flamebait comments, and since there's no sign of abatement we're about ready to ban the account. Could you please review the guidelines and stop? https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
  - ced 8y ago
    That article is glorious, thank you for posting!
  - zdragnar 8y ago
    N=1, but exercise was not useful for me. If anything, the cool-down period afterwards just encouraged me to avoid doing anything, and the pain of strenuous exrrcise also added to the misery index. I did, however, find a medicine that worked wonders. Since then, I have worked out 30-45 minutes 5 days a week, but I certainly don't notice a difference in mood from before and after i started working out again. Edit: I want to make clear that this is not a rebuttal of what worked for you, but a point to consider when discussing with others who may be suffering. If you speak in absolutes about what works, and they find that it does not work for them, they may end up feeling even more hopeless.
  - tempguy9999 8y ago
    Agreed with @astura here. > The other day I was crushingly depressed and had been for a week In my regrettably extensive experience, if you feel bad for a week then you can count yourself very, very lucky. I can't see what you describe as being depression, although of course people are very different (had GFs who had it bad for a week or so at a time every month). > I [...] hit my heavy bag for twenty minutes and came out feeling fine Depression made me exercise compulsively, to the point of damaging myself. It never made me feel better so I don't know why I did it, but I had to, and I understand this is common. Twenty minutes of exercise and you felt better? It's impossible to equate that in any sense with what I had. There's a big difference between feeling really crappy and knowing you'd literally be better of dead, and being in that state for years continuously. That kind of things hurts inside, worse than physical pain (I know both). > my lived experience is a superior epistemic method here Hmm. Good for you.
    - 0815test 8y ago
      > Twenty minutes of exercise and you felt better? High-intensity exercise, seems plausible. Aerobic exercise is an annoying timesink by comparison, even though it does nevertheless play an important role in building up cardio endurance.
    - tempguy9999 8y ago
      [edit] Replying to myself: I'll go a little further. Past few years have been extremely hard for me, haven't been able to concentrate for ~6 months to the point of not mentally being able to work (had to sign off sick (am in the UK)) and just starting to get back to work next week 1 day a week, unpaid. I can just about keep my clothes clean, and mostly keep my flat clean. I'm mentally very unwell to the point of being unable to go to the pub and socialise as I used to. I was unwell to the point of being a danger to other people (am over that now, thank god. Yes, I did talk to the doc). I am coping, barely. I have no current interest in life, music, little interest in other people etc. I'm abusing drugs and alcohol as a way of coping, though in the long term I know that's a bad idea (and I draw a clear distinction between drug use/drug abuse, entirely independent from what's legal/illegal). Point is, I feel justifiably terrible but I'm not clinically depressed. For sure I'm down, but I'm nowhere near the utter destructive blackness that is real depression, and I'm bloody grateful for it. So I can't see what you describe as depression in any way that I can comprehend. (NB, life sucks but any sympathy you can shove up your arse. I'd much prefer you took the piss, at least in a nice way. At least I'd get a laugh out of it).
- chapium 8y ago
  Sometimes just doing something for yourself that you know is beneficial helps slow down the downward spiral. I find exercise reduces stress, and that helps one cope with the day to day setbacks. If you are depressed, this should help. Of course this doesn't apply to all depression, but I can give this anecdotally an HN comment, unsourced.
- jdietrich 8y ago
  I broadly agree with you on the weakness of the evidence, but I'd strongly recommend exercise to everyone anyway. The overall health benefits are immense, even if it turns out that it doesn't do much for depression. Higher physical activity in the general population is likely to have a significant preventative effect on depression, because chronic physical illness is one of the most significant risk factors for developing a depressive illness and exercise has a strong preventative effect on chronic physical illness.
- GordonS 8y ago
  In the UK, my guess is that this is pushed because it's comparatively cheap. Interestingly, it's also pushed on those with CFS, despite evidence that it actually causes harm. IIRC, there is a NICE review going on at present, but recommendations are going to be made for a while yet. Sometimes the speed at which the NHS works is literally painful!
- nswest23 8y ago
  would you expect broad studies on something that only makes money for personal trainers and LA Fitness?
- emit_time 8y ago
  Anecdotally, I notice a large improvement in my mood within a week when I start exercising after not having done so in a while. This has happened to me on multiple occasions.
aszantu 8y ago
So does switching your diet to keto or carnivore. For some people its even veganism. Stop eating crap solves a lot of problems
- hourislate 8y ago
  Not sure why you are being junked? Diet and Gut flora are incredibly important for mental health and overall well being. In most 1st world countries, people eat way too much and often, unfortunately a lot of their food choices are heavily processed and cause massive inflammation.
  - umvi 8y ago
    > Not sure why you are being junked? Probably because it's so cliche that memes are made about it: https://www.reddit.com/r/starterpacks/comments/6w783j/i_dont_know_why_im_depressed_starterpack/ https://www.reddit.com/r/starterpacks/comments/6w783j/i_dont...
    - rjf72 8y ago
      This could be telling in a way though, don't you think? Scurvy is a fun example of what I mean. Most people now know that scurvy is just a disease caused by a lack of vitamin c. But for centuries it was not really understood what caused it, and it has resulted in countless millions of deaths throughout the centuries. Some people would discover the cure, but it never really stuck around. Part of this is because it sounds so absurd that e.g. eating limes is a way to stop an otherwise aggressive and deadly disease. Imagine I suggested you eat apples to stave off the flu. Sounds, at best, 'folky.' And this was also further complicated by the fact that lime juice can lose its nutritional character in some situations (such as certain sorts of storage), and so some experiments in using lime juice as a cure/prophylactic failed. It was also complicated because there's also high quantities of vitamin C in various fresh meats, and so crews that had access to these meats, but consumed minimal citrus, would also never seem to be affected. Tricky to nail down! As a fun factoid, vitamin c is ascorbic acid, but it wasn't always called that. It was originally named hexuronic acid. It was renamed ascorbic (against scurvy) acid once it was confirmed that it was indeed absolutely what was treating and preventing scurvy. Another fun one is that this is also related to the slang term for a Brit - a 'limey'. The nickname came from the fact that the British navy was one of the first to start dosing their sailors with lemon/lime juice to ward off scurvy. So the point of this is that if a whole bunch of people are suggesting something works, to the point of it becoming a meme, there may actually be something to it - even if it can be difficult to isolate the exact reason why, or why it may not work in 100% of cases. Definitively solving the mystery of scurvy took about 3,500 years from the point of it being formalized. So a bit of patience is probably justified for these sort of things.
hevi_jos 8y ago
As a programmer my experience is that I get "depressed" if I do not get out and exercise every single day. I get angry at other people or at things like clients or taxes or whatever. I start getting lazy at stuff to do. Just getting out for 30-40 every day minutes and sleeping and eating well does wonders for me. I get energized and life becomes full of opportunities, I see the bright side of people... I am almost certain that is the circulation of the lymphatic system. For people working in front of a computer for hours a day it is very important. Spain(most of it) is sunny most of the year and it is rare when I could not exercise outside, but in central Europe I notice it a lot with the dark winter.
- koolba 8y ago
  I’m convinced this is a special case of the more general “success begets success”. There’s likely a physical aspect of it as well but just feeling like you’re doing well drives you do better. It’s a virtuous cycle.
  - hevi_jos 8y ago
    In most of Spain there are 3 months a year in which there is so hot you can not do intellectual work without external aids like aid conditioners. This is something well proven, that over certain temperature, mathematical work drops enormously. Having experienced that I have the hypothesis that the body regulates the temperature of the brain and if it is too high it will make it to slow down, just like a computer does and make you lazy so you do not generate more heat. In the same way, it makes sense that if your lymphatic circulation is blocked, as it works only with movement, it will make you lazy so your cells do not generate more waste that can not be cleaned.
- Starknaked 8y ago
  I get the exact same results as you. As long as I exercise I feel much better also because I do it in the morning its easier to make it part of a good routine however it doesn't seem to help with the anxiety that underpins the depression. Not feeling depressed is good for a while until it starts to feel like you're not fixing the real issue. Tackling all those routine tasks like exercise, sleep, diet is really easy compared to doing the things that are really important to you where there is much more uncertainty, risk, and discomfort that cause me to feel very anxious which is very discouraging. Doing things like exercise to help with depression is like trying to repair a cracked stone wall by painting over it so you can't see the crack anymore.
mrfusion 8y ago
Does it count as aerobic if you get out of breath and develop lactic acid?
llamathrowaway 8y ago
Sorry for being slightly off-topic, but I really hope that PE lessons could focus more teaching the students how to enjoy exercising. It would have tremendously positive influence on the physical and mental health of the society as a whole. Not so long ago I came across a twitter thread in which people shared very negative experiences with PE lessons in schools. My own experience was not as bad as some of theirs, but frustrating enough to make me hate the very idea of exercising. My body shape was average, but somehow I was very clumsy. Among boys, I was one of the the slowest runners, only faster than the few kids who are quite overweight. I was also extremely bad at sports. Could not dribble for more than a few steps, could barely hit a badminton bird reliably, etc. My clumsiness itself was not something I felt bad about. It was the fact that my incompetence would be demonstrated in front of my classmates in a PE lesson that made me hate PE. In retrospect, they might not have noticed me anyway, and even if they did notice my failures, they are not going to remember. But this is not something a boy, eleven-year-old, driven by pride and a desire to show-off, could understand. What I learned from my PE lessons was simple: exercising sucks. Sport sucks. You better not do it if you've got the choice. I have seen enough evidence to convince me of the benefits of exercising. I wish I could enjoy exercising more. But I just can't. I wonder how things could be different, if I somehow had the chance to enjoy my PE lessons more as a child.
- kaybe 8y ago
  I have to say, in hindsight I am pretty annoyed with the general teaching methods. Rules and general movements were explained and shown to you once, and then you were left to your own devices only to be judged later on what you learned. (Learning by osmosis at that point, really.) Several times it took one small comment from someone else years later and I was able to do the thing considerably better. (Which muscles to relax, for example, or wrong direction of a movement.) That should have been a teacher's job.
- hazeii 8y ago
  Very interesting point; as a kid I hated PE but after some growing up I found myself naturally enjoying exercise. Maybe it's whether it's enforced or by personal choice?
- 8y ago
tstrimple 8y ago
I don't have the energy to get out of bed, but running will help! Am I wrong in feeling that this is as useful as telling the morbidly obese to just cut calories?
- learnstats2 8y ago
  A doctor once told me that I shouldn't exercise if I already felt exhausted - advice which I followed and it pushed me into a deeper depression - so, yes, it will help.
  - serpi 8y ago
    do not take exercise advice from people who do not do it themselves.
- AnthonBerg 8y ago
  I can feel that I’m not ready for exercise but be wrong. I can cerebrally know and trust that exercise may help un-kill my emotions and attempt to rotely manoeuver my body into exercise in the substantiated hope that the point to doing anything may return because of it. and it has worked.
- hgibbs 8y ago
  I actually notice my mood and energy levels drop significantly when I reduce my weekly exercise.
- umvi 8y ago
  Think of it more like your brain is lying to you about your energy levels and that exercise is calling your brain's bluff. Writing off exercise without trying it is like the Israelites writing off looking at the brass serpent.
  - VierScar 8y ago
    Is that supposed to be a commonly known fable?
  - 8y ago
RcouF1uZ4gsC 8y ago
The thing to be aware of is selection bias. Depression severely effects motivation. If you take depressed people who are routinely doing aerobic exercise, you can be selecting people who are less effected by depression, and thus instead of aerobic exercise being a treatment, it is selecting people with milder depression.
- amanaplanacanal 8y ago
  To make this work you have to randomize people to the exercise and no exercise groups. How to do good science is pretty well known.
ada1981 8y ago
I’m trying to figure out how much improvement they saw on the Beck inventory. For example most antidepressants are at best getting people a few points (from what I’ve read).
- 0xcde4c3db 8y ago
  Relatedly, I can't find anything about how the results compare between the exercise and non-exercise conditions. Unless I'm misreading, the abstract and "signal" only give numbers for the exercise condition.
127 8y ago
Playing Beat Saber on Expert+ seems to be more effective than meditation and therapy combined. It really unlodges various memories that I can then process, if I take mindful approach to it. Getting better access to my emotions and what's really bothering me, not being able to run away from them, or wanting to. The point is, I will always have some problems, but with exercising for 2 hours, they will become to surface where I can emotionally access them. Jogging works too, but I find Beat Saber is more fun and I have much easier time keeping a regular schedule.
- skellera 8y ago
  It’s the modern day DDR for getting people in shape mentally and physically in an enjoyable way. See this story time and time again. Glad you found a way to enjoy improving your health.
- fyfy18 8y ago
  Do you play to lose weight, or to just get in shape? Could you comment more on how the results have been through this method, compared to your previous attempts?
  - 127 8y ago
    Get in shape. I have problems that come from sitting in front of a computer screen too much, like stiff shoulders. Also aerobic exercise. Gets the blood moving. Of course, things like adjustable standing desk and properly adjusted seating that doesn't let me slouch is also important.
sdfin 8y ago
My hypothesis is that often depression is caused by giving attention to some particular patterns of thoughts and therefore anything that causes you to direct your attention somewhere else can be helpful to relieve the symptoms. There are activities that demand a big amount of our attention and those activities are likely the more effective ones to cause us to remove attention from depressive thoughts. Exercise, playing Beat Saber, meditating, and many other things can work. It isn't really my hypothesis. It's what metacognitive therapy suggests. It's a therapy developed by a psychologist that worked with CBT before suggesting some changes to the treatment. http://mct-institute.co.uk/depression/ http://mct-institute.co.uk/depression/
loo9283 8y ago
I've found ketamine to be surprisingly effective personally
deleted 8y ago
[deleted]
foxyv 8y ago
I've found indoor exercise to be ineffective. The only thing that works for me personally is getting outside. Cycling is the best so far, but walking is great too.
truth_seeker 8y ago
Surya Namaskar Yoga exercise is way more effective than any Aerobic exercise. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193657/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193657/

209 points by DanBC 8y ago

Exercise is often pushed as a treatment for depression on HN, but the evidence is surprisingly weak. Many of the studies aren't very good; most of the studies have inclusion criteria that exclude people with major depression or people who've had in-patient treatment. This means that the studies have included a bunch of people who had sponteneous remission, or who would have recovered no matter what intervention you gave them. This study only looked at people who were recruited from inpatient or outpatient MH services; it excluded people who had other long term physical problems; and it found similar effects for solo or group exercise, and for exercise that used or didn't use equipment.

astazangasta 8y ago
Look, the evidence is always surprisingly weak. This isn't necessarily because these things don't work, its because the epistemology used is terrible at evaluating these sorts of questions, when someone has bothered to look in the first place. See here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/ Anecdotally my life experience is that exercise is the best possible way to combat depression. The other day I was crushingly depressed and had been for a week. I went and hit my heavy bag for twenty minutes and came out feeling fine. The effect was profound and easily felt. I don't need a study to convince me further; my lived experience is a superior epistemic method here.
- massivecali 8y ago
  Severe depression leads to isolating behaviors. If you're not so depressed that you are able to leave the house and go somewhere, you're ahead of the game and excercise is just icing on the cake.
  - astazangasta 8y ago
    The floor is always available for pushups, but the social benefits of exercise are also worthwhile in combatting depression. Severe depression is another story, but most depressed people are not severely depressed.
  - leib 8y ago
    When I was younger I think I was depressed. It got to the stage where people would talk to me and I wouldn't talk back, I'd just stare; I'd lie in bed doing nothing; I let my hair grow long because I didn't want to go outside or talk to a barber. I'm much better now, and I think exercise was one of the key things that improved my general mood. It was a constant sturggle though for a while. YMMV, of course, and I was never diagnosed or anything.
  - HeyLaughingBoy 8y ago
    That still doesn't mean that he wasn't depressed though. I've experienced the same thing. I struggled with depression in my 20's but I found that if I was able to drag myself out of the house and get on my bike, I'd feel better within minutes. However, the huge struggle was getting out of bed and walking outside in the first place.
- astura 8y ago
  Anecdotally, for me, when I was in the mist of severe clinical depression exercise did absolutely nothing for me except make me feel much worse and made me vomit... a lot. Of course, I was suffering from severe clinical depression not "feeling terrible for a week" level "depression." That's really key, severe clinical depression profoundly affects your response to stimuli in pathological ways. Another example for me is severe clinical depression (of which I've suffered two episodes of in my life) makes me unable to taste food.
  - rleigh 8y ago
    If exercise is making you vomit, I think you're doing it wrong. What did you have to do to get that reaction? Did you try backing off the intensity to a level where you could simply cope and enjoy it?
    - tempguy9999 8y ago
      > If exercise is making you vomit, I think you're doing it wrong. Good point. I'm interested in their answer on that. > [...] and enjoy it? Fuck me :) That was amusing! No offence but you really don't get it. Exercise in that state we use as a coping mechanism. I guess he, like me, overdid it hence the vomiting (just a guess though - love to hear the answer). There is no enjoying it because there's little if anything to enjoy if you're hurting inside. To repeat: exercise is a coping mechanism. It's not 'fun'.
      - astura 8y ago
        Didn't overdo it or anything, if anything I underdid it, my workouts, depressed or not depressed, are not particularity intense and the depression takes the intensity down, since I'm feeling so shitty. Vomiting is simply my body's response to stress while disfunctioned by severe depression. During that timeframe, I was sitting in a room with coworkers discussing specifics of a project and that was just so completely overwhelming to me that I had to run out of the room and go vomit. Later that week I had to take an extended leave of absence from work because I could just no longer function at work.
    - 8y ago
- DanBC 8y ago
  The context is people being given treatment by the state, sometimes against their will, sometimes when they've been deprived of their liberty. Given that context it's important that we don't force people to do anything unless we know it works, and the previous evidence didn't tell us that. I'm glad exercise works for you, and I always support people finding out what works for them.
  - atomical 8y ago
    Is exercising harming them? Why apply such a high standard to something is healthy especially when western populations are sedentary? I think there should be a measured approach.
    - kaybe 8y ago
      Exercise usually hurts more that lying around, even when you're not depressed. So yes, I think it can harm.
      - atomical 8y ago
        https://www.cnn.com/2017/05/15/politics/donald-trump-exercise/index.html https://www.cnn.com/2017/05/15/politics/donald-trump-exercis... > Trump believed the human body was like a battery, with a finite amount of energy, which exercise only depleted. So he didn't work out.
        chillwaves 8y ago
        The link only demonstrates the absurdity of your previous statement. Unless that's what you are going for?
        sctb 8y ago
        We've asked you countless times to stop posting unsubstantive, trollish, or flamebait comments, and since there's no sign of abatement we're about ready to ban the account. Could you please review the guidelines and stop? https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- ced 8y ago
  That article is glorious, thank you for posting!
- zdragnar 8y ago
  N=1, but exercise was not useful for me. If anything, the cool-down period afterwards just encouraged me to avoid doing anything, and the pain of strenuous exrrcise also added to the misery index. I did, however, find a medicine that worked wonders. Since then, I have worked out 30-45 minutes 5 days a week, but I certainly don't notice a difference in mood from before and after i started working out again. Edit: I want to make clear that this is not a rebuttal of what worked for you, but a point to consider when discussing with others who may be suffering. If you speak in absolutes about what works, and they find that it does not work for them, they may end up feeling even more hopeless.
- tempguy9999 8y ago
  Agreed with @astura here. > The other day I was crushingly depressed and had been for a week In my regrettably extensive experience, if you feel bad for a week then you can count yourself very, very lucky. I can't see what you describe as being depression, although of course people are very different (had GFs who had it bad for a week or so at a time every month). > I [...] hit my heavy bag for twenty minutes and came out feeling fine Depression made me exercise compulsively, to the point of damaging myself. It never made me feel better so I don't know why I did it, but I had to, and I understand this is common. Twenty minutes of exercise and you felt better? It's impossible to equate that in any sense with what I had. There's a big difference between feeling really crappy and knowing you'd literally be better of dead, and being in that state for years continuously. That kind of things hurts inside, worse than physical pain (I know both). > my lived experience is a superior epistemic method here Hmm. Good for you.
  - 0815test 8y ago
    > Twenty minutes of exercise and you felt better? High-intensity exercise, seems plausible. Aerobic exercise is an annoying timesink by comparison, even though it does nevertheless play an important role in building up cardio endurance.
  - tempguy9999 8y ago
    [edit] Replying to myself: I'll go a little further. Past few years have been extremely hard for me, haven't been able to concentrate for ~6 months to the point of not mentally being able to work (had to sign off sick (am in the UK)) and just starting to get back to work next week 1 day a week, unpaid. I can just about keep my clothes clean, and mostly keep my flat clean. I'm mentally very unwell to the point of being unable to go to the pub and socialise as I used to. I was unwell to the point of being a danger to other people (am over that now, thank god. Yes, I did talk to the doc). I am coping, barely. I have no current interest in life, music, little interest in other people etc. I'm abusing drugs and alcohol as a way of coping, though in the long term I know that's a bad idea (and I draw a clear distinction between drug use/drug abuse, entirely independent from what's legal/illegal). Point is, I feel justifiably terrible but I'm not clinically depressed. For sure I'm down, but I'm nowhere near the utter destructive blackness that is real depression, and I'm bloody grateful for it. So I can't see what you describe as depression in any way that I can comprehend. (NB, life sucks but any sympathy you can shove up your arse. I'd much prefer you took the piss, at least in a nice way. At least I'd get a laugh out of it).
chapium 8y ago
Sometimes just doing something for yourself that you know is beneficial helps slow down the downward spiral. I find exercise reduces stress, and that helps one cope with the day to day setbacks. If you are depressed, this should help. Of course this doesn't apply to all depression, but I can give this anecdotally an HN comment, unsourced.
jdietrich 8y ago
I broadly agree with you on the weakness of the evidence, but I'd strongly recommend exercise to everyone anyway. The overall health benefits are immense, even if it turns out that it doesn't do much for depression. Higher physical activity in the general population is likely to have a significant preventative effect on depression, because chronic physical illness is one of the most significant risk factors for developing a depressive illness and exercise has a strong preventative effect on chronic physical illness.
GordonS 8y ago
In the UK, my guess is that this is pushed because it's comparatively cheap. Interestingly, it's also pushed on those with CFS, despite evidence that it actually causes harm. IIRC, there is a NICE review going on at present, but recommendations are going to be made for a while yet. Sometimes the speed at which the NHS works is literally painful!
nswest23 8y ago
would you expect broad studies on something that only makes money for personal trainers and LA Fitness?
emit_time 8y ago
Anecdotally, I notice a large improvement in my mood within a week when I start exercising after not having done so in a while. This has happened to me on multiple occasions.

aszantu 8y ago

So does switching your diet to keto or carnivore. For some people its even veganism. Stop eating crap solves a lot of problems

hourislate 8y ago
Not sure why you are being junked? Diet and Gut flora are incredibly important for mental health and overall well being. In most 1st world countries, people eat way too much and often, unfortunately a lot of their food choices are heavily processed and cause massive inflammation.
- umvi 8y ago
  > Not sure why you are being junked? Probably because it's so cliche that memes are made about it: https://www.reddit.com/r/starterpacks/comments/6w783j/i_dont_know_why_im_depressed_starterpack/ https://www.reddit.com/r/starterpacks/comments/6w783j/i_dont...
  - rjf72 8y ago
    This could be telling in a way though, don't you think? Scurvy is a fun example of what I mean. Most people now know that scurvy is just a disease caused by a lack of vitamin c. But for centuries it was not really understood what caused it, and it has resulted in countless millions of deaths throughout the centuries. Some people would discover the cure, but it never really stuck around. Part of this is because it sounds so absurd that e.g. eating limes is a way to stop an otherwise aggressive and deadly disease. Imagine I suggested you eat apples to stave off the flu. Sounds, at best, 'folky.' And this was also further complicated by the fact that lime juice can lose its nutritional character in some situations (such as certain sorts of storage), and so some experiments in using lime juice as a cure/prophylactic failed. It was also complicated because there's also high quantities of vitamin C in various fresh meats, and so crews that had access to these meats, but consumed minimal citrus, would also never seem to be affected. Tricky to nail down! As a fun factoid, vitamin c is ascorbic acid, but it wasn't always called that. It was originally named hexuronic acid. It was renamed ascorbic (against scurvy) acid once it was confirmed that it was indeed absolutely what was treating and preventing scurvy. Another fun one is that this is also related to the slang term for a Brit - a 'limey'. The nickname came from the fact that the British navy was one of the first to start dosing their sailors with lemon/lime juice to ward off scurvy. So the point of this is that if a whole bunch of people are suggesting something works, to the point of it becoming a meme, there may actually be something to it - even if it can be difficult to isolate the exact reason why, or why it may not work in 100% of cases. Definitively solving the mystery of scurvy took about 3,500 years from the point of it being formalized. So a bit of patience is probably justified for these sort of things.

hevi_jos 8y ago

As a programmer my experience is that I get "depressed" if I do not get out and exercise every single day. I get angry at other people or at things like clients or taxes or whatever. I start getting lazy at stuff to do. Just getting out for 30-40 every day minutes and sleeping and eating well does wonders for me. I get energized and life becomes full of opportunities, I see the bright side of people... I am almost certain that is the circulation of the lymphatic system. For people working in front of a computer for hours a day it is very important. Spain(most of it) is sunny most of the year and it is rare when I could not exercise outside, but in central Europe I notice it a lot with the dark winter.

koolba 8y ago
I’m convinced this is a special case of the more general “success begets success”. There’s likely a physical aspect of it as well but just feeling like you’re doing well drives you do better. It’s a virtuous cycle.
- hevi_jos 8y ago
  In most of Spain there are 3 months a year in which there is so hot you can not do intellectual work without external aids like aid conditioners. This is something well proven, that over certain temperature, mathematical work drops enormously. Having experienced that I have the hypothesis that the body regulates the temperature of the brain and if it is too high it will make it to slow down, just like a computer does and make you lazy so you do not generate more heat. In the same way, it makes sense that if your lymphatic circulation is blocked, as it works only with movement, it will make you lazy so your cells do not generate more waste that can not be cleaned.
Starknaked 8y ago
I get the exact same results as you. As long as I exercise I feel much better also because I do it in the morning its easier to make it part of a good routine however it doesn't seem to help with the anxiety that underpins the depression. Not feeling depressed is good for a while until it starts to feel like you're not fixing the real issue. Tackling all those routine tasks like exercise, sleep, diet is really easy compared to doing the things that are really important to you where there is much more uncertainty, risk, and discomfort that cause me to feel very anxious which is very discouraging. Doing things like exercise to help with depression is like trying to repair a cracked stone wall by painting over it so you can't see the crack anymore.

mrfusion 8y ago

Does it count as aerobic if you get out of breath and develop lactic acid?

llamathrowaway 8y ago

Sorry for being slightly off-topic, but I really hope that PE lessons could focus more teaching the students how to enjoy exercising. It would have tremendously positive influence on the physical and mental health of the society as a whole. Not so long ago I came across a twitter thread in which people shared very negative experiences with PE lessons in schools. My own experience was not as bad as some of theirs, but frustrating enough to make me hate the very idea of exercising. My body shape was average, but somehow I was very clumsy. Among boys, I was one of the the slowest runners, only faster than the few kids who are quite overweight. I was also extremely bad at sports. Could not dribble for more than a few steps, could barely hit a badminton bird reliably, etc. My clumsiness itself was not something I felt bad about. It was the fact that my incompetence would be demonstrated in front of my classmates in a PE lesson that made me hate PE. In retrospect, they might not have noticed me anyway, and even if they did notice my failures, they are not going to remember. But this is not something a boy, eleven-year-old, driven by pride and a desire to show-off, could understand. What I learned from my PE lessons was simple: exercising sucks. Sport sucks. You better not do it if you've got the choice. I have seen enough evidence to convince me of the benefits of exercising. I wish I could enjoy exercising more. But I just can't. I wonder how things could be different, if I somehow had the chance to enjoy my PE lessons more as a child.

kaybe 8y ago
I have to say, in hindsight I am pretty annoyed with the general teaching methods. Rules and general movements were explained and shown to you once, and then you were left to your own devices only to be judged later on what you learned. (Learning by osmosis at that point, really.) Several times it took one small comment from someone else years later and I was able to do the thing considerably better. (Which muscles to relax, for example, or wrong direction of a movement.) That should have been a teacher's job.
hazeii 8y ago
Very interesting point; as a kid I hated PE but after some growing up I found myself naturally enjoying exercise. Maybe it's whether it's enforced or by personal choice?
8y ago

tstrimple 8y ago

I don't have the energy to get out of bed, but running will help! Am I wrong in feeling that this is as useful as telling the morbidly obese to just cut calories?

learnstats2 8y ago
A doctor once told me that I shouldn't exercise if I already felt exhausted - advice which I followed and it pushed me into a deeper depression - so, yes, it will help.
- serpi 8y ago
  do not take exercise advice from people who do not do it themselves.
AnthonBerg 8y ago
I can feel that I’m not ready for exercise but be wrong. I can cerebrally know and trust that exercise may help un-kill my emotions and attempt to rotely manoeuver my body into exercise in the substantiated hope that the point to doing anything may return because of it. and it has worked.
hgibbs 8y ago
I actually notice my mood and energy levels drop significantly when I reduce my weekly exercise.
umvi 8y ago
Think of it more like your brain is lying to you about your energy levels and that exercise is calling your brain's bluff. Writing off exercise without trying it is like the Israelites writing off looking at the brass serpent.
- VierScar 8y ago
  Is that supposed to be a commonly known fable?
- 8y ago

RcouF1uZ4gsC 8y ago

The thing to be aware of is selection bias. Depression severely effects motivation. If you take depressed people who are routinely doing aerobic exercise, you can be selecting people who are less effected by depression, and thus instead of aerobic exercise being a treatment, it is selecting people with milder depression.

amanaplanacanal 8y ago
To make this work you have to randomize people to the exercise and no exercise groups. How to do good science is pretty well known.

ada1981 8y ago

I’m trying to figure out how much improvement they saw on the Beck inventory. For example most antidepressants are at best getting people a few points (from what I’ve read).

0xcde4c3db 8y ago
Relatedly, I can't find anything about how the results compare between the exercise and non-exercise conditions. Unless I'm misreading, the abstract and "signal" only give numbers for the exercise condition.

127 8y ago

Playing Beat Saber on Expert+ seems to be more effective than meditation and therapy combined. It really unlodges various memories that I can then process, if I take mindful approach to it. Getting better access to my emotions and what's really bothering me, not being able to run away from them, or wanting to. The point is, I will always have some problems, but with exercising for 2 hours, they will become to surface where I can emotionally access them. Jogging works too, but I find Beat Saber is more fun and I have much easier time keeping a regular schedule.

skellera 8y ago
It’s the modern day DDR for getting people in shape mentally and physically in an enjoyable way. See this story time and time again. Glad you found a way to enjoy improving your health.
fyfy18 8y ago
Do you play to lose weight, or to just get in shape? Could you comment more on how the results have been through this method, compared to your previous attempts?
- 127 8y ago
  Get in shape. I have problems that come from sitting in front of a computer screen too much, like stiff shoulders. Also aerobic exercise. Gets the blood moving. Of course, things like adjustable standing desk and properly adjusted seating that doesn't let me slouch is also important.

sdfin 8y ago

My hypothesis is that often depression is caused by giving attention to some particular patterns of thoughts and therefore anything that causes you to direct your attention somewhere else can be helpful to relieve the symptoms. There are activities that demand a big amount of our attention and those activities are likely the more effective ones to cause us to remove attention from depressive thoughts. Exercise, playing Beat Saber, meditating, and many other things can work. It isn't really my hypothesis. It's what metacognitive therapy suggests. It's a therapy developed by a psychologist that worked with CBT before suggesting some changes to the treatment. http://mct-institute.co.uk/depression/ http://mct-institute.co.uk/depression/

loo9283 8y ago

I've found ketamine to be surprisingly effective personally

deleted 8y ago

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foxyv 8y ago

I've found indoor exercise to be ineffective. The only thing that works for me personally is getting outside. Cycling is the best so far, but walking is great too.

truth_seeker 8y ago

Surya Namaskar Yoga exercise is way more effective than any Aerobic exercise. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193657/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193657/