3 ms·

I do wonder how many people do not take care of the basics and instead go for anti-depressants and Ozempic. I get it if you tried everything, but how many do?

I do wonder how many people do not take care of the basics and instead go for anti-depressants and Ozempic. I get it if you tried everything, but how many do? When I stop compulsively eating and drinking, when I look for every opportunity to do something as an exercise, I snap out of my [self-diagnosed] depression and malaise in a few days, and feel great. The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business".

bobthepanda 2y ago
? Doctors tell people to diet and exercise all the time. The problem is that the doctor has very little to offer other than to tell people to do that, and the vast majority of people will nod and continue doing whatever they were doing.
mr_mitm 2y ago
This really downplays the impact of clinical depression. It's often not solved by exercising alone, and if you talk to a psychologist about this, the first thing they do is recommend exercising or at least goeing for walks as an immediate measure before potentially therapy or medication starts. When I went to a doctor complaining about low energy, literally the first question was about weight gain and exercising, so I'm not sure where your comment about the pills comes from.
- renegade-otter 2y ago
  My comment comes from the seeming ease of procuring these drugs - with people going on Ozempic out of pure vanity.
  - toofy 2y ago
    you did end your comment with: > The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business" which makes it appear as even with your “self-diagnoses” you’re under the impression that doctors rarely ask about exercise and diet and then move forward from there. which is the exact opposite of what i’ve seen from a college roommate, a close friend, and an ex who saw multiple different doctors, and each of those doctors first insisted on: a) find a hobby, dive into it. and, b) exercise multiple times per week. and, c) get a nutritionist. and d) only after those things showed little results would they prescribe SSRIs or other long term drugs. i promise this isn’t coming down on you, i promise, but, we seem to have a massive trend of confidently wrong people implying they’re smarter than actual doctors or (just about any other subject it seems), they just guess what doctors do and don’t do. and even far more concerning is how often these confidently wrong people issue blanket advice to randoms online as if they’re at all qualified and as if they know any of the important intricate details of the randoms they’re advising. we desperately need to get back to a place where people can confidently say “i don’t know” again. we’re (including myself) too desperate to chime in even if we’re woefully ill equipped. maybe every secondary-university semester everyone should get a refresher session on the most basic ass socrates/plato: the smartest person is the one who knows, understands, and admits about how much they are ignorant.
- sfn42 2y ago
  Most people don't know what depression is. I'd say I've been depressed most of my life but the best periods have been the ones where I was physically active. Now, there's a bit of a chicken and egg problem here -am I sedentary because I'm depressed or am I depressed because I'm sedentary? I would agree with the previous poster that exercise brings me out of depression, but I spend most of my depressive periods thinking I should be more active, right now I'm in one and I keep trying to get into some healthy habits but I keep giving up because I just don't have whatever it is that I need to keep it going. I even get nearly immediate results, just a few weeks of activity has me feeling better already. But then I find some reason to take a break and then the break drags on and I'm back to where I started. So maybe it's the depression keeping me down or maybe it's my lack of discipline causing depression but either way I'd say physical activity is important for how you feel on a daily basis and I genuinely think just getting into a regular rhythm of exercise even just one day a week can have huge impacts on your life.
dspillett 2y ago
> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business". I'm guessing you are in the US? There is a lot of medical advice here (UK, and Europe more widely) which is essentially “eat better and move around more”. A great many don't listen to that, but it is definitely said. > When I stop compulsively eating and drinking [and do some] exercise This is a key issue: not what doctors are prescribing but what people do to self-medicate. The harmful side of self-care when “a bit of what you like does you good” becomes overconsumption and underactivity. It can be even worse for those of us with significant mental issues over the norm (bit of a bipolar pillock myself, got a piece of paper saying so & everything, and like you describe with depression I find the right exercise, while not at all a panacea, helps regulate my mind quite a lot as well as stopping my body falling apart).
- bobthepanda 2y ago
  even in the US a lot of doctors say this because it is usually less of a pain in the ass than filling out referral paperwork to specialists that cost more for the patient anyways. part of the problem in the US is that at least some medical practices/hospitals measure patient satisfaction as a metric to evaluate performance, but what is good for the patient and what makes them happy is not necessarily correlated. it's a factor into how the opioid epidemic got as bad as it did in the US. and also i'd imagine if you kept telling people this for decades and they didn't listen people might just not bother.
orthoxerox 2y ago
> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business". That's because advice like this is useless. Everyone knows they should eat more vegetables, you need someone to guide you through habit formation, which is not what the doctors are for.
petercooper 2y ago
I do wonder how many people do not take care of the basics and instead go for anti-depressants and Ozempic. Bear in mind that for many people therapies like SSRIs and weight loss medications (or even counselling/therapy) can get them into the right mental and physical place to start doing more exercise and eat better. It's easy to advise people to eat well and exercise, but it can be a bit like telling a miserable person with a migraine to smile more. Improve the underlying issue artifically, then they can have a better chance of starting the natural things. Doctors do need to do both, though, merely handing out medications without encouraging the next step is irresponsible IMO.
- hunter-gatherer 2y ago
  I've never suffered from a mental illness, so I'm genuinely curious; is exercise not ever used as a prescription for depression? Physical therapy is a thing, so it can be a prescription in some cases, no?
  - petercooper 2y ago
    Oh, it absolutely is, and from what I've read, it can work really well! It's just not necessarily a 'one size fits all' which is what makes medicine complicated and good doctors valuable. If someone's hit the point where they're thinking "I'd rather be dead than leave the house", improving their mental health by any means necessary should be the first step. But not everyone should be given pills as the first option and many doctors are guilty of such laziness (over prescription of opioids and antibiotics are other examples of this – some patients urgently need them, most don't).
  - wbl 2y ago
    Compliance matters. Once a day pill is much easier to do than rework routine especially when patient has the "can't anymore" disease. Read Darkness Visible if you want to hear all about what that looks like.
  - autoexec 2y ago
    I think it'd be a great idea to perscribe physical therapy for people who need to exercise. Especially for the highly inactive who may not know how to start, and haven't made it a routine. That would send patients to a therapist who would help make sure they aren't doing more than they should and that they're working out correctly, and also provide the doctor with feedback/monitoring of their progress. The problem is that in the US no doctor is going to do that because no insurance company will pay for it. In the US even people who have serious injuries and need physical therapy to recover properly from them often can't get their insurance to pay for physical therapy or to pay for enough of it (for example insurance might only cover 3 sessions when they need 12) Insurance companies would rather have doctors print out a a few sheets of paper that kind of explain several exercises (maybe with a couple black and white pictures if you're lucky) and then expect the patients to figure it all out on their own at home, in the exact same environment they have been in, surrounded by distractions, and with no one to help them which leads to poor compliance and zero data to give back to the doctor. Insurance companies are criminally stupid in this sense. They'd rather not pay for things that would make people healthier like physical therapy, preventative medicine, medical tests, or even gym memberships, even when by not doing those things it will clearly end up costing them more down the road.
zeroonetwothree 2y ago
Every doctor I’ve ever been to starts out recommending lifestyle changes. I think it’s the patients that ask for the medication.

bobthepanda 2y ago

? Doctors tell people to diet and exercise all the time. The problem is that the doctor has very little to offer other than to tell people to do that, and the vast majority of people will nod and continue doing whatever they were doing.

mr_mitm 2y ago

This really downplays the impact of clinical depression. It's often not solved by exercising alone, and if you talk to a psychologist about this, the first thing they do is recommend exercising or at least goeing for walks as an immediate measure before potentially therapy or medication starts. When I went to a doctor complaining about low energy, literally the first question was about weight gain and exercising, so I'm not sure where your comment about the pills comes from.

renegade-otter 2y ago
My comment comes from the seeming ease of procuring these drugs - with people going on Ozempic out of pure vanity.
- toofy 2y ago
  you did end your comment with: > The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business" which makes it appear as even with your “self-diagnoses” you’re under the impression that doctors rarely ask about exercise and diet and then move forward from there. which is the exact opposite of what i’ve seen from a college roommate, a close friend, and an ex who saw multiple different doctors, and each of those doctors first insisted on: a) find a hobby, dive into it. and, b) exercise multiple times per week. and, c) get a nutritionist. and d) only after those things showed little results would they prescribe SSRIs or other long term drugs. i promise this isn’t coming down on you, i promise, but, we seem to have a massive trend of confidently wrong people implying they’re smarter than actual doctors or (just about any other subject it seems), they just guess what doctors do and don’t do. and even far more concerning is how often these confidently wrong people issue blanket advice to randoms online as if they’re at all qualified and as if they know any of the important intricate details of the randoms they’re advising. we desperately need to get back to a place where people can confidently say “i don’t know” again. we’re (including myself) too desperate to chime in even if we’re woefully ill equipped. maybe every secondary-university semester everyone should get a refresher session on the most basic ass socrates/plato: the smartest person is the one who knows, understands, and admits about how much they are ignorant.
sfn42 2y ago
Most people don't know what depression is. I'd say I've been depressed most of my life but the best periods have been the ones where I was physically active. Now, there's a bit of a chicken and egg problem here -am I sedentary because I'm depressed or am I depressed because I'm sedentary? I would agree with the previous poster that exercise brings me out of depression, but I spend most of my depressive periods thinking I should be more active, right now I'm in one and I keep trying to get into some healthy habits but I keep giving up because I just don't have whatever it is that I need to keep it going. I even get nearly immediate results, just a few weeks of activity has me feeling better already. But then I find some reason to take a break and then the break drags on and I'm back to where I started. So maybe it's the depression keeping me down or maybe it's my lack of discipline causing depression but either way I'd say physical activity is important for how you feel on a daily basis and I genuinely think just getting into a regular rhythm of exercise even just one day a week can have huge impacts on your life.

dspillett 2y ago

> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business". I'm guessing you are in the US? There is a lot of medical advice here (UK, and Europe more widely) which is essentially “eat better and move around more”. A great many don't listen to that, but it is definitely said. > When I stop compulsively eating and drinking [and do some] exercise This is a key issue: not what doctors are prescribing but what people do to self-medicate. The harmful side of self-care when “a bit of what you like does you good” becomes overconsumption and underactivity. It can be even worse for those of us with significant mental issues over the norm (bit of a bipolar pillock myself, got a piece of paper saying so & everything, and like you describe with depression I find the right exercise, while not at all a panacea, helps regulate my mind quite a lot as well as stopping my body falling apart).

bobthepanda 2y ago
even in the US a lot of doctors say this because it is usually less of a pain in the ass than filling out referral paperwork to specialists that cost more for the patient anyways. part of the problem in the US is that at least some medical practices/hospitals measure patient satisfaction as a metric to evaluate performance, but what is good for the patient and what makes them happy is not necessarily correlated. it's a factor into how the opioid epidemic got as bad as it did in the US. and also i'd imagine if you kept telling people this for decades and they didn't listen people might just not bother.

orthoxerox 2y ago

> The doctors rarely tell you to eat your salads. "Here is a pill, thank you for your business". That's because advice like this is useless. Everyone knows they should eat more vegetables, you need someone to guide you through habit formation, which is not what the doctors are for.

petercooper 2y ago

I do wonder how many people do not take care of the basics and instead go for anti-depressants and Ozempic. Bear in mind that for many people therapies like SSRIs and weight loss medications (or even counselling/therapy) can get them into the right mental and physical place to start doing more exercise and eat better. It's easy to advise people to eat well and exercise, but it can be a bit like telling a miserable person with a migraine to smile more. Improve the underlying issue artifically, then they can have a better chance of starting the natural things. Doctors do need to do both, though, merely handing out medications without encouraging the next step is irresponsible IMO.

hunter-gatherer 2y ago
I've never suffered from a mental illness, so I'm genuinely curious; is exercise not ever used as a prescription for depression? Physical therapy is a thing, so it can be a prescription in some cases, no?
- petercooper 2y ago
  Oh, it absolutely is, and from what I've read, it can work really well! It's just not necessarily a 'one size fits all' which is what makes medicine complicated and good doctors valuable. If someone's hit the point where they're thinking "I'd rather be dead than leave the house", improving their mental health by any means necessary should be the first step. But not everyone should be given pills as the first option and many doctors are guilty of such laziness (over prescription of opioids and antibiotics are other examples of this – some patients urgently need them, most don't).
- wbl 2y ago
  Compliance matters. Once a day pill is much easier to do than rework routine especially when patient has the "can't anymore" disease. Read Darkness Visible if you want to hear all about what that looks like.
- autoexec 2y ago
  I think it'd be a great idea to perscribe physical therapy for people who need to exercise. Especially for the highly inactive who may not know how to start, and haven't made it a routine. That would send patients to a therapist who would help make sure they aren't doing more than they should and that they're working out correctly, and also provide the doctor with feedback/monitoring of their progress. The problem is that in the US no doctor is going to do that because no insurance company will pay for it. In the US even people who have serious injuries and need physical therapy to recover properly from them often can't get their insurance to pay for physical therapy or to pay for enough of it (for example insurance might only cover 3 sessions when they need 12) Insurance companies would rather have doctors print out a a few sheets of paper that kind of explain several exercises (maybe with a couple black and white pictures if you're lucky) and then expect the patients to figure it all out on their own at home, in the exact same environment they have been in, surrounded by distractions, and with no one to help them which leads to poor compliance and zero data to give back to the doctor. Insurance companies are criminally stupid in this sense. They'd rather not pay for things that would make people healthier like physical therapy, preventative medicine, medical tests, or even gym memberships, even when by not doing those things it will clearly end up costing them more down the road.

zeroonetwothree 2y ago

Every doctor I’ve ever been to starts out recommending lifestyle changes. I think it’s the patients that ask for the medication.