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Exercise can be nearly as effective as therapy for depression

• cheald 9mo ago
  This is a finding that keeps coming up, and I've certainly found it true in my life, but there's a significant chicken-and-egg problem in that depression frequently precludes the motivation to exercise, and if you don't already have a deeply-disciplined routine to overcome the lack of motivation, people won't do it. Exhortation to develop those good habits in the good times, I suppose.
  • zaptheimpaler 9mo ago
    It doesn't have to take deep discipline. I started my routine by just going for short walk after dinner everyday and it built up from there. It's intimidating to have to start at gym for 60 minutes 3x/week. Just do whatever little you like - a few pushups, a walk, a dance and stop when its not enjoyable. It tends to naturally build up.
  • WackyFighter 9mo ago
    Much like the sibling comment I started walking around the local park before spending more time hiking. I live semi rurally though and wouldn't want to walk in an urban environment. I normally feel much better after walking and cycling. Also I think doing something repetitive like walking allows you to think, tune out of other things.
    • wk_end 9mo ago
      Everyone is different, so I say this not to tell you how to feel but just to offer a different perspective: Walking in urban environments can be its own sort of joy. Cities (well, good ones anyway) are full of life and energy and humanity, have unexpected nooks and crannies, and a rich sense of dynamism and excitement. Even late at night (as long as you're safe), a quiet city can be a source of serenity and melancholic beauty. Writers like Baudelaire and Benjamin described at great lengths the pleasures of flânerie. Nature is wonderful too, of course! I love a good hike through the forests and mountains...but I also love a good stroll downtown.
      • WackyFighter 9mo ago
        No. Urban environments suck to walk around. What you wrote is utter drivel. If one needs to justify it by quoting authors, that suggests it isn't self evident and they are just trying to justify something that they know isn't good.
        • wk_end 9mo ago
          What an unnecessarily hostile comment. "Utter drivel"? I was talking about how I personally feel. Am I just imagining enjoying the things that I enjoy? Writers have, obviously, written about how walking in nature is nice. Does me saying that now mean that walking in nature is awful? Maybe you're doing other people a favour by staying away from them, sheesh.
          • WackyFighter 9mo ago
            > What an unnecessarily hostile comment. "Utter drivel"? I was talking about how I personally feel. Am I just imagining enjoying the things that I enjoy? No it isn't. Anytime you make an fairly straight forward statement on any website you get some unnecessary contrarian response. There are a bunch of downsides to doing any sort of outdoor activity in an urban environment. That is just a fact. It is noisier, often there it nothing to look at, repetitive (in a bad way) etc. etc. Therefore I would not recommend walking as a form of exercise in that environment as the vast majority of people wouldn't enjoy it. Whimsical writings by 19th century French poets aren't relevant to those facts. > Maybe you're doing other people a favour by staying away from them, sheesh. What an unnecessary comment to make. I never said anything about what you are like.
        • tailspin2019 9mo ago
          What a bizarre response.
          • WackyFighter 9mo ago
            Not at all. It was a contrarian response. Walking in an urban environment is generally not very pleasant. It is often repetitive (in the bad way), noisy and there is little to look at. It the reason they often carve out space for parks and commons.
  • HauntingPin 9mo ago
    I also question the universality of it. No amount of exercise changed my depression or made life any less miserable. Anti-depressants finally helped me get past the trauma I was unable to properly process otherwise.
    • 2muchcoffeeman 9mo ago
      And you think the effects of drugs is universal? Exercise is a side effect free treatment that works for some people so it’s worth a shot because it sometimes works.
      • PaulHoule 9mo ago
        I'd argue that depression kills and optimal therapy is: anti-depressants, exercise AND talking therapy and the time to start is NOW. I wouldn't knock the effectiveness of any of them with the caveats that: (1) you can get anti-depressants from you primary care doc, the best practice is to start on something, ramp up your dose and try something different if it is not working or you don't like the sides. I really thought Vanlafaxine was a comfortable ride but it raised my blood pressure to the "go to the ER" range. Call on the phone and lean in about adjusting your meds. (2) Getting an appointment for talk therapy can take a while these days. (3) In a hard case you can get a more complex medication cocktail from a psychiatrist but the wait could be worse than the talk therapy. (4) People in the military do insane amounts of cardio because it helps dealing with insane amounts of stress. 2 hours a day of cardio helped me deal with a business development process that went on for years before ultimately failing.
        • stuffn 9mo ago
          Or avoid medication for anything but treatment resistant depression. SSRIs are not well understood. Their side effects are not great. Getting off them is miserable. I had them. I felt dead inside. Mission accomplished. Depression was gone, so was my desire to eat, have sex, or do anything else. I wasn’t depressed, I was a zombie. 8 adjustments and medications later I got off them and realized they’re yet another pill to fix a problem 98% of people can fix other ways if they tried. I do not understand this intense desire to be medicated. Exercise, go outside, talk to people. Get good sleep. Once the rest of your life is squared away get some meds if necessary. Psychiatrists and psychologist walk the razors edge of quackery every single day. Talk therapy is a program to take tremendous amount of money from people and funnel it into their account. It’s absolutely nuts the average talk therapist bills at over 300 dollars an Hour. There is no reproducibility in mental health. in their “science”. Therefore, there’s no reason to believe their magical pills will fix problems they barely understand at a biological level. As a final note people in the military do a ton of cardio because running and rucking is hard work you train for. It is certainly not to “stay sane”.
  • 4fterd4rk 9mo ago
    Well... sure. I've had trouble with anxiety and it's actually an incredibly anxiety provoking thing for me to go to therapy. But I read enough information telling me that therapy is good for anxiety so I finally went. I think there's people out there who need to know that exercise is helpful for depression, even if the depression makes it difficult.
  • boplicity 9mo ago
    We have a certain amount of "willpower" that can overcome motivational barriers. This willpower is limited, though. It's very helpful to have clear guidance on where to allocate this very limited resources, especially in situations where people are otherwise struggling. All of which is to say -- these exhortations can play a useful role. :)
    • LorenPechtel 9mo ago
      Yup, which is why diets fail. People who are fat generally do not have enough available willpower to lose weight.
      • CrossVR 9mo ago
        This has more to do with hunger requiring a tremendous amount of willpower to ignore rather than fat people having less willpower than people of average weight.
        • PeterStuer 9mo ago
          It feels very different. Depressed people lack the motivation/energy to start exercise, fat people seem more in line with addiction in not being inclined to overcome short term craving for more feed. While at a certain level of abstraction you can reduce both to A -> !B -> C, that generalization seems to obfuscate specific important differences that impact pathways to treatment. Craving is not the same as lacking energy. Craving, while subversive, energizes, depression does not.
        • browningstreet 9mo ago
          If you eat poorly, those foods will not satiate and the "hunger" (it's not the hunger of a body starved of calories) persists. Eat for sustenance and the hunger you may feel will be different. I also know that if I overeat, I have a strong urge to keep feeding (more chips, more pizza, more chipsahoy). Whereas when I eat a proper meal, I'm fine when the eating of that meal ends.
          • 9mo ago
  • oldpersonintx 9mo ago
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  • refulgentis 9mo ago
    This is 100% true, and what I'm about to describe isn't an attempt to falsify it: took me 11 years and 3 cities to figure it out. You don't have to exercise so much as get moving. I'm the best I've been in 37 years, and it's because in August I started forcing myself to just keep walking whenever I went out to have a cigarette. I was in Boston, and would end up ~nowhere and exhausted. Then started doing random stuff: "might as well walk to Harvard Square instead of the bike path again" "might as well go to a bookstore instead of somewhere random" "I should use the skate park, I don't fit in*, but I miss rollerblading from middle school" Then my dog died, 2 days later I severely sprained my ankle at the skate park and couldn't walk anywhere substantive for a couple weeks. By the time I'm able to do a sustained 10m+ walk it's winter. Went to visit California as a not-tech-employee for the first time, so I saw San Luis Obispo and Los Angeles for the first time. And the same habit kicked in, in SLO I ended up hiking for the first time on what I find out later was not a real trail, end up hiking every day that week. Get to LA and it's nothing like I would have thought. Egalitarian, tons of stuff to do, and Waymo is a godsend. Whenever I get antsy there's somewhere to go and a way to get there. 2 weeks later, I got an apartment in LA, moving away from Northeast for the first time in my life. I could see me just spending another 4 months decaying in Boston until its barely warm enough out to take a 30m walk, and I'm tired of that cycle.. All that to say, I'm fit, I had a great career in high school sports, I played basketball occasionally, but couldn't really get active consistently. Treadmill was never stimulating enough to keep my attention on anything other than being bored. In retrospect, I really wish I heard this old saw ~all of us know and heard it as "moving around" instead of exercise. (n.b. this was all under active mental health care x medications spanning a decade+. It's not that the mental health care was useless, I don't think I could have done what I did without it. But it couldn't "fix" me on it's lonesome, only enable me to get moving.) * in retrospect this was wrong, plenty of newbies, and one of the most welcoming social environments I've been in. just people out there all trying to do the same thing and supporting each other.
    • cheald 9mo ago
      That's a great way to think about it. "Get moving" is a lot less intimidating and feels more achievable than "exercise" which conjures images of marathons and four-plate squats.
  • Insanity 9mo ago
    Nail on the head. I know that exercise will make me feel better, but during a period of depression/grief I could not even get out the house.
    • AnthonBerg 9mo ago
      To my surprise, it has been my experience that this turns out to be pulmonary. It was always the chicken-and-egg of... breathing. Seems like this has been my story: Severe prolonged stress floored me. Turns out that the autonomous control of bronchoconstriction and dilation had gone out of wack, into dysregulation. My lungs were basically clamped shut. (Muscular tension and sundry dysregulation from severe prolonged stress makes sense, right? Applies to the lungs too!) Exercise worked when I could get myself to do it... because exercise forces lungs to open. And the nervous system and brain, well it requires lots of oxygen. In order to learn. And unlearn. — edit: Also interesting: Ketamine therapy worked. And... ketamine is a bronchodilator!
      • ambicapter 9mo ago
        That's interesting. I've noticed when I go for a long-enough run and my body warms up to an optimal state, breathing feels easy and effective. I wish I could breathe like that all the time.
  • cultofmetatron 9mo ago
    its amazing that we haven't found anyone dualwielding the skill of therapist and personal trainer. we already have things like sex surrogacy (https://www.webmd.com/sex/what-is-sexual-surrogacy https://www.webmd.com/sex/what-is-sexual-surrogacy) so its not like it would be that weird by comparison.
  • KellyCriterion 9mo ago
    You can also have a "deeply-disciplined routine" and get thrown out of it and hit depression because exactly by that one impact. Source: Myself.
    • gloxkiqcza 9mo ago
      I’m not sure if you need to hear this but in case you do: There’s only one way to get back to it and the sooner you do it, the easier it is. First week is hardest, then the positive feedback loop starts kicking in. Do not to think about it, just get it done.
      • undeveloper 9mo ago
        reread what you replied to
      • KellyCriterion 9mo ago
        What most people without this "experience" never understand: you just _cant_ If you've seen a distinct "low bar", its nearly impossible to get straight up above this bar
  • heavyset_go 9mo ago
    > Exhortation to develop those good habits in the good times, I suppose. This is what medication for more severe cases of things like depression is supposed to offer: an opportunity to learn, usually through therapy, to cope with the condition in a healthy way.
    • hu3 9mo ago
      Yup! Same thing for ADHD. Medication helps having willpower/focus to develop better habits and realize you are not a useless dumb human. It's just that your brain is a little finicky to get going sometimes. In fact the few diagnosed ADHD people I know are wicked smart. It's just that their brain overclocks to unproductive levels without medication.
  • yomismoaqui 9mo ago
    Motivation is fleeting but routine persists. When there is something that you want to do regularly (exercise, doing the final boring part of some sideproject, cleaning the house...) you remove willpower from the equation and set a day and a time. For example, everyday from 18 to 19 I work on my sideprojects, or saturdays from 16 to 18 is house cleaning time. There is no question if I want to do it, it is set at that time and I have to do it, period. The nice thing about routine is that the first times it is hard, but after some repetitions your mind (and body) begin to get used and it transforms into a routine and then it's like it's written in stone. That time period of that day X is for Y and it is what it is. Routine can be used for bad things but also for good things.
    • jjtheblunt 9mo ago
      I bet simply having a dog needing walking tips the scales into an exercise routine at some level.
      • multiplegeorges 9mo ago
        It did for me. You have to be truly heartless to see a dog being sad about not going outside. So you take it for a walk, then another and another. Soon enough you're researching hiking trails in your region and getting healthier. Dogs are the best.
        • jjtheblunt 9mo ago
          agreed, with an addendum : we have rescue cats too, and they too are like "nope, off the computer, time to play". And perhaps because we have both, they all will play games together (and with us humans): the cats are like dogs who can do gymnastics. the cats will walk outside on leashes but look annoyed and embarrassed. however our feral ancestry dog is like having Richard Simmons on meth...and makes me amused at people who are like "a border collie is a handful". i'm like tell it to her paw.
      • specproc 9mo ago
        God yeah. So much healthier and happier in my forties than my thirties, and it's all down to my executive assistant.
  • mustaphah 9mo ago
    Once exercise becomes a habit, it's very easy to do even on days when your mood is terrible. A strict routine (initially) is the trick to making things easier forever. You definitely want to build that habit when you're at your best.
  • hannob 9mo ago
    True, but the same is true for therapy. Finding a good therapist isn't easy, and having depression certainly doesn't make it easier.
  • baincs 9mo ago
    That may be true if you're severely depressed, but I think it can save you if you're starting to get depressed. That's what happened to me at one point, and an online comment saved me. I was like 60% depressed but on my way there. I just took my first computer science class in college but I was overly ambitious when I participated in an undergrad CS research. The stress and imposter syndrome was shoving me to the downward spiral. I posted some gloomy thoughts on an online forum. It was long ago, but I remember the post contained how I could kind of relate to the villain while watching the movie The Dark Knight Rises. Some online person advised me "lift weights". I had never tried seriously lifting weights, but I was living in a student apartment 10 minutes away from the student gym, so I decided to give it a try. I can't forget the sensation when I did a set of bench press. After a period of amassing so much stress, each rep felt like I was reaching my hand into my brain, directly scooping out the waste and tossing it away. I became much more active after that, and successfully finished the research and the degree. It's like how homelessness is more reversible for people who became homeless less than a year ago, and why organizations focus on those groups.
    • eudamoniac 9mo ago
      If psychiatrists could mind control their depressive patients into doing 2-3 weeks of heavy compound lifts, I'm certain more than half would be cured.
  • iamacyborg 9mo ago
    Motivation generally follows action, not the other way around.
  • javanissen 9mo ago
    I think the real exhortation is to develop a multi-pronged strategy for managing depression. I didn't feel like my depressed life got durably better until I had both exercise and therapy, and there are still times where things aren't going well with no clear discernible reason. I suspect that adding a low dose of medication on top would help. Every additional coping mechanism you add, that works well for you, provides defense in depth.
  • broof 9mo ago
    Also the bad times can be a great time to build good habits. I’ve tried and failed to develop an exercise routine many times, but it wasn’t until I was laid off for 6 months that it finally stuck. I had a friend who went to the gym every day in the middle of the day so I didn’t really have a reason not to go. 6 months was long enough for the habit to stick and fast forward years later and I still have the habit. It’s been so good that I regularly think about how good it was that I had the opportunity to be laid off.
  • econ 9mo ago
    I hear ice swimming also works.
  • deleted 9mo ago
    [deleted]
  • lightbulbish 9mo ago
    That is true. And motivation is not a fixed variable. It is possible to get increased motivation by a better plan, resulting in increased self efficacy. From studies like this, maybe more awareness and perhaps funding to solutions providing smaller steps Shameless plug, I am building one: Low friction mini games, social, squats/situps/pushups. Feelgoodcrew.com
  • mnky9800n 9mo ago
    i think what is missing from this narrative is not whether or not people have a routine, it is that exercise elevates your mood away from the depressed state, therapy encourages you to question your thoughts and decisions through out your day that might lead you away from a depressed state. to put it a different way, whats the point of exercising every day if you continue the thoughts and habits that are less than satisfactory to you without any self awareness?
  • darkhorse222 9mo ago
    My two cents on this topic is to create short term, superficial incentives to help create the practices that yield the long term incentives. For me this is paying extra for a gym with a hot tub, sauna, and cold plunge. Now I derive relaxation from the workout, but before that I also received a lot of support from the knowledge that the amenities afterwards were waiting for me. I'm not a big believer in discipline.
  • is_true 9mo ago
    If you are or you know some that is depressed one of the best things you can do is start exercising with someone.
    • pinkmuffinere 9mo ago
      I really like this advice. When I'm sad I don't want to leave the house, and certainly won't have the motivation to do much exercise on my own. But having friends peer-pressure me into making good choices would (and has) helped a lot.
  • singpolyma3 9mo ago
    One thing that worked well for me is I switched my transportation to almost exclusively bicycle. Do I always want to exercise? Do I always want to get on my bike when it's below zero in active weather? No, not always. But if I want to get where I'm going that's my option and I get the exercise in the process (and save a buttload of money too)
  • baby 9mo ago
    I think we also approach exercise the wrong way. And IMO this is true with sleep too (which also impacts depression). We're using the wrong metrics. The most important thing to get started with working out is just to start doing some exercise. You can start on one push up a day or something. It's all about creating momentum and habit. Once you do it, then you can increase the time and the intensity and optimize exercise and all. But doing sport should be about doing one push up a day and thats it. About starting as slow as you can. Sleep is the same in that we try to sleep as much as we can, and get as much REM and deep sleep, and these are not the right metrics for most people. The most important is just to go to bed and wake up at the same time everyday. That's it. People are obsessed with trying to go to sleep at some point in time. Don't. Go to sleep when you're tired, wake up sleep deprived at the right time, the next evening it'll be easier to sleep at the right time
  • jimnotgym 9mo ago
    I always wondered if this kind of research was just finding that depressed people motivated to exercise are already in a recovery mindset
  • vlod 9mo ago
    “Action precedes motivation.” ― Robert McKain This seems to work for me at least. If I start trying to reason with myself why I should get out of bed at 5am to go to the gym rather than excuse XYZ, I will talk myself out of it. If I simply start "moving" and start doing "stuff" without engaging my brain, things happen and within a short space of time, I'm pumping iron and feeling great.
  • NedF 9mo ago
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  • _DeadFred_ 9mo ago
    Fun fact, people suffering from loss of quality of life issues don't lack motivation. Lots of these people are in great pain, constantly, every day. My mother had a hip issue where the pain could instantly shoot up so bad she couldn't move (from just the normal, constant, almost in tears pain). She couldn't risk going somewhere to exercise, she would be stuck. She couldn't risk exercising on days where she needed to work the next day. Some days she would break down crying going to the grocery store because she had gotten stuck there the previous time she went. A LOT of quiet unassuming people are INSPIRINGLY motivated to push through INCREDIBLE pain and obstacles, every day. Many that prevent them from 'just exercising until life gets better'. It is bullshit to say they lack motivation/character/willpower.
• unsupp0rted 9mo ago
  I take this to mean therapy for depression (particularly for men) is barely effective at all and exercise is not quite as barely effective at all. If therapy for depression were a pill, I'm not sure it'd demonstrate enough efficacy to get approved.
  • EA-3167 9mo ago
    The problem is that the same is true for many medications and other treatments, but if you're in the "lucky" minority (a pretty large one) for whom there's some relief... it's worth the try. It's not like choosing bleeding and emetics instead of chemotherapy for cancer, it's just the best we have right now to treat a complex system that we barely have the earliest understanding of.
    • pfisherman 9mo ago
      Adding to this, the molecular mechanisms of psychiatric disorders such as depression, bipolar disorder, and schizophrenia are not well understood. People prefer their brains and skulls intact so taking brain samples for study is not possible. Diagnosis and grading is fuzzy - a cluster behavioral symptoms observed and reported by patients, family members, and clinicians. Based on some of the genetic evidence, which can also be fraught, it is likely that something like depression is in fact a grouping of a bunch of separate underlying disorders / causes that all result in the same (easily) observable symptoms. Hence why some treatments work on a subset of patients, but are ineffective in others.
  • derbOac 9mo ago
    Psychotherapy is similar to pharmacotherapy in effect size but longer lasting after discontinuation. Given that the latter has been approved, it's safe to assume psychotherapy would be approved if it were a pill.
  • throw128 9mo ago
    Anecdotal obviously, but from my experiences and those in my friend-group, therapy seems actively harmful in many circumstances. Therapy can be an enabler of bad behavior, helping to build a new fancy framework of excuses just as easily as it can help you land somewhere better. How long has it been since you've seen something bad (maybe it was just slightly selfish, maybe it was something worse and chronic) waved away as "self-care"? Or if you've lost faith in people or communication generally, then you're not going to feel better by going through many rounds of therapist mismatch and at some point you've aggravated problems rather than fixing them. Fortunately for the industry, measuring the harm is just as difficult as measuring the benefits. The advice to "just exercise more" may not help, but at least it really can't hurt.
• emsign 9mo ago
  It's almost as if humans were optimized to constantly move around all day by evolution. Huh. Who would have thought.
• srameshc 9mo ago
  I will speak from my experience. I have diabetes and I try to manage it well, with workout. But sometimes when the sugars are high for a while, I can feel it, the sadness, the hopelessness. It took me a while to understand that is high sugar levels and a mild form of depression. Now I will do some workout when I feel that and after a little workout, I can see how my mind also start to feel better. This is not a solution for everyone who is experiencing depression probably but might help some who are experiencing because of high sugar levels.
  • hu3 9mo ago
    hey friend, I'm glad to hear you found a way to improve things. It's not easy. I also notice my mind better after workouts.
• gehsty 9mo ago
  If it helps anyone I take antidepressants and have had a positive experience with them. Depression can be caused by a chemical imbalance and no amount of exercise or talking about it will fix it. One of the most frustrating things when your really low is people giving advice like do exercise to feel better - please don’t do this.
  • ge96 9mo ago
    that $5K deductible though...
    • gehsty 9mo ago
      Apologies - one of the very few great things left in UK is the NHS and my diagnosis was free and my prescription is £9/month. I take sertraline (Zoloft in the US I think) and that is cheap - $20/30 month.
      • ge96 9mo ago
        I'm not even talking medication, talking about cost of therapy it's like $200 per session sometimes but yeah all depends I had to pay $3K for an MRI in cash one time, which yeah you get what you pay for but my buddy pays $2.8K/mo in insurance for his family, like that's a big chunk of his monthly pay Oh I want to be clear no snark towards you this is the cliche topic of healthcare in US Regarding the topic at hand though, yeah I lift 5 days a week and do a half hour of maximum inclined walk for those days as well. Mental health but also I want to be ripped. Helps my job has a gym and I'm the only one in there in the mornings. We also walk like 2 miles at work, in circles around the parking lot, talking to co-workers 4 days a week. My main problem is anxiety, like I wish I could walk downtown in a city and do street photography but I fear that someone will ask me for money or get robbed. The funny thing is I'm a big guy, like 6', I bench almost 300 lbs. I'm not like a stick. I have a fear of crowds too I can do shopping but sometimes in like a WalMart that's a lot of people and of course I'm terrible with women, the fear even if I have the bod. I'm just scared of eye contact and low self-esteem even having a six-fig job my self-determined value is whether a woman will say yes to me or not, it's funny. I don't have a fear of speed I can drive 160mph+ on the highway, helps to have a good car. But for the moment I'm working towards freeing myself from debt and then being able to live a life where I'm not in fear of losing my job. I'm a privileged person, this is brought on by myself eg. dropping $1.2K a night at a strip club or $600 Venmoing a band to play song requests. I'm complaining about therapy cost lmao.
• stormed 9mo ago
  I decided to go unmedicated from SSRIs/mood stabilizers in 2024 and it changed my life for the better. Prior to stopping, I thought I was physically unhealthy until I found out excessive overheating & exhaustion was a common side effect of Zoloft. Since then, I've lost around 40 pounds and have been able to regularly exercise without issues. My mental health also improved with forcing myself to get vitamin D outside. It can be the simplest of things to improve your life, but it can be easy to forget (especially WFH).
  • PeterStuer 9mo ago
    Did you get the "brain zaps" when coming off the SSRIs? How long did it take?
    • stormed 9mo ago
      Definitely. It wasn’t too bad, but it took roughly a month for the brain zaps to completely stop with Zoloft & Wellbutrin. I had worse brain zaps in the past from Lexapro, that was bad enough I’d lose focus on whatever task I was doing.
• cung 9mo ago
  Nearly as effective? It’s significantly more effective!
• imzadi 9mo ago
  This is only talking about therapy and not medication. The original study is a bit light on details https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004366.pub7/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD... > For the 57 trials (2189 participants) comparing exercise with no treatment or a control intervention, the pooled SMD for depressive symptoms at the end of treatment was −0.67 (95% confidence interval (CI) −0.82 to −0.52; low‐certainty evidence), showing that exercise may result in a reduction in depressive symptoms. When we included only the seven trials (447 participants) with adequate allocation concealment, intention‐to‐treat analysis and blinded outcome assessment, the pooled SMD was smaller (SMD −0.46, 95% CI −0.88 to −0.04). Pooled data from the nine trials (405 participants) with long‐term follow‐up provided very uncertain evidence about the effect of exercise on depressive symptoms (SMD −0.53, 95% CI −1.11 to 0.06; very low certainty evidence). Like, what does -0.67 really mean in this context. I read the study and it is not really explained. Maybe I'm too dumb to get it, though.
  • verteu 9mo ago
    It's a standardized mean difference, which I believe can roughly be interpreted as: "treated groups had 0.67 stddev lower depression score than control groups." That's a pretty substantial improvement - consider someone who's more depressed than 75% of the population becoming completely average. (Because the 75th percentile is about 0.67stddev above the median.)
    • D-Machine 9mo ago
      You cannot say if this is a substantial change or not, because you need to know by how much the groups actually differ on average, i.e. you need the unstandardized effect size, expressed as a mean difference in the scale sum scores, or as an actual percentage of symptoms reduced, or etc. In general, there are monstrous issues with standardized mean differences, even setting aside the interpretability issues [1-3]. See also my response to GP. [1] https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000347 https://journals.plos.org/mentalhealth/article?id=10.1371/jo... [2] https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1348/000712608x377117 https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1348/0...). [3] https://www.tandfonline.com/doi/abs/10.1080/00031305.2018.1549101 https://www.tandfonline.com/doi/abs/10.1080/00031305.2018.15...
• golemiprague 9mo ago
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• commiepatrol 9mo ago
  I read the title as "Exorcise". I'll show myself out.
• Simulacra 9mo ago
  I found this to be contradictory with my mental health period even after losing nearly 100 pounds, and going from zero to walking 8 to 10 miles a day, my mental health did not improve. It felt good to accomplish goals, two life-changing goals, really, but my overall disposition and deep depression did not change. I have no explanation for this.
  • nineteen999 9mo ago
    It may be worth looking into childhood trauma if that's something that may be applicable. I had a similar experience, after losing 35kg over 3 years I felt and looked great on the onsite, even having to overcome back surgery during that period as well, felt like I'd conquerered the world. I thought I'd "done enough work", but as I found out, sometimes there is work to be done on the inside as well.
• jimmar 9mo ago
  I took meds for depression a few years ago. I don't know that they did anything other than signal to myself that I wasn't ready to give up. They may have served as a kind of "dumbo's feather" that helped me get through a rough patch. Exercise might be similar. People who choose to exercise make the statement to themselves that they are worth doing something positive for. Some mental health problems resolve with time and without medication, and in those cases, exercise might be a great way to address them. But if you're struggling, call your doctor and make and appointment. Medication is sometimes the answer.
• jokoon 9mo ago
  I tried intensive workout It's unhelpful because I got tired, and then I stopped workout entirely Now I just do fast walking and it's nice
  • cpursley 9mo ago
    Have you tried lifting weights (different pace than HIT)?
  • bunnybomb2 9mo ago
    You sound like a couch potato, like me. Try HIIT 1 minute walking, 1 minute running stimulating for the brain, safe, fun and an easy way to ease into running.
• denim_vampire 9mo ago
  I think one of the tricky things about depression is how unique each person's experience with it can be. I can only speak from my own history. For me, medication was indispensable in getting me to a point where lifestyle changes could occur. That being said, I do believe that exercising, eating right, maintaining a healthy sleep schedule, etc., all the boring lifestyle things have been key to preventing myself from slipping back into that depressed state, years after stopping medication.
• einsteinx2 9mo ago
  It’s also fantastic for anxiety, or at least it has been for me. Though I’ve heard anxiety and depression are often linked so I wonder if there’s some common underlying mechanism by which it helps either both.
• taeric 9mo ago
  I would assume that "doing something" is the key here? Successfully doing exercise probably has add on benefits that you can more successfully do other things afterward. But successfully reading a book can help me get out of depression. Successfully cleaning the kitchen. Really, just successfully doing anything is a huge cure against depression.
  • yoyoma1234 9mo ago
    No, it’s more specific - doing something physical. Cleaning dishes yes, reading a book no
    • taeric 9mo ago
      My point in including both is that both can be surprisingly effective and turning my mood around. Despite them being very different. Included the dishes because that is physical and a chore that most people actively dislike. Edit: Just to be clear, per my other post sibling to this, I should say that they can both seem to be very effective at turning my mood around. I do not, necessarily, think either is causal on their own.
  • filchermcurr 9mo ago
    I'm not sure this is the type of depression being talked about here. It's unfortunate that we have conflated periods of being sad / down with clinical depression. I have no doubt that reading a book or cleaning the kitchen or accomplishing a goal can help with feeling down or general sadness, but clinical depression is a whole separate beast without such easy a fix.
    • taeric 9mo ago
      Who said these were "easy" fixes, though? I am emphatically not claiming that "just doing something" will work. Though, fair that what I put there can seem that way. I am more trying to claim that "just doing something" has an annoying track record of looking like "it" is what worked. I would fully believe that, in reality, the thing that worked was already at play before the success started happening. That is, fully depressed people don't succeed at any of these things.
• ElijahLynn 9mo ago
  The audiobook Spark by Dr. John Ratey, psychiatrist is a great listen with a bunch more evidence based arguments to support that exercise is better then drugs for depression. I highly recommend the audiobook as it is read by him and he is very enthusiastic about his research. The one quote I remember from the book is that he stopped prescribing Prozac and started prescribing treadmills...
  • chegra 9mo ago
    I did a summary here: https://www.chestergrant.com/highlights-from-spark-how-exercise-will-improve-the-performance-of-your-brain-by-dr-john-ratey https://www.chestergrant.com/highlights-from-spark-how-exerc... It's in my top 15 books that changed my worldview. Some key highlights: 1. In 2001 fit kids scored twice as well on academic tests as their unfit peers. 2. German researchers found that people learn vocabulary words 20 percent faster following exercise than they did before exercise, and that the rate of learning correlated directly with levels of BDNF. 3.Specifically, every fifty minutes of weekly exercise correlated to a 50 percent drop in the odds of being depressed.
• D-Machine 9mo ago
  Unfortunately, if exercise is only nearly as effective as therapy for depression, it may mean that the benefits of exercise are not actually really clinically observable, if measured properly and not just based on arbitrary statistical significance. Standardized effect sizes like the ones reported here have no clinical meaning, they are purely statistical. To measure if these kinds of changes matter, you need to determine the Minimal (Clinically) Important Difference [1-2]. I.e. can clinicians (or patients) even notice the observed statistical difference. In practice, this is a change of about 3-5 points on most 20+ item rating scales, or a relative reduction of 20-30% of the total (sum) score of the scale [1-2]. Unfortunately, anti-depressants are under or just barely reach this threshold [3-4], and so should be widely to be considered ineffective or only borderline effective, on average. Of course this is complicated by the fact that some people get worse on these treatments, and some people experience dramatic improvements, but, still, the point is, depression is extremely hard to treat. EDIT: There is less data on MCIDs for therapy, but at least one review suggests therapy effects can be in the 10+ point range [5]. But the way the exercise study is presented, with a standardized effect size, we can have no idea if the results matter at all [6]. [1] Button, et al. (2015). Minimal clinically important difference on the Beck Depression Inventory - II according to the patient’s perspective. Psychological Medicine, 45(15), 3269–3279. https://doi.org/10.1017/S0033291715001270 https://doi.org/10.1017/S0033291715001270 [https://www.cambridge.org/core/journals/psychological-medicine/article/minimal-clinically-important-difference-on-the-beck-depression-inventory-ii-according-to-the-patients-perspective/9672DAAEECECA90E73A518676A00D844 https://www.cambridge.org/core/journals/psychological-medici...] [2] Masson, S. C., & Tejani, A. M. (2013). Minimum clinically important differences identified for commonly used depression rating scales. Journal of clinical epidemiology, 66(7), 805-807. [https://www.jclinepi.com/article/S0895-4356(13)00056-5/fulltext https://www.jclinepi.com/article/S0895-4356(13)00056-5/fullt...] [3] Hengartner, M. P., & Plöderl, M. (2022). Estimates of the minimal important difference to evaluate the clinical significance of antidepressants in the acute treatment of moderate-to-severe depression. BMJ Evidence-Based Medicine, 27(2), 69-73. https://doi.org/10.1136/bmjebm-2020-111600 https://doi.org/10.1136/bmjebm-2020-111600 [https://ebm.bmj.com/content/27/2/69.abstract https://ebm.bmj.com/content/27/2/69.abstract] [4] Jakobsen, J. C., Gluud, C., & Kirsch, I. (2020). Should antidepressants be used for major depressive disorder?. BMJ evidence-based medicine, 25(4), 130-130. https://doi.org/10.1136/bmjebm-2019-111238 https://doi.org/10.1136/bmjebm-2019-111238 [https://ebm.bmj.com/content/25/4/130.abstract https://ebm.bmj.com/content/25/4/130.abstract] [5] Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. Journal of affective disorders, 159, 118–126. https://doi.org/10.1016/j.jad.2014.02.026 https://doi.org/10.1016/j.jad.2014.02.026 [https://pubmed.ncbi.nlm.nih.gov/24679399/ https://pubmed.ncbi.nlm.nih.gov/24679399/] [6] Pogrow, S. (2019). How Effect Size (Practical Significance) Misleads Clinical Practice: The Case for Switching to Practical Benefit to Assess Applied Research Findings. The American Statistician, 73(sup1), 223–234. https://doi.org/10.1080/00031305.2018.1549101 https://doi.org/10.1080/00031305.2018.1549101
• shevy-java 9mo ago
  This kind of makes sense. Most forms of depression have to do with not wanting to do something or lacking motivation to do so. Whereas in sports, people get busy usually, they do something, even if it may just be soccer playing. Exercise is also usually good for one's physical well-being, blood circulation increases, muscles may improve, pain may go away (depends on the exercise, but usually say, two days after some heavy work out, most people may feel better than before, unless it was some extreme exercise that caused injury). I don't think this works for all type of depression though.
  • cj 9mo ago
    I wonder if there’s some survivorship bias. E.g. did they only study people who started and maintained a routine vs. everyone who started a routine but couldn’t stick with it due to depression symptoms
  • eastbound 9mo ago
    Observation bias. Those who succeed to drive themselves to do an effort, are already out of the depression. Try doing 7hrs sports a week and falling into depression: You won’t have the energy. It’s not sports that gets you out of depression, but sure it’s a stage on the way back and you gotta constantly give it a chance.
    • fastasucan 9mo ago
      This is spot on. "To stop being sick you just have to do all the stuff healthy people do, and not do the stuff sick people do! I have never seen a healthy person being sick, so it must work!".
• resumenext 9mo ago
  Therapy carries a huge risk, so maybe if you compare average outcomes exercise is only nearly as effective, but if you consider the 2 overall exercise comes out way, way ahead imho.
  • javanissen 9mo ago
    Is the huge risk being involuntarily committed? If so, that is a risk that is very dependent on local laws. I would be much more cautious about seeking mental health care in Florida, where the Baker Act makes it very easy, than in Connecticut [0]. The risk of being involuntarily committed also, of course, has to be balanced against the risk of forgoing mental health care when you need it and then injuring or killing yourself. [0] https://psychiatryonline.org/doi/10.1176/appi.ps.201900477 https://psychiatryonline.org/doi/10.1176/appi.ps.201900477
    • resumenext 9mo ago
      That seems like a minor concern. Therapeutic malpractice is a thing, misdiagnosis, iatrogenic treatments and so forth; not uncommon. Was a time when gay was in the dsm, the pendulum has swung back and forth on transgender children.
• isk517 9mo ago
  Exercise is great, just make sure to take sometime to evaluate where you are at mentally. I was running about 40 miles and doing 5 hours of lifting per week to try and stay a head of my depression, and when I finally burnt out everything came crashing down all at once.
  • MikeNotThePope 9mo ago
    Exercise is great for addressing feelings related to being physically inactive. It won’t address other mental health issues, such as learning to control your emotions & fostering healthy relationships.
    • nerdsniper 9mo ago
      > Exercise is great for addressing feelings related to being physically inactive. That definition is probably too narrow. https://en.wikipedia.org/wiki/Neurobiological_effects_of_physical_exercise https://en.wikipedia.org/wiki/Neurobiological_effects_of_phy...
    • observationist 9mo ago
      There's a deeper level to the way you calibrate your mental operation. If you're under a lot of mental stress, your body is evolved to prime you for physical effort, beyond the fight or flight responses. By engaging in exercise, you're resetting your physical condition, and that can put you in a much better position to mentally cope with whatever is happening. This is something that has very deep evolutionary roots. A looming project deadline, a relationship crisis, feeling burned out, general malaise about your place in life - all of those stressors can bring about different neurochemical and hormonal changes that are in whole or in part dealt with in a healthy way by engaging in strenuous physical activities. That puts you in a position to gain perspective without the immediacy of the negative emotion, so you don't have to feel anxious, or have subtle negative threat framing around everything. You can abuse that, like anything else, and mask real negative factors in your life, or it can be a phenomenal and healthy way to deal with the negative framing of otherwise neutral or even positive circumstances in your life.
• pedalpete 9mo ago
  There is a tri-lateral(?) relationship between exercise, sleep, diet, and how the three impact mental health. A waste product of exercise is Adenosine. Adenosine build-up leads to increased sleep pressure, and improved Neural Function of Sleep, not just "being unconscious". This is where things get a bit interesting when we look at depression. For many people, depression results in decreased Neural Function of Sleep (specifically slow-wave activity) even though sleep time often increases. However there is also some evidence that restricting slow-wave activity can act as a "reset" button. The researchers I have spoken to about this are either in the "too dangerous to do the research" camp, or "distrupting slow-waves for a very short period, then increase slow-wave activity". Of course, sleep and exercise would only be a single pathway to improving depression outcomes. Exercise alone, and the dopamine, oxygenation, and many other outcomes are also likely to come into play. Comparing this to pharmaceutical or behavioural therapies, I can see why they'd be as effective. You're treating the entire system, not just trying to change a single chemical in the brain, specifically when we aren't even measuring the chemical before or after treatment.
• lifeisstillgood 9mo ago
  This leads to a fairly obvious conjecture : That since for 100,000 years humans were roaming the landscape gathering or hunting, and for 10,000 years engaged in heavy agricultural work, is the modern day rise in depression not just correlated but caused by the modern day reduction in daily heavy exercise? It’s such an obvious idea I am wondering if folks know of any research / studies on it?
  • yousif_123123 9mo ago
    Don't underestimate the meaning and relationships people had in those times, hunting together to feed your family, farming with your community and interacting with animals etc. I think physical activity, even just going on walks makes one feel change is possible. If something sucks and I sit home all day on YouTube, then it continues to suck. If I can change my environment, do things outside, see new people and find myself if different situations, then the thing that sucks starts feeling like maybe it also could change. For example I doubt exercising in a basement just by yourself on 1 machine is likely to materially help with depression. At least not as much as going out doing a variety of things, or playing a game of basketball at the local gym/community center.
    • kayo_20211030 9mo ago
      Yeah. I think the communitarian point is valid, and valuable. Also, even if you only do that 1 machine thing in the basement, you can regard it as an achievement that's worth something. At least I did that thing. It makes me feel kinda ok too, or just better.
  • fastasucan 9mo ago
    >is the modern day rise in depression I think it was quite hard to get an appointment for a depression diagnosis 100,000 years ago.
• bradlys 9mo ago
  I exercised for years. I’m talking multiple hours a day. It was a part time job. It never improved my mood. Some people don’t suffer from chemical imbalances, unhealthy habits ruining their mood, or whatever your snake oil will magically cure. There’s a term called Shit Life Syndrome and some people just have that as their long term situation.
• owenpalmer 9mo ago
  Extremely disappointing analysis in the article and also the cited paper's abstract [0]. The only way this data could possibly hold any value is if they found a way to control for how depression might influence an individual's likelihood of choosing to participate in the trial in the first place, as well as trial completion rates. Even an amateur could read the headline and instantly understand this critical point the experiment's design, and yet it's not even acknowledged under the "Risk of bias" section. [0] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004366.pub7/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
• znpy 9mo ago
  I’m here ti add my own anecdotal two cents: 2024 has been a rough year. I didn’t begin any real recover until around march-may 2025… when i started going yo the gym and lifting weights. Yeah sure i’m doing therapy and all that jazz but the real improvements started with weight lifting.
• Geee 9mo ago
  I've found out that running outside just for 10 minutes with quite high intensity is really effective for anxiety / depression with instant effect. Also, specifically lactic acid producing exercises, such as doing free squats quickly works too. It might have something to do with how the brain uses lactic acid for some functions, but this is just my guess. Found out that there's some research on this: https://www.biotechniques.com/biochemistry/exercise-lactate-and-depression-whats-the-link/ https://www.biotechniques.com/biochemistry/exercise-lactate-...
• lazarus01 9mo ago
  I can see how therapy can be helpful for some people. But I find it to be a big scam from my own personal experience. What incentive do they have to give you immediate and durable results? Why do most only take cash? I did some ML work with an addiction psychiatrist at the peak of the opioid crisis. He said,”To pay my bills, I have to treat rich people.” I find taking long walks and speaking candidly about how I’m feeling is always the most effective way to deal with tough emotions.
  • sizzle 9mo ago
    You are assuming everyone has someone to take long walks with and speak their innermost vulnerable thoughts/feelings with. A therapist is a paid person to achieve this same outcome.
    • lazarus01 9mo ago
      No I’m not. Please read the first sentence of my post. I agree, it’s tough to be honest when you’re vulnerable. Expressing vulnerability exposes how people really feel about you.
      • sizzle 9mo ago
        You’re right I missed that. We’re in agreement then
  • Aeglaecia 9mo ago
    and people wonder why i call psychiatrists legal drug dealers - what incentive does a psychiatrist have to fix someone , when they could make 10x more money keeping that person dependant forever
    • azan_ 9mo ago
      If we had effective treatment, then psychiatrists that are effective would quickly displace ones that keep you hooked on non-effective ones.
• OhioMan2943 9mo ago
  [flagged]
• getnormality 9mo ago
  I'm sure the result is in some sense valid, but it's like saying that radiation therapy can be nearly as effective as antibiotics for a sore throat. The conditions under which it works, the method of action, and what is accomplished are all different.
• evanjrowley 9mo ago
  I've had many exercise regimens throughout my life but never has it ever helped me with mental health in any way. Exercise has always been a mental drain for me. A day when I go to the gym is a day when I give up mental capacity that could have been used for something else. I'll be less effective at work and less organized at home. It's like my IQ's dropped by double digits. I drink enough water and electrolytes, in case anybody's wondering.
  • wiether 9mo ago
    Sorry if I'm stating something obvious for some, but, exercise doesn't HAVE to be something pushed by the industry like running or going to the gym. I got great success converting friends and coworkers to... walking. Not going on a multi-hours hike on the weekend, but just walking around the block or in a park for half an hour at mid-day, and going through the same routes so you don't have to think about finding your way. By doing so, not only you are physically active, which is a big positive overall for most of office workers, but it requires so little of focus to achieve it that your mind is now free to wander as it please. During this free period, you can come up with a solution to an issue you've been stuck on during the morning or for days, or you'll think about plans for the future, or you'll just get back to work with a clear mind, ready to tackle the issues of the afternoon. > I give up mental capacity that could have been used for something else That's the beauty of _just walking_, it requires no mental capacity, it frees it actually. Don't overthink things, like where should I walk, when, do I have the right gear... Just get outside, put the appropriate clothing depending on the weather and, enjoy your free mind compute credits! Once you see how it works, it feels like cheating. Afterwards you'll feel better physically and mentally. All the gym/running/zone 2 stuff is something different altogether that could come up once you're converted to the light exercise/big effects of _just walking_.
• tsoukase 9mo ago
  Physical exercise, like diet, and mood are complicated bio-psycho-social functions that are depended on dozens of overlapping factors in each person. Most meta-analyses and their underlying studies ignore most of these dimensions and come to a binary yes-no conclusion based on a mere p-value. Huge confounding effects persist that the studies should heavily take into account. At least examining such popular functions provide large samples cheaply.
• bfrog 9mo ago
  Nothing has solved sadness for me as well as lifting weights, long fast bike rides, and team sports. Nothing.
• rcarr 9mo ago
  For a long time I used to be able to manage my exercise with depression. Eventually, it stopped working. I literally climbed a mountain, got to the top and felt nothing. What got me out of that place was improv comedy lessons. Highly recommend to anyone. Improv schools and theatres should be as ubiquitous as gyms.
  • rkomorn 9mo ago
    Did you mean manage your depression with exercise?
• unparagoned 9mo ago
  This is complete bullshit. Exercise has been show to be more effective than therapy and drugs. Exercise improves the biological health of the brain which can be fixing the underlying condition. If you are depressed because your brain is biologically unhealthy, therapy isn’t going to do anything
• artyom 9mo ago
  May rampant depression everywhere be caused by not the lack of exercise, but because of life becoming overly sedentary? 30 years ago moving your body wasn't going to the gym, it was part of everyday life. Staying 2 hours nonstop in front on the screen was to watch a movie, and maybe done a couple times a week, tops. Now we just deliver 3 tomatoes to our doorstep to avoid going out.