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Exercise can be nearly as effective as therapy for depression

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Re: Exercise can be nearly as effective as therapy for depression

#31

Post by AnthonBerg »

Insanity wrote: post #26
cheald wrote: post #2

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.

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.

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!

Re: Exercise can be nearly as effective as therapy for depression

#32

Post by chrneu »

throw128 wrote: post #23
unsupp0rted wrote: post #7

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.

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 awa…

> Therapy can be an enabler of bad behavior

Be aware that a lot of therapists are aware of this and actively try not to do this.

Unfortunately, services like BetterHealth allow clients to select their therapists in ways which results in people doctor shopping to get what they want. Doctors want to get paid so they'll say/do whatever to keep clients.

It's like the antibiotic issue with internal medicine. People will see a bunch of doctors until they get what they want.

Re: Exercise can be nearly as effective as therapy for depression

#33

Post by antonymoose »

HauntingPin wrote: post #5
cheald wrote: post #2

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.

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.

I don’t think depression is a universal root-cause diagnosis so I’m inclined to agree.

I’ve been diagnosed clinically several times in life with depression and the pills never did anything for me. Sometimes exercise worked, sometimes it was of little or no use.

With retrospect, all of my episodes of depression were a function of environment. As a child, growing up in a broken home situation and bad school environment, of course there is going to be depression. Life sucks. Further, no pill or weight lifting schedule is going to fix that either. Only breaking out of that situation will.

As an adult, I’ve absolutely had and broken out of a long episode of depression with exercise. Bad breakup, startup failure, then introduce chronic drinking and subsequent weight gain. Guess what, cutting back on drinking, bicycling to work 30 minutes each way, doing martial arts in the evenings, it was a great fix. It enhanced self image, added a new community of positive people, and broke a cycle of depression.

Re: Exercise can be nearly as effective as therapy for depression

#34

Post by stuffn »

PaulHoule wrote: post #18
2muchcoffeeman wrote: post #13

Earlier quoted context omitted.

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.

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 thoug…

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”.

Re: Exercise can be nearly as effective as therapy for depression

#35

Post by cultofmetatron »

cheald wrote: post #2

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.

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) so its not like it would be that weird by comparison.

Re: Exercise can be nearly as effective as therapy for depression

#37

Post by marcosdumay »

HauntingPin wrote: post #5
cheald wrote: post #2

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.

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.

There's no universality on anything linked to mental health.

Re: Exercise can be nearly as effective as therapy for depression

#38

Post by imzadi »

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.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.

Re: Exercise can be nearly as effective as therapy for depression

#39

Post by throw128 »

chrneu wrote: post #32
throw128 wrote: post #23

Earlier quoted context omitted.

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 awa…

> Therapy can be an enabler of bad behavior Be aware that a lot of therapists are aware of this and actively try not to do this. Unfortunately, services like BetterHealth allow clients to select their therapists in ways which results in people doctor shopping to get what they want. Doctors want to get paid so they'll say/do whatever to keep clients. It's like the antibiotic issue with internal medicine. People will s…

Yes but isn't this pretty fundamental to the process? You could look for more qualified/expensive people, but even if it were free and everyone was extremely qualified then there's still customer-satisfaction metrics to try and game.

To bring it back towards exercise, it's fair to say that it literally cannot hurt and might help, which is more than you can say about therapy. And at least it is very, very telling whether a therapist is working questions about sleep/exercise into the very first interactions. Anyone who does not is definitely a quack.

Re: Exercise can be nearly as effective as therapy for depression

#40

Post by cheald »

HauntingPin wrote: post #5
cheald wrote: post #2

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.

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.

Depression isn't monocausal so it'd be far too simple for it to have a single solution.

But in general, humans just work better when we're regularly putting our bodies under reasonable physical load.

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