Exercise can be nearly as effective as therapy for depression • Hacker News Board

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

#121

Post by skywhopper » Fri, Jan 09, 2026, 10:14 PM UTC

cheald wrote: post #95

smeej wrote: post #87

Earlier quoted context omitted.

> There is no question if I want to do it, it is set at that time and I have to do it, period. Gosh it must be nice to have at least an ordinary amount of executive function skills. Is it really this easy for neurotypical people to build routines? That's really all it takes? I don't see how this removes willpower at all. It just determines what time you have to use it.

It still requires willpower, but to use a metaphor, it's much easier to travel down a well-trod path than it is to cut a new path through the jungle. Repetition and consistency establishes the path, so the willpower required to travel down it the next day is reduced over time. Establishing a pre-set time and committing to that time ahead of time removes the "will I or won't I" decision at "go time", when you're most…

It really doesn’t remove that for everyone. Glad if it works for you.

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

#122

Post by BeetleB » Fri, Jan 09, 2026, 10:14 PM UTC

javier123454321 wrote: post #52

gehsty wrote: post #19

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.

Jim Carey had the best way to think about this: “I believe depression is legitimate. But I also believe that if you don’t exercise, eat nutritious food, get sunlight, get enough sleep, consume positive material, surround yourself with support, then you aren’t giving yourself a fighting chance.”

If you say that to a depressed person, they are going to sink deeper into despair. Most people (even those who are not depressed), are not meeting that bar.

Always remember, being true is not the same as being helpful.

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

#123

Post by javanissen » Fri, Jan 09, 2026, 10:15 PM UTC

resumenext wrote: post #113

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.

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

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

#124

Post by D-Machine » Fri, Jan 09, 2026, 10:15 PM UTC

verteu wrote: post #72

imzadi wrote: post #38

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…

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.)

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].

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

#125

Post by dns_snek » Fri, Jan 09, 2026, 10:15 PM UTC

lowdownbutter wrote: post #28

gehsty wrote: post #21

Earlier quoted context omitted.

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.

> my diagnosis was free As long as you don't factor in your taxes.

Do you think they're stupid and just don't realize that they pay for it with taxes?

You're not factoring in the most critical piece of financing - the mental burden. You don't want to be stuck figuring out how to get enough money to pay for mental health services when you need them the most. That's when your earning potential is at its lowest, and every minor obstacle to getting help gets magnified ten fold.

That may as well be a death sentence unless you're privileged enough to be able to easily pay for it with savings. Realizing that you need help, figuring out how to access it, and actually following through is hard enough as it is without any added financial burden.

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

#126

Post by skywhopper » Fri, Jan 09, 2026, 10:17 PM UTC

browningstreet wrote: post #75

CrossVR wrote: post #53

Earlier quoted context omitted.

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.

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.

I hope you realize that what works for you and your body doesn’t work for everyone. Your experience is not universal. Your body chemistry and genetics are not universal.

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

#127

Post by WalterBright » Fri, Jan 09, 2026, 10:17 PM UTC

yomismoaqui wrote: post #68

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.

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…

> Motivation is fleeting but routine persists.

Ahnold Schwarzenegger said that the gains in an exercise program happen when you really don't want to do it, but do it anyway.

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

#128

Post by ericmcer » Fri, Jan 09, 2026, 10:17 PM UTC

yomismoaqui wrote: post #68

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.

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…

It is really easy to have a routine when you are single and healthy in your 20s. It stops working so well later on. If you have friends, partner, kids, parents, pets, work, health issues etc. the routine is going to be challenged. If that only happens once every few months no big deal, but now that I am in my late 30s with a partner, kid, 3 pets and elderly parents. I literally have something derail my day almost every single day. Carefully planning my week would be a recipe for misery.

I think really successful people are ones that just don't give a shit, like full on narcissism. Like my dream is X, I need to do Y today. The dog is sick? My kid needs a ride? My parents need help? Not my problem I am doing Y full stop.

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

#129

Post by thewebguyd » Fri, Jan 09, 2026, 10:18 PM UTC

dahart wrote: post #78

LorenPechtel wrote: post #48

Earlier quoted context omitted.

Yup, which is why diets fail. People who are fat generally do not have enough available willpower to lose weight.

I wouldn’t phrase it that way. Relying on willpower is a recipe for failure. Humans generally don’t have enough willpower, it goes for most things, even when you don’t have strong physiological forces involved. The key to getting a diet to work is in figuring out how to not require willpower, which means thinking about it differently, forming new habits. Stress and social environment also need attention or they will…

> figuring out how to not require willpower

This goes for coping with a lot of executive function problems and disorders.

Part of how I have to manage my rather severe ADHD is specifically crafting an environment that's as ADHD friendly as possible, much to my wife's dismay.

That means nothing can ever be hidden away or out of sight, otherwise I will immediately forget it exists. It means every bill must be on autopay, or it will not get paid. It also means living as minimally as possible, for me. Even something as "simple" to a neurotypical like washing dishes or doing laundry is a seemingly impossible mountain for me to climb. I solve that by owning as little as possible, and I also remove choices by, for example, just owning multiples of the same exact outfit.

The moment any sort of friction or context switching is involved in a task, I am going to fail, so I have to architect my life in a way that reduces friction as much as possible.

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

#130

Post by skywhopper » Fri, Jan 09, 2026, 10:18 PM UTC

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.

Yeah, any of these studies that show “X works better than Y” are inevitably operating on averages. Not everyone will respond the same way. Not to mention that the very existence of the structure and human interaction required for these studies makes a huge difference in their outcomes.