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Exercise works for depression. So why isn't it treated like real medicine?

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Re: Exercise works for depression. So why isn't it treated like real medicine?

#21

Post by Etheryte »

> When we look at higher-quality evidence and direct comparisons, exercise performs similarly to, but not dramatically better than, established treatments. Overhyping it risks damaging credibility in this important area of mental health.

I get where he's coming from, but at the same time, if we can achieve even roughly the same result with exercise as with medication, that's a ridiculously huge win. Side effects of antidepressants are usually uncountably many, whereas for exercise it's (just) injuries and it's pretty well understood how to prevent them. Granted depression is a thousand different diseases in a trench coat, but even if we can ameliorate some forms with exercise, that would still make it considerably more available and approachable.

Exercise doesn't need to be complex or intimidating. Starting out with going for a short walk counts as exercise. You could even do it while you have the patient with you on an appointment, go walk out and about with them. Depression is a complex beast and the more tricks we have up our sleeves to fight it, the better.

If you're depressed, trying to make exercise happen can be the hardest thing in the world for some. But for those that it isn't, it could help a lot.

Re: Exercise works for depression. So why isn't it treated like real medicine?

#22

Post by scottious »

Exercise really is a wonder drug. The best of the best!

If only doctors could prescribe it and have people adhere to the prescription.

If only American culture weren't so car-centric and our daily lives involved some natural amount of exercising. We've built a society where only the privileged few can walk or bike to work. It's just too easy these days to barely move in our normal life. Drive to work, drive to the store, drive the kids places... you literally have to specifically schedule exercise (and ironically, many people will drive to the gym to walk on a treadmill).

Re: Exercise works for depression. So why isn't it treated like real medicine?

#23

Post by bilsbie »

There’s a good argument for making joining a gym or buying exercise equipment prescription only. A lot of people can injure themselves if they don’t know what they’re doing.

Maybe we could use flock cameras to enforce prescriptions for walking on the sidewalks.

Re: Exercise works for depression. So why isn't it treated like real medicine?

#25

Post by PedroBatista »

Just because a thing is true doesn't mean you can apply it. There are vast numbers of active ingredients discovered or developed that are effective in curing many deceases but there aren't "drugs"/pills with it because we haven't found a delivery mechanism for them to be effective where they should in the human body.

Going back to the subject: Have you ever been clinically depressed or dealt with people in that predicament? Getting up from the bed is already a huge win for that day, let alone exercising and doing it consistently and regularly. Even taking medication regularly can be a hit or miss.

So, yeah the prescription is easy to write and thank god it's real and effective, but that's only ~5% of the work.

Re: Exercise works for depression. So why isn't it treated like real medicine?

#26

Post by storus »

Aren't depressions coming with side-effects like inability to do anything at all? The block is somewhere else to overcome before even thinking about exercise and the brain might have a good reason to block it (e.g. some local energetic/metabolic failure and the brain forcing a "safe mode" to prevent further damage). It's like telling to people with endothelial damage that exercise would do them good when in fact it would cripple them further (e.g. from long covid).

Re: Exercise works for depression. So why isn't it treated like real medicine?

#27

Post by slopinthebag »

bilsbie wrote: post #23

There’s a good argument for making joining a gym or buying exercise equipment prescription only. A lot of people can injure themselves if they don’t know what they’re doing. Maybe we could use flock cameras to enforce prescriptions for walking on the sidewalks.

You should require a permit to leave your house, since a lot of deaths and injury happen outside of the house. The permit would generously give you the freedom to go outside for your job + once per week errand run. 1 hr/month leisure excursions permitted with good behaviour.

You know, for your safety.

Re: Exercise works for depression. So why isn't it treated like real medicine?

#28

Post by Forgeties79 »

Analemma_ wrote: post #13

Around the internet you can find tons of people griping about GLP-1s, saying "diet and exercise make you lose weight, they have to, the First Law of Thermodynamics, etc. etc. How come doctors don't prescribe those?". And the answer is "diet and exercise are not a cure, they are a proposed treatment plan with a dismal success rate". To treat something as medicine, we want it to work in the real world of fallible human…

A lot of us are concerned about more than objecting to GLP-1’s. They’re pretty aggressive as a “treatment” used for weight loss, TONS of people are on it, it’s aggressively marketed in ways that seem rather backwards with what we’ve learned about how to talk about bodies and weight, and we are already seeing concerning GI issues emerging from prolonged usage - which is a given unless someone makes a lifestyle change, which as you said is not a great assumption.

Re: Exercise works for depression. So why isn't it treated like real medicine?

#29

Post by [deleted] »

bilsbie wrote: post #23

There’s a good argument for making joining a gym or buying exercise equipment prescription only. A lot of people can injure themselves if they don’t know what they’re doing. Maybe we could use flock cameras to enforce prescriptions for walking on the sidewalks.

[deleted]

Re: Exercise works for depression. So why isn't it treated like real medicine?

#30

Post by geye1234 »

Exercise helps my ADHD, but it requires quite a bit of sequential cognitive processing to actually get to the point of starting it. Adderall makes this initial part much easier. I expect something parallel is happening in those with depression.
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