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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?

#91

Post by thrixton »

arcfour wrote: post #41
PedroBatista wrote: post #25

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 predi…

Exercise is great on the days I can do it, I love going for a walk. But sometimes when I hear that suggestion - I wonder if those people have ever lain in a totally uncomfortable position in bed for 45 minutes because they felt paralyzed, unable to will their muscles to reposition themselves into something more comfortable. From that perspective, even light exercise seems like walking on the moon; merely a thought, n…

I appreciate your difficulties but have always wondered at our lack of support for preventative measures as a society here in Australia and possibly worldwide.

Would a personal trainer or paid or not training buddy or something of the sort help your motivation?

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

#92

Post by kstrauser »

anon7000 wrote: post #86
kstrauser wrote: post #67

Earlier quoted context omitted.

Hear, hear. I've fortunately not had to personally deal with depression, but have been around those who have, and "just go to the gym" is right up there with "have you just tried not being sad?" on the list of unactionable plans. See also: "Why don't more people with ADHD get treatment?" "Because if they were able to initiate and follow through a complex plan of meeting with care providers, arguing with insurance, an…

Bingo. It took years to get an ADHD diagnosis after severe issues with productivity and executive function. I finally get a medication to try, and on the way home it falls out of my pocket. Don’t realize till I’m home and go back and find it… smashed in the street, run over by a car. Lol. So yeah, it’s a real struggle.

That just about broke my heart. I can imagine how awful and hopeless I'd feel in that situation, at least as a first reaction. Great. Just I'll just plan on not planning until I can get the doctor to send a new prescription, which they might not do because FDA.

There's a reason I pick up my refills exactly on time, even if I still have some of the old prescription left. That little overlapping buffer gives me great peace of mind.

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

#93

Post by SpicyLemonZest »

anon7000 wrote: post #87
SpicyLemonZest wrote: post #75

Earlier quoted context omitted.

The article says that 41% of mental health professionals never recommend exercise. Is it really the case that these 41% have only patients with the severest forms of depression who struggle to get out of bed at all? Or do they have many patients who get out of bed for work and such, and could force themselves to exercise, but don't know that it's worth the hurdle because they haven't been told about the mental health…

I don’t know a single person in my life who thinks exercise isn’t worth it. I think it’s widely known that exercising is one of the best things you can do for your health, but actually making it a habit is extremely hard.

Perhaps I’m atypical, but when my doctor gave me an exercise regimen and told me I must do it in order to treat a joint issue I was having, I found that much easier to maintain than any workout schedule before or since. Knowing it’s good in general is different than confidence it’ll treat some specific problem.

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

#94

Post by snapplebobapple »

everybody gets paid to recommend pills and other treatment (directly or indirectly). Nobody gets paid to recommend exercise. You can't gate exercise behind a control mechanism and mark it up 1000X production cost.. the list of why goes on and on...

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

#95

Post by storus »

tekla wrote: post #55
storus wrote: post #26

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 w…

Any non hack psych will tell you to go outside and take a walk. Meds are a minimal solution

If your brain has a local metabolic failure leading to the inability to replete neurotransmitters, how taking a walk is a solution to your problem? You need to improve energetics first. Or what if some virus/auto-antibody is occupying some receptors in the brain, messing it up? Pushing the brain would likely just exacerbate the underlying failure.

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

#96

Post by SubiculumCode »

I believe forced exercise actually is counterproductive in terms of the facts that exercise usually has on depression, at least in animal models that have looked at the differences in forced versus voluntary exercise. There's a whole literature out there I believe.

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

#97

Post by rootusrootus »

Forgeties79 wrote: post #90
rootusrootus wrote: post #73

Earlier quoted context omitted.

Ah, okay, I was thinking you might have run across something more recent. The latest science seems to be going mostly in the opposite direction, saying that with additional data it looks like early concerns about things like pancreatitis (and worse, cancer) were overblown. If there are some newly identified adverse reactions I'm always interested to learn more about them.

I don’t know what exactly this is but it rubs me the wrong way. You say you’re curious and can’t find anything, but then you dismiss all the stuff I linked in minutes as if no valid literature exists yet and you already have a formed opinion. It doesn’t seem like you’re particularly curious and it feels like my time is being wasted by a lack of transparency.

Sorry, wasn't trying to offend. I skimmed the links, and the majority of what I saw was observations that nausea, constipation, and diarrhea remained fairly common side effects even after having been on the medication for a while. That seems pretty mild [0]. I saw a couple mentions of pancreatitis, which is something that seems mostly debunked by now.

The really interesting one out of those was the first one, which showed an actual physical side effect. In rats, not humans, with disclaimers about how hard it is to replicate in humans. I will keep an eye out for more mentions of that effect, for certain.

[0] Okay, I wanted to say more about the nausea thing, because I suppose this might be a controversial hot take ;-). I think the physical punishment dished out by the medication is the only reason many people see continued success. They could eliminate the side effects by eating less, but that was always the problem. If they lower the dose the side effects go away, but without the punishing side effects they start to gain weight.

Or maybe it's just my own demons talking. Can't tell you how many times I've asked myself why I was eating something in spite of knowing it was the wrong answer, that I was not hungry, etc. If I could answer that with reliably action, I wouldn't take tirzepatide. People may look down on me for being unable to tame those demons, but oh well, I do what works for me. I do want to be on the lookout for long term problems that me outweigh the massive improvement in my health that came with losing 100 pounds, however.

> It doesn’t seem like you’re particularly curious and it feels like my time is being wasted by a lack of transparency.

Sorry, I probably just misread your comment as the usual "hey you lazy fat fuckers why don't you just eat less instead of cheat with a pill" moralizing that crops up in these discussions. I don't really think those links you provided a lot of ammunition disproving that, at least not to me.

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

#98

Post by arcfour »

thrixton wrote: post #91
arcfour wrote: post #41

Earlier quoted context omitted.

Exercise is great on the days I can do it, I love going for a walk. But sometimes when I hear that suggestion - I wonder if those people have ever lain in a totally uncomfortable position in bed for 45 minutes because they felt paralyzed, unable to will their muscles to reposition themselves into something more comfortable. From that perspective, even light exercise seems like walking on the moon; merely a thought, n…

I appreciate your difficulties but have always wondered at our lack of support for preventative measures as a society here in Australia and possibly worldwide. Would a personal trainer or paid or not training buddy or something of the sort help your motivation?

It's a good question. I could see it working for some people (accountability, companionship) but at least for me, one of my parents is a certified PT and while she has helped a bit, the problem is just more deeply rooted than that unfortunately, at least for me.

But, again, everyone's experiences are different.

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

#99

Post by mcherm »

kstrauser wrote: post #92
anon7000 wrote: post #86

Earlier quoted context omitted.

Bingo. It took years to get an ADHD diagnosis after severe issues with productivity and executive function. I finally get a medication to try, and on the way home it falls out of my pocket. Don’t realize till I’m home and go back and find it… smashed in the street, run over by a car. Lol. So yeah, it’s a real struggle.

That just about broke my heart. I can imagine how awful and hopeless I'd feel in that situation, at least as a first reaction. Great. Just I'll just plan on not planning until I can get the doctor to send a new prescription, which they might not do because FDA. There's a reason I pick up my refills exactly on time, even if I still have some of the old prescription left. That little overlapping buffer gives me great p…

The healthcare system in the United States is deeply, horribly broken.

Recently, my wife was going to be out of the country about a week-and-a-half. Her prescription for a medicine to manage arthritis would run out at the very beginning of that time. But insurance company policies refused to allow her to fill it even a little bit early. As a result, her only option was to go without the medicine for several days.

Policies should be set by organizations whose primary goal is to provide effective health solutions, not organizations whose primary goal is to minimize costs in order to make a profit.

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

#100

Post by mcherm »

bawolff wrote: post #78

> Start with brisk walking three times a week for 20-30 minutes at an intensity where you can still talk. When people talk about exercise as a treatment for depression, i never imagined they meant such small amounts.

And yet even that little exercise produces significant differences in outcome compared to doing less.
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