Live data from Hacker News

Exercise Does Not Make You Less Depressed

bmj.com

31–35 of 35 posts

Re: Exercise Does Not Make You Less Depressed

#31
post #21
post #17

The title of this post does not match the title of the paper. The report does not say "exercise does not make you less depressed". The report mentions some of the weaknesses; some comments to the article do a good job at pointing out other weaknesses. Exercise is not just pushed at people with depression to treat that depression; it's to help with other stuff too:- * medication side effects (sometimes include weight…

The title matches the results though... "Results: There was no evidence that participants offered the physical activity intervention reported improvement in mood by the four month follow-up point compared with those in the usual care group; adjusted between group difference in mean Beck depression inventory score −0.54 (95% confidence interval −3.06 to 1.99; P=0.68). Similarly, there was no evidence that the interven…

It's not clear from the report whether they're talking about people who had the intervention and who did exercise, or if they're talking about people who had the intervention but who didn't do the exercise. (Or maybe it is and I just missed it?)

> Nor was there evidence that the intervention reduced antidepressant use

People are recommended to stay on anti-depressants for at least 6 months after feeling well, and for at least two years if they're at risk of relapse.

(http://publications.nice.org.uk/depression-in-adults-quality...)

So it's difficult to use antidepressant use as a guide to whether people feel recovered or not.

It's also unclear whether the intervention offered matches current NICE guidelines, which says

> 1.4.2.4 Physical activity programmes for people with persistent subthreshold depressive symptoms or mild to moderate depression should:

> * be delivered in groups with support from a competent practitioner

> *consist typically of three sessions per week of moderate duration (45 minutes to 1 hour) over 10 to 14 weeks (average 12 weeks).

About prescription: Yes, some people think exercise is a wonder drug. I'm not interested in those people unless they're treating patients. Your wikipedia article says:

> While positive psychology can inform clinical psychology, it is not helpful to stretch beyond this point

I live in the UK. Clinicians should refer to the NICE guidance. The NICE guidance is pretty specific about what constitutes physical exercise. That's because the evidence for exercise isn't great. The Cochrane review (http://summaries.cochrane.org/CD004366/exercise-for-depressi...) has a good summary of the evidence - when you only include high quality reviews there's only small benefits from exercise.

But, even if the benefit for depression from exercise is slim there are other reasons to do exercise, and it's important that people are helped to exercise, especially if they're at risk of self-neglect.

More research is needed. It's great that this study has been done. But it's incredibly frustrating that this one study is reported in terms such as "Exercise does not help depression".

Re: Exercise Does Not Make You Less Depressed

#33

Anecdata: Earlier this year, I was exercising regularly. I had a lot of energy and felt great about my body and my brain. Some stuff happened that made me stop exercising. It's been several months. I am generally kind of mopey, lethargic, and unhappy with myself. And putting on weight, which only makes me grumpier. YMMV.

I found myself in a similar situation and decided to just 'walk' to get my mind out of the funk.

I just made sure I was going for at least 30 mins and just listening to some music with no real goal in terms of fitness.

Eventually I just got to the point while walking that I would get little energy bursts and turn it into a jog instead of a walk. Now I'm working my way through one of the couch to 5K style apps and loving it.

Forcing myself out the door the first few times was really key though (regular times I could stick to easily was great as well)

Re: Exercise Does Not Make You Less Depressed

#34

Earlier quoted context omitted.

Interesting; I usually feel tired after a bunch of weight-lifting but invigorated after a long hard run.

The key, I find, is that you have to be on a schedule of lifting; for the first few times, you feel pretty crummy after.

Right, once I got on a schedule I felt pretty bad when I didn't get in my daily lift.

Re: Exercise Does Not Make You Less Depressed

#35

Earlier quoted context omitted.

Interesting; I usually feel tired after a bunch of weight-lifting but invigorated after a long hard run.

The key, I find, is that you have to be on a schedule of lifting; for the first few times, you feel pretty crummy after.

having a schedule and pushing yourself as hard as you can is probably the point. When you lift you are pushing yourself. When I run hard for 30 minutes I am pushing myself. It is pure self motivation. Why would you not feel good after that? At the very minimum you are helping to sustain a certain mental focus. Additionally, if you think about CBT and how that is used to treat depression it is easy, in my mind, to glean how thinking about your thinking for good, particularly during exercise can be a positive on your mental health. I know when I am 22 minutes I am thinking a lot of positive thoughts about making it to the end and that I am strong enough to finish. This shit is CBT.
Post reply on HN