
Aerobic exercise is an effective treatment for depression - DanBC
https://discover.dc.nihr.ac.uk/content/signal-000711/aerobic-exercise-is-an-effective-treatment-for-depression
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llamathrowaway
Sorry for being slightly off-topic, but I really hope that PE lessons could
focus more teaching the students how to enjoy exercising. It would have
tremendously positive influence on the physical and mental health of the
society as a whole.

Not so long ago I came across a twitter thread in which people shared very
negative experiences with PE lessons in schools. My own experience was not as
bad as some of theirs, but frustrating enough to make me hate the very idea of
exercising. My body shape was average, but somehow I was very clumsy. Among
boys, I was one of the the slowest runners, only faster than the few kids who
are quite overweight. I was also extremely bad at sports. Could not dribble
for more than a few steps, could barely hit a badminton bird reliably, etc.

My clumsiness itself was not something I felt bad about. It was the fact that
my incompetence would be demonstrated in front of my classmates in a PE lesson
that made me hate PE. In retrospect, they might not have noticed me anyway,
and even if they did notice my failures, they are not going to remember. But
this is not something a boy, eleven-year-old, driven by pride and a desire to
show-off, could understand. What I learned from my PE lessons was simple:
exercising sucks. Sport sucks. You better not do it if you've got the choice.

I have seen enough evidence to convince me of the benefits of exercising. I
wish I could enjoy exercising more. But I just can't. I wonder how things
could be different, if I somehow had the chance to enjoy my PE lessons more as
a child.

~~~
jdietrich
An issue that occurred to me as obvious at the time: all my secondary school
classes were streamed by ability, _except_ PE. I hated PE, because it
invariably meant getting tackled to the ground or attacked with hockey sticks
by boys twice my size. Nobody is in physical danger if they're bad at
arithmetic, but I saw several boys get carted off the games field by ambulance
after getting knocked out by a high tackle or a bouncer.

One particularly kind-hearted PE teacher had the (rather obvious) idea of
sending the wheezies, fatties and wimps to the sports hall to play badminton
and table tennis, while the rest of the class went off to the games field to
play rugby. It was a revelation. I wasn't cold, I wasn't wet, nobody was
trying to knock my teeth out, everyone else was equally bad - I was loath to
admit it, but it was almost fun.

~~~
colordrops
Wait, your school required you to play contact sports? Even in the late 80s
when I went to school, contact sports were varsity and you had to try out to
even get a chance to play.

~~~
0db532a0
Growing up in England, I played rugby and cricket from primary (elementary)
school onwards.

~~~
fyfy18
Rugby was the worse. The season is during the cold months of the year, so you
were basically guaranteed to end up cold, wet and muddy. I would have
preferred to play hockey, but at my school that was for girls only.

This was at secondary school (11 - 16). At my primary school (until age 11) we
didn't have showers so the sports were more tame.

~~~
NeedMoreTea
Be careful what you wish for. :)

From age 11 on, also in the UK, we played rugby league, football (soccer),
cricket, and hockey. Hockey was the only one that played some games boys vs
girls. Mixed hockey seemed _by far_ the most dangerous of the sports - for the
boys!

Junior was cricket, footie and the inevitable rounders.

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DanBC
Exercise is often pushed as a treatment for depression on HN, but the evidence
is surprisingly weak. Many of the studies aren't very good; most of the
studies have inclusion criteria that exclude people with major depression or
people who've had in-patient treatment. This means that the studies have
included a bunch of people who had sponteneous remission, or who would have
recovered no matter what intervention you gave them.

This study only looked at people who were recruited from inpatient or
outpatient MH services; it excluded people who had other long term physical
problems; and it found similar effects for solo or group exercise, and for
exercise that used or didn't use equipment.

~~~
astazangasta
Look, the evidence is always surprisingly weak. This isn't necessarily because
these things don't work, its because the epistemology used is terrible at
evaluating these sorts of questions, when someone has bothered to look in the
first place. See here:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/)

Anecdotally my life experience is that exercise is the best possible way to
combat depression. The other day I was crushingly depressed and had been for a
week. I went and hit my heavy bag for twenty minutes and came out feeling
fine. The effect was profound and easily felt. I don't need a study to
convince me further; my lived experience is a superior epistemic method here.

~~~
tempguy9999
Agreed with @astura here.

> The other day I was crushingly depressed and had been for a week

In my regrettably extensive experience, if you feel bad for a week then you
can count yourself very, very lucky. I can't see what you describe as being
depression, although of course people are very different (had GFs who had it
bad for a week or so at a time every month).

> I [...] hit my heavy bag for twenty minutes and came out feeling fine

Depression made me exercise compulsively, to the point of damaging myself. It
never made me feel better so I don't know why I did it, but I had to, and I
understand this is common. Twenty minutes of exercise and you felt better?
It's impossible to equate that in any sense with what I had.

There's a big difference between feeling really crappy and knowing you'd
literally be better of dead, and being in that state for years continuously.
That kind of things _hurts_ inside, worse than physical pain (I know both).

> my lived experience is a superior epistemic method here

Hmm. Good for you.

~~~
tempguy9999
[edit] Replying to myself:

I'll go a little further. Past few years have been extremely hard for me,
haven't been able to concentrate for ~6 months to the point of not mentally
being able to work (had to sign off sick (am in the UK)) and just starting to
get back to work next week 1 day a week, unpaid.

I can _just about_ keep my clothes clean, and mostly keep my flat clean. I'm
mentally very unwell to the point of being unable to go to the pub and
socialise as I used to. I was unwell to the point of being a danger to other
people (am over that now, thank god. Yes, I did talk to the doc). I am coping,
barely. I have no current interest in life, music, little interest in other
people etc. I'm abusing drugs and alcohol as a way of coping, though in the
long term I know that's a bad idea (and I draw a clear distinction between
drug use/drug abuse, entirely independent from what's legal/illegal).

Point is, I feel justifiably terrible but I'm not clinically depressed. For
sure I'm down, but I'm nowhere near the utter destructive blackness that is
real depression, and I'm bloody grateful for it.

So I can't see what you describe as depression in any way that I can
comprehend.

(NB, life sucks but any sympathy you can shove up your arse. I'd much prefer
you took the piss, at least in a nice way. At least I'd get a laugh out of
it).

~~~
johnchristopher
Wait, what's missing from your description to fit the clinical depression ?

~~~
tempguy9999
I see what you're asking, but I've had real depression.

Now I can cope, more or less, and don't mind living (though I'm not fond of it
much). Full-on depression is where death is outright appealing. Full-on
depression hurts inside, really hurts. I've described it as soul-cancer. It
fucking hurts. It's difficult to explain how much it hurts. It's over now, but
if that came back I doubt I'd be alive for more than a few months if that.

That experience, which was a huge chunk of my life, allows me to put this in
perspective - things are shite now (in fact they're worse than I've described)
but it could be so much worse. I can cope.

~~~
johnchristopher
Ah, I see. Thanks for sharing.

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hevi_jos
As a programmer my experience is that I get "depressed" if I do not get out
and exercise every single day. I get angry at other people or at things like
clients or taxes or whatever. I start getting lazy at stuff to do.

Just getting out for 30-40 every day minutes and sleeping and eating well does
wonders for me. I get energized and life becomes full of opportunities, I see
the bright side of people...

I am almost certain that is the circulation of the lymphatic system. For
people working in front of a computer for hours a day it is very important.

Spain(most of it) is sunny most of the year and it is rare when I could not
exercise outside, but in central Europe I notice it a lot with the dark
winter.

~~~
koolba
I’m convinced this is a special case of the more general “success begets
success”. There’s likely a physical aspect of it as well but just feeling like
you’re doing well drives you do better. It’s a virtuous cycle.

~~~
hevi_jos
In most of Spain there are 3 months a year in which there is so hot you can
not do intellectual work without external aids like aid conditioners.

This is something well proven, that over certain temperature, mathematical
work drops enormously.

Having experienced that I have the hypothesis that the body regulates the
temperature of the brain and if it is too high it will make it to slow down,
just like a computer does and make you lazy so you do not generate more heat.

In the same way, it makes sense that if your lymphatic circulation is blocked,
as it works only with movement, it will make you lazy so your cells do not
generate more waste that can not be cleaned.

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127
Playing Beat Saber on Expert+ seems to be more effective than meditation and
therapy combined. It really unlodges various memories that I can then process,
if I take mindful approach to it. Getting better access to my emotions and
what's really bothering me, not being able to run away from them, or wanting
to.

The point is, I will always have some problems, but with exercising for 2
hours, they will become to surface where I can emotionally access them.

Jogging works too, but I find Beat Saber is more fun and I have much easier
time keeping a regular schedule.

~~~
fyfy18
Do you play to lose weight, or to just get in shape? Could you comment more on
how the results have been through this method, compared to your previous
attempts?

~~~
127
Get in shape. I have problems that come from sitting in front of a computer
screen too much, like stiff shoulders. Also aerobic exercise. Gets the blood
moving. Of course, things like adjustable standing desk and properly adjusted
seating that doesn't let me slouch is also important.

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tstrimple
I don't have the energy to get out of bed, but running will help! Am I wrong
in feeling that this is as useful as telling the morbidly obese to just cut
calories?

~~~
screye
I know the exact feeling. I am almost sure that I am depressed as of the last
2 months.

I have written less than a page of code (last sem in uni) but have the IDEE
open in front of me 24/7\. Stopped working out, stopped developing my hobbies.
For context, I used to be a proper high functioning extrovert and juggled full
grad level course-load with good grades through 2017 and 2018. have even
landed my dream job starting in July.

It is frustrating to see people tell me to just get on with it. I am fully
motivated to do the tasks that are piling on, but the absolute sense of mental
inertia is something no one understands. I have blocked websites. Avoided
"time wasting events" and stayed up at night hoping to do something. But, it
has failed literally every time.

I am slowly inching towards a solution, and it has to do with making the task
more mentally accessible.

Instead of working out at the gym, I do pullups on my door frame every-time I
stand up from my laptop. I try to walk to the campus whenever needed instead
of taking public transport to catch some sun and get some exercise. Instead of
going to the gym, I follow the feet of my friend who is also going to the gym,
just so I reach there first. (not even lying)

Making the task a series of small and achievable smaller tasks seems to have
been the best approach so far. It's not perfect, but I am getting there.

I am however, sure about what my 'depression' (not diagnosed, so can't be too
sure) is based in. My friends have all graduated and I have no peer group
left. My relationship with my project guide is purely professional, and I feel
like an imposter to ask him questions about simple things when I get stuck.
Lastly, I am stuck in the project in a spot where the problem can't be broken
down into a series of small steps.

I have seen plenty of others stuck in such a situation during their time in
grad school. In almost all cases, external support is what works best. A new
group of friends you can rely on. A gym buddy who will pull you to the gym. A
mentor who is willing to go beyond call of duty to walk you through the block.

At this point, I can't wait to graduate and move to the new town, where I have
established friends and get a breath of fresh air. Hopefully, that change will
be sufficient.

~~~
ollerac
This sounds terrible. I'm sorry.

~~~
screye
Thanks for being supportive.

If it is any consolation, things aren't as bad as I make it out to be. My life
is technically speaking (from 3rd person POV) the best it has ever been. I
have landed my dream job with a really amazing team. I have group of really
supportive friends in the city where my job is. I stay far-away from family,
but my brother is literally the best emotional support anyone could ever wish
for.

This Monday, I will at least try and give one of our university counselors a
visit, while I still have free university care. I have tried twice and bailed
on it. Maybe 3rd time's the charm.

Lastly, sorry for venting out on the platform here. It's not your baggage.

~~~
tstrimple
I can definitely resonate with downplaying depression because by all other
metrics you lead a successful life and are surrounded by people who love you.
Unfortunately depression don't give a shit about any of that. Hopefully you're
able to follow through on your visit today. Best of luck!

~~~
screye
Thanks.

The brain certainly works in mysterious ways. It is like fighting with
yourself.

------
aszantu
So does switching your diet to keto or carnivore. For some people its even
veganism. Stop eating crap solves a lot of problems

~~~
brailsafe
Feeling like you're doing something solves even more problems. No doubt some
of those diets actually help people improve their nutrition, but I'd wager
that the thing is arbitrary and it's more about the sense of empowerment you
get from feeling like you're doing something right or for a reason.

~~~
chapium
I made a similar comment above. Somehow though, I don't think drowning your
sorrows in alcohol will help with depression, even if it feels like you doing
it for release and self-improvement.

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RcouF1uZ4gsC
The thing to be aware of is selection bias. Depression severely effects
motivation. If you take depressed people who are routinely doing aerobic
exercise, you can be selecting people who are less effected by depression, and
thus instead of aerobic exercise being a treatment, it is selecting people
with milder depression.

~~~
amanaplanacanal
To make this work you have to randomize people to the exercise and no exercise
groups. How to do good science is pretty well known.

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ada1981
I’m trying to figure out how much improvement they saw on the Beck inventory.

For example most antidepressants are at best getting people a few points (from
what I’ve read).

~~~
0xcde4c3db
Relatedly, I can't find anything about how the results compare between the
exercise and non-exercise conditions. Unless I'm misreading, the abstract and
"signal" only give numbers for the exercise condition.

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sdfin
My hypothesis is that often depression is caused by giving attention to some
particular patterns of thoughts and therefore anything that causes you to
direct your attention somewhere else can be helpful to relieve the symptoms.
There are activities that demand a big amount of our attention and those
activities are likely the more effective ones to cause us to remove attention
from depressive thoughts. Exercise, playing Beat Saber, meditating, and many
other things can work.

It isn't really my hypothesis. It's what metacognitive therapy suggests. It's
a therapy developed by a psychologist that worked with CBT before suggesting
some changes to the treatment. [http://mct-
institute.co.uk/depression/](http://mct-institute.co.uk/depression/)

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truth_seeker
Surya Namaskar Yoga exercise is way more effective than any Aerobic exercise.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193657/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193657/)

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foxyv
I've found indoor exercise to be ineffective. The only thing that works for me
personally is getting outside. Cycling is the best so far, but walking is
great too.

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mrfusion
Does it count as aerobic if you get out of breath and develop lactic acid?

