Exercise for Depression: Better Than Antidepressants

With a number needed to treat (NNT) of 2, exercise looks much better than psychiatric drugs for depression.

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A recent study has confirmed that exercise is an effective treatment for depression, with an effect size larger than antidepressants.

ā€œExercise is efficacious in treating depression and depressive symptoms and should be offered as an evidence-based treatment option focusing on supervised and group exercise with moderate intensity and aerobic exercise regimes,ā€ the researchers write.

Exercise showcased a larger average improvement over placebo than antidepressants (4.7 points in this study, versus less than 2 points for antidepressants). Moreover, exercise had an NNT (number needed to treat) of 2, meaning 1 out of every 2 people who exercise will experience improvement. The typical NNT cited for antidepressant drugs is 7 or more, meaning that only 1 out of every 7 people (at best) taking the drug gets better.

ā€œFor every two people treated with exercise, it is expected at least one to have a large magnitude reduction in depressive symptoms,ā€ the researchers write.

The international group of researchers was led by Andreas Heissel at the University of Potsdam, Germany, and the study was published in the British Journal of Sports Medicine.

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Peter Simons
Peter Simons was an academic researcher in psychology. Now, as a science writer, he tries to provide the layperson with a view into the sometimes inscrutable world of psychiatric research. As an editor for blogs and personal stories at Mad in America, he prizes the accounts of those with lived experience of the psychiatric system and shares alternatives to the biomedical model.

22 COMMENTS

  1. Our systems rewarding ā€œhard workā€ to earn money reward lots of people with sedentary, sometimes high-paid jobs. Work requiring exerciseā€”work that results in food to eat and homes to live inā€”thatā€™s for someone else.
    Those someone elses work so hard and long doing the physical labor left to them, they develop occupational illnesses and disabilities and injuries.
    So some get flabby and depressed from getting too little exercise, while others get unfairly overworked while often being underpaid. Systematically. What could be wrong? Smells oppressive.
    And some who do sedentary ā€œworkā€ wonder why others who bust their asses every day at work just donā€™t want to work any more.

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  2. Some people who have never done a dayā€™s work in their lives complain that others who do the physical, exercise-imbuing work needed for their cushy survivalā€”the very work they have been systematically insulated from, the work they have spent a lifetime avoidingā€”just donā€™t want to work anymore, or enough, or hard enough to produce their necessities or to make them money. Is that ā€œironyā€?

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  3. Then, after a day devoid of healthful exercise working, itā€™s off to the gym to work out to get exercise, the results of whichā€”other than the personal health benefit and social experience ā€”is unproductive. The results of ā€œworking outā€ arenā€™t beneficial to the community or the world. The results are left there in the gym, while no evidence of work being done is left behind. The world is unchanged by this work and so in a sense it was work wasted.

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      • Someone who expends energy working changes something about the world. On the other hand, when done working out, the weights are put back where they were found.

        While both could be viewed as being productive from an exercise viewpoint, the former accomplishes something (ā€œproductiveā€) that the latter doesnā€™t.

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          • Good points, Birdsong.

            I agree but would substitute the word “guilt” for shame. Or rather, the shame-driven need to prove our innate worth as human beings rooted in an *excessive* need to seek and receive external forms of validation.

            I danced my way through life as a way to stay sane and to maintain a sense of self and connection, even and especially when no one was watching.

            Other physical activities throughout my life helped too (including free weights at one point), but dancing and walking are what I continue to turn to as a crone and will be for as long as I’m able.

            I do it for the sake of my emotional, psycho-spiritual and physical health.

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  4. The cause of depression: isn’t it generally a natural response to our social and psychological environment as it is? What is the psychological environment? It is our social experience but also our socially conditioned thinking and thought processes, so depression is a natural response to society. I don’t think you will find many animals in nature that suffer chronic depression: perhaps an old male lion or leopard who can no longer hunt big prey might get depressed, I don’t know, but who has ever come across a case of chronic depression in an animal of nature? Only in captive animals have I seen this. Certainly depression is found in domestic animals – doesn’t that tell us everything we need to know? So see the insanity of applying ANY treatment solution to a problem of environment. I’m suffering the consequences of my social environment therefore I do more exercise? Therefore I do yoga? Therefore I do therapy? Surely the first sane response is to penetrate through awareness, through perception, the exact dynamics between mind, feeling and environment, meditavely, in order to gain an understanding of the total problem, which is LIFE ITSELF AS IT IS, and the emotional and mental accumulations of life within the psychological mould of our socially conditioned thinking mind. So why call it a mental health problem or a psychological problem? You only have this one thing called life and that is the total problem, not mind or world. Understanding that total problem, which is also self understanding, produces intelligent action in relation to that problem when you know how to observe. The problem is we try to identify and interpret and solve our problem through the socially conditioned mind which cannot lay its hands on the most crucial data of life, which is the total dynamic interplay of all the parts of consciousness, which only perception can observe inaction. I don’t know if I’m conveying what is intended here. It’s just emerging into language. I will try and improve the way I convey it. But if you do see what I’m seeing then looking back at the whole field of psychology and pschiatry one has to ask WHAT THE FUCK DO WE THINK WE ARE DOING. It’s as untrue as the medieval response to witchcraft. You just think what the fuck do these deluded psuedo-experts think they are doing. They can’t understand the problem they are dealing with at all, thinking the problem is in the brain and feeling and past rather then the whole situation of life, the whole circumstances of the person. And if the person understood all this sufficiently they would observe, understand and act intelligently to transform the problem, and that is not mental health treatment at all. It’s the sanity and clarity of any natural organism. It’s what every natural creature does – observe and understand the total happening of life, which is also consicousness, and respond intelligently and sensitively to it. We have forgotten how to do this because we’ve been taken over by a social programme that calls itself ‘me’ which is how it enslaves us, takes us over and makes us depressed, unhappy, angry, lustful, explosive. So where does this put the critic of psychiatry? This critic has laid their hands on a very important and illustrative problem that helps unmask the whole of our broken and diseased state of unfreedom within this social historical process of civilization and the thinking mind. The answer to the problem of psychiatry is not reform: the answer to the problem of psychiatry is not different from the answer to all of our problems. It’s meditation, but not as a practice – it’s the natural state, and the natural response of a socially conditioned brain can when it discovers through it’s own enquiries and understanding of life that it has to become aware of the totality of what is taking place within the consciousness all of the time, which incudes the world which is in my consciousness. When IT realizes this meditation happens naturally, and the interruptions to meditation can then be observed and understood as part of meditation. Now, all this I am absolutely certain of, but I wonder who on Earth besides me sees it? Obviously people do, but they are not really evident at all in the field of psychology, psychiatry or critical psychiatry or social critique or any social discourse that I know of. It does come through however in some of the comments of people who have been through mental illness on this website. Interesting. This is like an Agatha Christie novel to me. When I get to the end no doubt I’ll spill the beans.

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  5. Yes, I think your comment (at best) for 1 in 7 getting better on ADs is probably overstated when you take into consideration those that get much worse! It appears Pharma takes adverse event participants out of the study to improve their efficacy.

    One of the issues with those suffering from depression is they have very little energy or motivation to exercise. I think that’s why physicians and patients look for some quick fix (pills) when it is likely time and self reflection/realization to heal.

    Thanks for writing your article!

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  6. If we put rats in a cage and deprive them of food we don’t call their distress and aggression mental illness or crime, do we. We manufactured all such human circumstances out of the raw materials of nature. What we call madness and crime is social pathology obscured by intellectual pathology, because these socially conditioned ideas destroy our capacity to grasp and understand ourselves and our world, and being free of them existence is illuminated by awareness, and a clear perception plus radical penetration of life emerges. Nobody can own it and words cannot touch it, and whoever has it lives in the same world. Everyone else lives in a lonely and unreal world exclusive to them. Those with clarity apprehend only the total misery – the personal becomes the total. If you care about the whole Earth and the whole of humanity then at least something of this is in you, but hope is it’s enemy, a formidable foe. Don’t touch it.

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      • Amen! I think we can learn almost everything from animals and animal studies. Heck – humanity is one big animal study with very extreme methods indeed. I wonder who the leading scientist behind it is. Don’t blame God! It’s got to be the black spot on the human soul we call ‘the devil’ but I also call the ‘me’. Animals don’t have this black spot because they chase and eat squirrels or beat up the other animal when it threatens it’s babies.

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          • Do you know I came across this study, but thanks for this reference and article – I can’t remember how I cam across it but it probably played an essential role somewhere in connecting this brain of mine and giving it the best possible excuse in the Universe for not trying to control my addictions. Funnily enough through doing so it no longer has the character of the addiction, and that when I do use, I know why I use and it’s OK. I’ve gone off hard drugs and even psychedelics don’t appeal to me much right now. Mind you, I don’t need them because my head is now permanently inside out anyway. If anyone is in doubt about the relationship between addiction and environment please see this study, and we can ask ourselves why we separate the traumatic presentations we call addiction, mental illness and crime when they are all obviously responses of life to a sprawling and blind social historical process that has consumed our lives and created as the pinnacle of this gleaming Mecca of absurdity Donald Trump, Elon Musk and a legion of 20 year olds and depraved and plastic vampires that now govern your life, world and future. Trump will be influencing the whole global development of our crisis ridden world not because he has power to DECIDE effects but because of the butterfly effect of his actions which because of his role necessarily ripple around the whole world and global social consciousness. For example it is almost certain that he has he has already crippled global efforts to tackle the Gaza conflict, climate change, Ukraine and Palestine, and will probably initiate a worldwide epidemic of copy cat aid cuts that will lead probably to millions of uncounted deaths. Not sure how I started with Rat Park and ended up here but one could probably draw a straight line between the two anyhow seen as we’re talking about America! Don’t worry – your Mother Country is a rat cage abandoned by the rats, with only their turds and their bad smell remaining.

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