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11.08.2014
Some ideas seem so nice, so inoffensive and so harmless, that it seems a shame to criticize them. The authors took a large community sample of Norwegian people, the HUNT-2 study, which was done between 1995 and 1997. What they found was that there was an association between taking part in physical exercise as a leisure activity, and lower self-reported symptoms of depression. I think the push for exercise as a treatment for mental illness is so typical of biological approach we have to psychiatry. Now, I could say it's all about endorphins, but that negates the positive psychological and social aspects of me taking up sport. I can understand why this would exercise would not work for many people, but through taking up other activities, sufferers can experience many of the positive outcomes of exercise that I experienced.
Just skimmed through this article and it looks interesting, though a few potential pitfalls jump out at me. I would expect this phenomenon anyway, since a person who has time to spend on leisure sporting activity is unlikely to be also working strenuous shifts – the groupings will to some extent be the complement of each other. There may also be some selectivity going on here, particular with respect to leisure exercise: those who are depressed may be less likely to engage in sporting or athletic activities. I'm not sure that this study really undermines the idea of advising someone to engage in leisure physical activity to assist with combating depression. I think that, if one were to try and compare a 40-hour per week heavy labor job with more than 3 hours per week of leisure-based physical activity, you would come up kind of short – so I think that you are right.
I think psychotherapy operates much the same way – people need to choose psychotherapy actively (or at least buy into the concept) to obtain its full benefit. For myself at least, it is true that after exercise, particularly immediately after it, I do feel good.
I read a research article a few years ago that where a session of exercise led to a mood boost in the immediate aftermath, but when tested the next day the depressed people's mood was in many cases actually LOWER than it had been prior to the exercise session. Could you run those findings over to Public Health England fast as looks like they're bent on transforming us into a nation of happified gym rats. I know these benefits can be true for exercise because I have a slightly obsessive friend that became depressed while out of work that always talked about going to the gym but never did because of his self-image. However there was a time when I was depressed and I'd go cycling in an attempt to be proactive, only to get a short distance and return home feeling worse. Yesterday I read how some people respond to stress differently than others in dissed and victimised, and how genetics may play an important roll. But as we all know, the physiological benefits of exercise, increased fitness etc, are proportional to how long it is, and its intensity. My sense here in the US is that the vast majority of psychs look at exercise as a second- or third-line choice if someone is not ready to accept (or maybe doesn't think they have time for) psychosocial approaches such as CBT, IPT etc.
There is also the augmentation study (Trivedi et al – Exercise as an augmentation strategy for treatment of major depression. Totally off subject I know, but veri just posted something that I actually understood when I read it….
I find it a bit of a leap to assert or postulate a relationship between no benefit from exercise done as part of one's job and questionable benefit from exercise as prescribed by a practitioner.
I am doing a project in school about healthy eating and exercising, would you allow me to use your picture.
I speak from experience when I say that exercise is the most important source of help for depression.


Sure, depression is a mental condition but it's been proved time after time that exercise is the best form of help for depression. Many athletes actually know that overexercising is not good for you and infact can CAUSE depression in particular when nutrition and proper rest is not paid attention to. Exercise is not a well defined term: It matters how much you do, how often you do it and what you do.
It's like saying that alcohol in moderation has horrible effects on the heart because alcoholics and heavy drinkers are more likely to suffer from heart disease.
In addition saying the placebo effect could be responsible for all the improvements is quite unreasonable as well.
Actually it has been reported countless times that people who exercise regularily feel worse emotionally and have more stress related symptoms once they quit their exercise routine.
There are infact many depressed individuals who are using exercise to reduce stress and depressive symptoms as well who promptly have a relapse once they stop.
In addition even moderate exercise can reduce stress levels quickly and improve brain circulation and many other stuff. Then the article is relying on one single study to make the argument and saying it fits in with an other study. At best this study could be viewed as a starting point for further research but i think no one could view this proof or significant evidence that exercise worsens depression or that it is ineffective if you subtract the placebo effect.
I think excercise has been hyped a bit as depression treatment, it's not a miracle treatment but it does have some benefits in some or even many.
If you've ever been part of a group of obsessed marathoners you will see that sometimes the exercise just creates a new problem. Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. Here are just a few examples of recent designs from the Keep Calm-o-Matic creative community.
And a large observational study from Norway has just cast doubt on it: Physical activity and common mental disorders.
Over 90,000 people were invited to take part and full data were available from over 40,000. That didn’t help at all, and indeed the most strenuous jobs were associated with more depression (but less anxiety, strangely). Well, many randomized trials have indeed shown exercise to be better than not-exercize for depression, but the problem is that these trials are never really placebo controlled. It suggests that these people could still get the benefits attributed to exercise even if they did less demanding forms of meaningful activity. It was only when I started to attend circuit training and spinning lessons at the gym that I found my symptoms lifted. I mean both in terms of the types of people in each group, and also conceptually in terms of how much exercise is done. Indeed, employees who suffer from depression may also be less likely to have the confidence to move from a strenuous job if it's taking its toll.
You're comparing people with very different jobs, which contributes to their depression. I encouraging him to go and do regular exercise, go to the gym, and now that he does his mood (and whining) has improved significantly. So being depressed and heading out exercising often exposes one to situations or memories which can have detrimental psychological effects.


If you read the Cochrane review of exercise for depression (linked to in the post), it found that the duration of the study had no impact on how beneficial the exercise was on depression symptoms.
That's because I look at all the young hard-bodied folks zipping along on the treadmills and ellipticals at the health club and I realize how old, fat, and out of shape I am! The treatment was to be told how many caloires per week they burned as the result of their work cleaning hotel rooms. Don't tell me that this is the nocebo effect or the absence of a placebo effect or due some other hidden variable. There could be countless other reasons why people in those jobs are more likely to be depressed. Well there are countless studies on this and similiar subjects it's really easy to cherry pick one or two (even if the majority of the available studies contradicts the claim) and argue this to be proof of something. It's like using heroin as an antidepressant, it might make you feel better for a while but it never lasts, you keep needing more, and it can have a detrimental effect on all of your social relationships.
His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens. Click through to see more designs, create your own, share designs and purchase customised products. For people who don’t much like psychiatry, exercise offers a lovely alternative to psych drugs – why take those nasty antidepressants if exercise will do just as well?
By contrast, doing heavy work as part of your job, while physiologically beneficial, is unlikely to be so much fun.
I continued to take up sport, running the Edinburgh Marathon, and racing as a competitive cyclist, all the time my symptoms lifting.
This may show simply a quadratic relationship between the amount of physical activity a person does and depression, as the groups don't overlap exactly. Also, people who work in manual labor tend to be more often lower SES, minority status, and live in urban environments, all of which contribute to the prevalence rates of anxiety and depression. They found at one and three months follow up that those informed of the health benefits of their work had lost more weight and reported better psychological and physical outcomes. When I broke up one time with the love of my life, instead of pigging out I woke up 5am every morning and jogged my heart out listening to Boyz 2 Men. I've always found associations between physical activity and cognitive ability to be interesting. That kind of added psychological stress could negate some of the benefits of physical activity. But I still ended up with severe depression, which after a while would keep me out of the gym for weeks at a time.
I liken it to the way I feel after taking diazepam, which may suggest there is something in the endorphin theory after all!
I get the sense from studies like this that psychs are looking at exercise as simply another choice for the nonpharm approach area, in which case they are relying on the fact that, as with CBT and others, the patient has to buy into it in order for it to really have benefit. In the latter, one would in theory have choice about the kind of exercise, the duration and the intensity. Exercise might be better at benefiting cognitive rather than affective aspects of psychiatric disorders.



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