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I have been diagnosed with PTSD after many years in the infantry and being deployed many times. While I still believe that exercise is the best medicine that has -- for most people -- an immediate benefit (in addition to something else, which I will talk about briefly at the end of my post), there was a period of my life when I ran five miles a day and still could not shake the crushing anxiety and depression. At the time, there were some added stressors piled on top, a death in the family and my ex-wife had left me. I had exercised myself out of depression/anxiety previously, and so was dismayed to find it not working during this period of my life. This is one of the worst times of my life. I would go to the psych and get so angry because there was nothing for them to do. The only thing that worked for me were benzos and time, and in retrospect I believe the benzos were a huge mistake and the reason I do not remember the first six months of 2011. The benzos did help somewhat, but I was also set up for failure by the Army docs, as I had totally forgotten my supply when I went overseas and came off of them cold turkey and almost died. I was totally unprepared for that, having been given no warning. I wasn't educated enough about the drugs they were supplying. I wish I had better advice in this lengthy story, but when I have friends or family contact me and tell me that they know someone who is going through a lot and exercise (and sleep and proper diet) are not helping, I can only answer with "time" and that is unfortunate. My other suggestions are psilocybin mushrooms or MDMA. This may prove to be extremely unpopular here, but I would say my own life has been saved by the use of those two things and almost nothing else. You can google for research done by MAPS (in fact I was enrolled in one of their pilot research studies looking at the efficacy of MDMA in treating PTSD and anxiety). And while I must warn you against breaking the law, please buy a test kit from DanceSafe.org and know what you're putting into your body. I guess with this post I am only trying to say that I understand where you are coming from with this, and I'm really sorry exercise isn't more helpful for you.

It's not uncommon for mild depressive symptoms to resolve with exercise. In fact, it's rare for exercise to not be helpful in depression.

But where most commenters go off the rails is in assuming that other people's depression is equivalent to what they experienced in the past, which couldn't be farther from the truth. If exercise produces a mild improvement for you and your symptoms were mild to begin with, you'll likely approach remission, which is awesome. But if your depression is moderate or severe, then intense exercise may only move you from "really miserable" to "still kind of miserable". Again, not arguing that exercise shouldn't be encouraged, but it's critical to remember that your depression experiences are not equivalent to others' depression.

What actually made a difference, for me, was changing my work. My dad experienced this too. If you're depressed maybe you need to change your life, this is hard. It was for me.

Out of curiosity, what was the change that you made?

> What about athletes: students-athletes, NBA players, olympians. Do they show a significantly lower rate of mental health issues?

We have this testimony from Pete Sampras: [Letter to My Younger Self](http://www.theplayerstribune.com/pete-sampras-letter-to-my-y...)

HN discussion: https://news.ycombinator.com/item?id=9803867

Exercise is shown in a number of clinical studies to benefit people who have ADHD, depression, anxiety, etc.

You know one thing those studies do, though, that we don't on HN? Screen every participant to make sure they qualify. Those screening tests take out people who don't meet clinical definitions of (ADHD, depression, anxiety, etc.), screen out people with physical problems that prevent them from completing the protocol, and then track participants.

Exercise is good medicine, but it's not the only one -- and the parent post here points out that sometimes it isn't the answer at all. For an anecdote I'll pull out a friend diagnosed as "just depressed" -- stomach hurt, some tough family situations. "Exercise! It'll help!" All the running, swimming, rock climbing in the world didn't really help. You know what did? Two surgeries to take care of the endometriosis that wasn't diagnosed for 6 years.

We're complex creatures. Try exercise: it's cheap, don't need a prescription, might have benefits esp if you form more social ties while you're at it. If it doesn't help, don't ignore that -- keep looking!

Believe me I'm not saying exercise has solved my issues because it hasn't. But I know that science shows that it does in fact help with many mental health ailments such as anxiety and depression, and I'm merely noting that I recognize the benefit.

It's a legitimate answer in that, given any of those --- depression, anxiety, drug withdrawal --- you will probably quite literally feel better, more often, if you exercise than if you don't.

Of course, the same is true of someone who is experiencing no mental health problems. But although someone without mental health problems perhaps ought to exercise, and probably would enjoy both a significant improvement in mood and a reduction in stress levels; that person nonetheless doesn't need and hasn't been identified as someone who needs a significant improvement in mood or ability to cope with stress.

To my understanding, the reason that exercise is mentioned so often in the context of mental illness is that (a) it very, very likely to have a definite and subjectively detectable positive effect (unlike many potential medications), (b) it has very few potential negative side effects, (c) it may improve the body's ability to metabolize some drugs, (d) it is something that the patient can have control of, (e) it can add some structure to an otherwise unfocused life. Although it might have a "tipping point" effect for some people at some times, and some people may associate it with the end of an isolated episode of chronic depression, I don't think that it is often recommended (by doctors) in the hopes that it will 'cure' mental illness, per se. It can help treat it, and it can help treat confounding factors like lack of purpose, lack of success, lack of agency or autonomy, lack of social contact... et cetera.

I'm sorry that exercise doesn't provide any positive benefit for you. It's not entirely clear whether you're comparing sustained periods (on the order of weeks or months) of low exercise to periods of frequent exercise, or whether you're expecting to find a difference between a day on which you exercise and a day in which you don't. From my experience, I tend to think of it as a general metabolic effect. It's possible that it genuinely doesn't or won't help you; it's possible that you do exercise more than enough, and that you might (or might not) feel worse than you do now were you to cease exercising entirely.

I certainly share your frustration with people who deflect conversations in the direction of exercise as an answer to (let alone cure for) mental illness, most especially when they are proposing to "solve" a problem that they themselves have not experienced or have no substantive knowledge of.

comparing periods of months and years

Oh. well, that sucks. Although for all we know, you might be immune to the debilitating psychological effects of lack of exercise that plagues most of the population, if you want to take an "oh look a glass full of air!" perspective on it.

I can see why assumptions about the curative powers of exercise would bother you.

I think you hear people recommend exercise because many of us in the tech sector don't get enough exercise, and for many it can make a huge difference. After I started jogging regularly a year ago, my depression lessened dramatically. But of course, everybody's different, so your mileage may vary.

My experiences with this are mostly not tech related. It seems to come up everywhere. I'm glad that you found something that worked for you.

I really emphasize with what you're saying here.

As a kid, I remembering hearing - "drink water" all the time.

It never helped. I never once felt better drinking water than not. But no-one cared. "I'm already drinking water." "It doesn't help." It was the panacea to a sea of unrelated problems and no-one was interested in actually checking up on whether it worked.

Now, I'm at a different place in my life, and the water is immensely helpful.

Exercise really helps - on average, statistically, it's one of the most effective interventions, and if you're any sort of health care provider you immediately notice the difference in a whole group of patients after they exercise vs a day they don't. And a lot of times individuals cannot notice the difference from inside, even if their behavior is a lot more upbeat.

But for someone people who need something entirely different, it might not help for that particular issue.

If I had to guess people at the highest level of any profession are more likely to have mental issues. I wouldn't say that looking at the mood of Olympic weight lifters would say a lot about the general population's response to exercise.

I completely concede to that. I, admittedly, was just reaching for the most obvious example of people who exercise.