Aerobic exercise is an effective treatment for depression | Hacker News Reader

Aerobic exercise is an effective treatment for depression

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209 pointsDanBC115 comments

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.

Very interesting point; as a kid I hated PE but after some growing up I found myself naturally enjoying exercise.

Maybe it's whether it's enforced or by personal choice?

I hated PE except but I love riding my bike. It doesn't feel like exercise, it feels like magic.

Personal experience, I mostly hated PE as well, but I ran track as an endurance runner (ran 400m, 800m, 1600m, 3200m & 4x400m) aand later competed amaturely in cycling.

When I was running, I was putting in 8-10 miles a day. Cycling was around 1.5 hours for a weekday, 3-4 hours per day on a weekend.

I wouldn't say I was depressed at all in those times, but I was certainly stressed quite a bit and I did feel that the exercise was a cathartic escape from the stress and worrying. I'd kind of zone out at 25 mph, 30 miles from home on the bike and the mind would just clear.

I also loved the competition. I never won a race, but I placed second with a near win in a bike race. Racing on a bike is an experience of its own right. When you're in the peloton, it can be nearly deathly quiet. You can have a quiet conversation with the person next to you. All you hear is the tire noise on the road and the turn of chains over the gears. Zero wind noise. It's weird and magical. Something you don't expect or get to experience as an amateur training alone.

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.

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.

Given the mentions of rugby and "a bouncer" (i.e. Cricket), it sounds like GP had a British (or adjacent) education, and I can also attest that these sports were initially mandatory at my school (equivalent of grades 6-8).

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

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.

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.

I don't know how it was in your country but where I live I think PE is supposed to be about more than exercise. It should develop proprioception, hand-eye coordination, multiple moving bodies awareness, etc.

What kind of PE lessons do you think would have been suitable for your 11 year old self ?

Replying to myself: I could see some outdoor scouting activities be an alternate way to do that.

I think part of the problem here is people comparing themselves to others.

Exercise is about self improvement, and at the start it does suck. It requires hard work and persistence along with pushing yourself outside your comfort zone.

Once you start improving and even getting good at something however it becomes enjoyable and you start to look forward to it.

If you don’t know how to get started I’d suggest picking something where if you had to, you could imagine yourself enjoying it, and getting a coach.

For me personally, I’ve found boxing to be a lot of fun, it burns the calories and teaches you useful skills.

With a good coach they should be able to help you progress at your own pace - all you have to do is show up.

I used to think exercise sucks at the start. But if you start with moving weight, instead of aerobic activity, it doesn't suck -- at least not longer than a few seconds at a time. You are then able to sidle into running a lot more easily.

I've found exercise to be more tolerable if it's done regularly and early in the day.

Walking around outside is a pretty non-demanding and enjoyable form of exercise. It's particularly pleasant in a park, waterfront, or natural environment.

PE lessons as such never inspired me much, except for swimming lessons which seemed fun and useful. But in primary school we had this great thing called "recess" where we could just go outside and do whatever we wanted (or nothing at all) with whatever equipment they had. Staff were available for assistance if needed but didn't direct activities. Games and sports, if any, were generally self-organized.

I'm pretty sure that is a good general model for a school that would actually be fun and educational. Or at least a better balance of something like 10% directed activities vs. 90% undirected/self-directed.

Recess periods might be a good idea for day jobs as well.

Regarding sports, I think they're quite a bit easier as an adult when you have better coordination!

I have to say, in hindsight I am pretty annoyed with the general teaching methods.

Rules and general movements were explained and shown to you once, and then you were left to your own devices only to be judged later on what you learned. (Learning by osmosis at that point, really.)

Several times it took one small comment from someone else years later and I was able to do the thing considerably better. (Which muscles to relax, for example, or wrong direction of a movement.) That should have been a teacher's job.

One issue I’ve noticed from growing up is that “exercise” and “healthy” were always adjectives of last resort — if something was described that way, I knew I was in for a thoroughly unpleasant experience.

Some comments:

Poor motor skills seems to be associated with people on the autistic spectrum. I certainly fit into this mold, and I bet a lot of people here do.

My memories of PE are about team sports. Throw somebody with poor motor skills into team sports and they are going to have a bad time all around.

People with poor motor skills are not going to enjoy competitive sports. Competition might motivate some people, but if you always lose that's a pretty big demotivator.

Individual activities like running or weightlifting are probably a better match for a lot of kids. Something where your only goal is to be better than you started.

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.

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/

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.

Severe depression leads to isolating behaviors. If you're not so depressed that you are able to leave the house and go somewhere, you're ahead of the game and excercise is just icing on the cake.

The floor is always available for pushups, but the social benefits of exercise are also worthwhile in combatting depression. Severe depression is another story, but most depressed people are not severely depressed.

When I was younger I think I was depressed. It got to the stage where people would talk to me and I wouldn't talk back, I'd just stare; I'd lie in bed doing nothing; I let my hair grow long because I didn't want to go outside or talk to a barber.

I'm much better now, and I think exercise was one of the key things that improved my general mood. It was a constant sturggle though for a while.

YMMV, of course, and I was never diagnosed or anything.

That still doesn't mean that he wasn't depressed though. I've experienced the same thing. I struggled with depression in my 20's but I found that if I was able to drag myself out of the house and get on my bike, I'd feel better within minutes. However, the huge struggle was getting out of bed and walking outside in the first place.

Anecdotally, for me, when I was in the mist of severe clinical depression exercise did absolutely nothing for me except make me feel much worse and made me vomit... a lot.

Of course, I was suffering from severe clinical depression not "feeling terrible for a week" level "depression."

That's really key, severe clinical depression profoundly affects your response to stimuli in pathological ways. Another example for me is severe clinical depression (of which I've suffered two episodes of in my life) makes me unable to taste food.

If exercise is making you vomit, I think you're doing it wrong. What did you have to do to get that reaction? Did you try backing off the intensity to a level where you could simply cope and enjoy it?

> If exercise is making you vomit, I think you're doing it wrong.

Good point. I'm interested in their answer on that.

> [...] and enjoy it?

Fuck me :) That was amusing!

No offence but you really don't get it. Exercise in that state we use as a coping mechanism. I guess he, like me, overdid it hence the vomiting (just a guess though - love to hear the answer).

There is no enjoying it because there's little if anything to enjoy if you're hurting inside. To repeat: exercise is a coping mechanism. It's not 'fun'.

Didn't overdo it or anything, if anything I underdid it, my workouts, depressed or not depressed, are not particularity intense and the depression takes the intensity down, since I'm feeling so shitty.

Vomiting is simply my body's response to stress while disfunctioned by severe depression. During that timeframe, I was sitting in a room with coworkers discussing specifics of a project and that was just so completely overwhelming to me that I had to run out of the room and go vomit. Later that week I had to take an extended leave of absence from work because I could just no longer function at work.

Ah, yes, the very predicable "doing it wrong" comment. Honestly, what on Earth possesses you make such a comment?

I'm wasn't "doing it wrong," its severe depression that causes such a reaction, not intensity. My workouts are never particularly intense anyways. That's depression - it causes profound disruptions in response to stimuli. Other innocuous things make me vomit too when severely depressed as well. It's called severe clinical depression. I mean, that's literally a diagnosis criteria, anhedonia - An inability to experience pleasure from activities usually found enjoyable.

I can exercise just fine when not depressed without vomiting or feeling like garbage.

> Did you try backing off the intensity to a level where you could simply cope and enjoy it?

This is the equivalent of suggesting to a depressed person that they should just try being happy.

The context is people being given treatment by the state, sometimes against their will, sometimes when they've been deprived of their liberty.

Given that context it's important that we don't force people to do anything unless we know it works, and the previous evidence didn't tell us that.

I'm glad exercise works for you, and I always support people finding out what works for them.

Is exercising harming them? Why apply such a high standard to something is healthy especially when western populations are sedentary? I think there should be a measured approach.

Exercise usually hurts more that lying around, even when you're not depressed. So yes, I think it can harm.

https://www.cnn.com/2017/05/15/politics/donald-trump-exercis...

> Trump believed the human body was like a battery, with a finite amount of energy, which exercise only depleted. So he didn't work out.

The link only demonstrates the absurdity of your previous statement. Unless that's what you are going for?

We've asked you countless times to stop posting unsubstantive, trollish, or flamebait comments, and since there's no sign of abatement we're about ready to ban the account. Could you please review the guidelines and stop?

https://news.ycombinator.com/newsguidelines.html

Hi,

Could you please delete all my comments from the site?

Idiots downvoted me.

What gave you that idea?

Some people use the word “exercise” to mean any physical activity, and others use it to mean pushing your body near its limits. Lots of the bewilderment that happens in these discussions is between people that define the word different ways and don’t realize it.

Experience.. if we're not talking about a leisurely walk or light garden work, there is always some pain in exercise. (These endorphins people talk about.. how long do you have to run for? Maybe if one gets more fit? )

There is joy in moving (and good feelings afterwards) too, but if you are unable to feel that, then only the boredom and pain remains.

That article is glorious, thank you for posting!

N=1, but exercise was not useful for me. If anything, the cool-down period afterwards just encouraged me to avoid doing anything, and the pain of strenuous exrrcise also added to the misery index.

I did, however, find a medicine that worked wonders. Since then, I have worked out 30-45 minutes 5 days a week, but I certainly don't notice a difference in mood from before and after i started working out again.

Edit: I want to make clear that this is not a rebuttal of what worked for you, but a point to consider when discussing with others who may be suffering. If you speak in absolutes about what works, and they find that it does not work for them, they may end up feeling even more hopeless.

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.

> Twenty minutes of exercise and you felt better?

High-intensity exercise, seems plausible. Aerobic exercise is an annoying timesink by comparison, even though it does nevertheless play an important role in building up cardio endurance.

[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).

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

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.

Ah, I see. Thanks for sharing.

You're less depressed, not "not depressed."

Ok, if you must know, that week was at the end of the Oregon winter, my first time north of 40 degrees after years of California living. In addition I had just moved away from all my friends to a new city, had started remote work and felt isolated from my coworkers. I also had some other deep conflicts that were difficult for me.

In other words it was not just one bad week, I was fucking depressed. It was one bad week after months of being down. But thanks for making me play "more depressed than thou", I hope I won this round.

I don't think depression is measured by your circumstances.

That's not fair. I mean, yes I don't believe what he had was depression as I know it but he still clearly had a bad time. Maybe he hadn't had experiences that would allow him to put it in perspective but he had it pretty miserable anyway and I feel for anyone going through that.

Yeah, I don't mean to question him having had it miserable.

>That kind of things hurts inside, worse than physical pain (I know both).

I agree completely and totally.

Sometimes just doing something for yourself that you know is beneficial helps slow down the downward spiral.

I find exercise reduces stress, and that helps one cope with the day to day setbacks. If you are depressed, this should help.

Of course this doesn't apply to all depression, but I can give this anecdotally an HN comment, unsourced.

I broadly agree with you on the weakness of the evidence, but I'd strongly recommend exercise to everyone anyway. The overall health benefits are immense, even if it turns out that it doesn't do much for depression.

Higher physical activity in the general population is likely to have a significant preventative effect on depression, because chronic physical illness is one of the most significant risk factors for developing a depressive illness and exercise has a strong preventative effect on chronic physical illness.

In the UK, my guess is that this is pushed because it's comparatively cheap.

Interestingly, it's also pushed on those with CFS, despite evidence that it actually causes harm. IIRC, there is a NICE review going on at present, but recommendations are going to be made for a while yet. Sometimes the speed at which the NHS works is literally painful!

would you expect broad studies on something that only makes money for personal trainers and LA Fitness?

Anecdotally, I notice a large improvement in my mood within a week when I start exercising after not having done so in a while.

This has happened to me on multiple occasions.

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.

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.

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.

I get the exact same results as you. As long as I exercise I feel much better also because I do it in the morning its easier to make it part of a good routine however it doesn't seem to help with the anxiety that underpins the depression.

Not feeling depressed is good for a while until it starts to feel like you're not fixing the real issue. Tackling all those routine tasks like exercise, sleep, diet is really easy compared to doing the things that are really important to you where there is much more uncertainty, risk, and discomfort that cause me to feel very anxious which is very discouraging.

Doing things like exercise to help with depression is like trying to repair a cracked stone wall by painting over it so you can't see the crack anymore.

> Just getting out for 30-40 every day minutes and sleeping and eating well does wonders for me.

This is great. I think self-discipline is the underlying thread among all these items. When we have self-discipline and eat well, sleep right, and exercise it starts to spill over into work and personal relationships. And yes, it is a type of success begets success situation.

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.

It’s the modern day DDR for getting people in shape mentally and physically in an enjoyable way. See this story time and time again. Glad you found a way to enjoy improving your health.

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?

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.

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?

A doctor once told me that I shouldn't exercise if I already felt exhausted - advice which I followed and it pushed me into a deeper depression - so, yes, it will help.

do not take exercise advice from people who do not do it themselves.

I can feel that I’m not ready for exercise but be wrong. I can cerebrally know and trust that exercise may help un-kill my emotions and attempt to rotely manoeuver my body into exercise in the substantiated hope that the point to doing anything may return because of it. and it has worked.

I actually notice my mood and energy levels drop significantly when I reduce my weekly exercise.

Think of it more like your brain is lying to you about your energy levels and that exercise is calling your brain's bluff. Writing off exercise without trying it is like the Israelites writing off looking at the brass serpent.

Is that supposed to be a commonly known fable?

> Writing off exercise without trying it

It's a mistake to assume that people who don't currently exercise are doing this.

To abuse the metaphor, telling the obese to cut calories may not help, but all the same cutting calories is exactly what they need to do to get better.

Anecdotally, when I'm exercising all the crap in my life just fades away to where just putting one foot in front of the other is all that matters. It's not a state of not caring, it's more that it doesn't exist in my head the same way The Game doesn't. It's Zen almost - calming and peaceful.

Less anecdotally, you can rationalize the release of endorphins as an evolutionary trick to get us to do something that while unpleasant used to be very necessary for survival. (Imo, whether this is true or not is not important. Rather it is a rational for productive self-delusion).

This morning I woke up at 9am intending to run at about 10 (I'm training for a marathon, so I wanted to get started on my long run early). I stayed in bed until noon and didn't start running until around 2:15. I was able to do the run (and I feel good for having done it), but motivating myself to begin was still difficult.

The motivation to start is often the hardest part for me, but I never regret it once I get going. In a sense, I always want to run soon but I never want to run now.

It can help to join a local training group or running club with organized runs. Then you have more motivation to show up at a particular time and run with the others.

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.

This sounds terrible. I'm sorry.

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.

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!

Thanks.

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

Sorry to hear, this sounds like burnout

For me it took a loooooong time of mostly failing to get out of bed, but occasionally convincing myself to get up and do something. Like half a decade. Once I get up and start there is almost always plenty of energy and it feels good, but the prediction you make when you’re lying in bed feeling shitty is that exercise is gonna suck and you’re gonna feel crap and what’s the point in even trying. It’s like I had to un-learn the prediction and train whatever makes those predictions to expect what really happens. I still fail sometimes, but those days are by far the minority now.

I do think this advice on its own is mostly /r/wowthanksimcured because the advice people really need is the how of setting up a situation where they will actually get out if bed and get started. And I don’t have an answer for that because I think I did it the hard way and kinda got lucky.

Some tips. You don't have to take them, but if you ever feel like trying it, they might be useful. This is for solo exercise. Getting a partner is sometimes good too, but because the partner can also derail you as well as motivate you, it can be hit or miss. Solo stuff is up to you.

- Exercise at a set time every day. I find that morning is easiest for me due to a few tricks. But do what works for you. Also, if it's not working, then try something else.

- Designate some cloths as "exercise" clothes (whatever exercise you decide to do). At first, it literally doesn't matter what they are. Don't go out and buy something. Just put aside some clothes that are only for exercise. Make a rule that when the set time comes to exercise that you put on your exercise clothes. If you don't feel like exercising, then at least put on the exercise clothes!

- Morning works well for me because I set out the exercise clothes the night before (which is easier because I'm not about to exercise). When I see the exercise clothes in the morning, before I wake up I put on the exercise clothes. Following random rules when I am groggy seems to be easier than when I can think up good excuses.

- Keep in mind that you will almost certainly not want to do it. Keep saying to yourself, "Well, at least do X". Don't think past X. If there is a good excuse why you can't do your exercise today, try to put it at the back of your mind and think only about "At least do X". At first, X is just "put on the exercise clothes". Even if you know you are not going to exercise, put on the clothes. It will only take 30 seconds.

- Do some warmup before your main exercise. Keep it light and easy. After you put on your exercise clothes, you might as well do the warmup. Otherwise it's a waste of time to put on the exercise clothes, right? The warmup should be relatively short -- up to 5 minutes. If I'm running, then walking for 2-3 minutes away from my house is perfect. Even if you know that you are not going to exercise, just do the warmup. It's easy. It's light. You won't get sweaty. It's less than 5 minutes. If your schedule is so tight that 5 minutes is going to make a difference, then you are going to burn yourself out anyway. Just take the 5 minutes and do a warmup. You owe it to yourself to just have that "me" time.

- If you really aren't up for it, feel free to go back home after that warmup. But even if you are ill, or hung over or busy, or whatever, put on the exercise clothes. Then just do the warmup -- it's only 2-3 minutes (max 5 minutes). However, as you are dressed and warmed up, you might as well do 1 minute of jogging (or cycling, or fast walking, or whatever). It's only 1 minute and if you are really feeling bad, you can always go home after that.

- It's important to always allow yourself that real choice. If you are really feeling bad, then go home. But are you really feeling bad? It's easy to lie to lie to yourself, but it's also easy to detect the lie. If you don't know if it is a lie, then just do the 1 minute, or whatever. It's not going to kill you. You'll find out if you really can't do it. But if you can't, then go home after that 1 minute.

- When doing aerobic exercise, breathing is really, really important. If walking or running, breathe in for 5 steps and then breathe out for 5 steps. If you have no trouble with that cadence, then speed up. When you start to have trouble, switch to 5 in, 4 out. Then 4 in 4 out. Keep working your way down to 3 in 3 out, or even 3 in 2 out. Then adjust your pace until you can maintain that.

- Getting that breathing going is actually kind of tricky. If you are walking, you may have to jog a bit to get your breath going. Then you may have to slow down to a walk to maintain that level. Or you may just have to adjust your pace, but it takes concentration.

- If you are not in good shape, it may take longer than your workout and so you won't experience it, but you body will slowly switch from burning more sugar to burning more fat. Fat is interesting in that it already binds some oxygen. Because of that, it requires less oxygen to "burn". Somewhere around when you start burning more fat than sugar, you will get your "second wind". If you are super fit, this will happen almost immediately, but if you are not it can take 20-30 minutes to get there. The first time you experience it, you will be surprised. You will go from suffering and having trouble gulping down the air to it being practically effortless to get enough oxygen.

- For the first 2 weeks, no matter what exercise you choose, it will probably feel bad. It will be hard to get your breath regulated. It will be hard to push yourself. Your body will feel bad. It will be hard to keep concentration. When it inevitably happens, just think to yourself, "Yep. That's it. That's exactly what should happen." Too many people think that aerobic exercise isn't for them because they never get past this phase and they expect to enjoy it at first. Enjoyment comes later, unfortunately. My experience has been that it usually is about 2 weeks later that you have a day where you think, "Wow. That was great. I can't wait to do it again tomorrow". Then a while later you will feel the same way again. Eventually, almost every day (unless you are ill) that's how you will feel. It will even get to the point that if you don't exercise you feel absolutely awful and you are pulling your hair out until you get get a run, or cycle or swim or whatever in.

- Your body will hurt at first. It's important to understand the difference between "good" hurt and "bad" hurt. You will get some sore muscles from doing exercise. You may think, "I'd better rest because my muscles are sore. I don't want to get an injury". However, with sore muscles (even if they are really sore), this is not necessary or desirable. After 2 weeks or so, you will never get sore again (assuming you keep doing the same kinds of exercise), no matter how much you do. However, if you get a sharp pain somewhere, then slow down, stop, and figure out why you have the pain. Take a rest and if it persists, go and see a sports medicine doctor. There are some common training injuries (illial tibial band syndrome, shin splints, etc, etc). Googling can help. Try to do a different kind of exercise until the injury heals. Don't push that kind of injury!

- Exercise 6 days a week. One day off a week is usually enough to prevent over training unless you are doing really intense stuff (which you won't be). Trying to do less is just an invitation to "I'll make up for it tomorrow". If you are training practically every single day, there are no days to be able to make up. If you miss a day, you miss a day. So, just put on the clothes. You can't afford to miss a day. Just do the warmup. If you at least do the warmup, then you might do the exercise. Just do 1 minute. If you do 1 minute, you might do the whole thing. By the time you have gone half the distance, you are committed because you have to go the other half to get home ;-) Every day is dramatically easier to maintain than every second day (the the point where if you choose to exercise every second day, I'm willing to bet that you won't continue with it long term).

- Start off with only doing exercise for about 10 minutes (so 30 seconds to get dressed, 5 minutes to warm up, 10 minutes to do your main exercise -- 15 minutes 30 seconds total ;-) ). Every week, extend that by 1 minute. Only 1 minute! After 5 months you will be exercising 30 minutes 6 days a week (3 hours of exercise a week). From there you'll be in a good position to figure out what works best for you. The 1 minute of extra per week will avoid injuries. Injuries are crap because if you get one, you have to rest and then start the whole process over again.

- Realise that it is hard to do this. Take pride when you succeed. Forgive yourself when you do not. But the most important thing to remember: Today is the best day to start over. If you lapse, start over today. Just keep starting over until it sticks. It's totally normal to lapse. It's totally normal to start over. It's totally awesome when you string 2 days in a row.

Solid tips. I am sure they are well earned. The funny thing is, this type of knowledge doesn't seem to transfer well with language alone.

Like everything else when it comes to depression, yes for some people this won't help. But it will definitely help some portion of people, knowing that you really have to prioritise exercise is useful. At least it was the case for me when I first found out about the mood benefits of regular exercise.

This is a good point. The aim isn't to just tell people to go for a jog / cut calories, but to provide them with access to a structured program to help. For people losing wieght that might be 3 months free access to Slimming World. For people with depression that might be 3 months access to a structured sports group, or help to access Park Run.

Here's one park run that's coordinating with their local NHS Mental Health service provider around suicide prevention: https://www.sussexpartnership.nhs.uk/our-events/parkrun

But your point is one of the things that I found so irritating about the exercise advice. People would describe profound deep depression, and someone in the comments would say "go for a jog" (or "cut out sugar"), which always felt really trivialising.

What you describe is a bootstrap problem: not meeting the prerequisites to get the process of getting better started. It's not an isolated case, think of all the "too poor to start saving" or "too busy to rethink priorities" problems.

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

Not sure why you are being junked?

Diet and Gut flora are incredibly important for mental health and overall well being.

In most 1st world countries, people eat way too much and often, unfortunately a lot of their food choices are heavily processed and cause massive inflammation.

> Not sure why you are being junked?

Probably because it's so cliche that memes are made about it:

https://www.reddit.com/r/starterpacks/comments/6w783j/i_dont...

This could be telling in a way though, don't you think? Scurvy is a fun example of what I mean. Most people now know that scurvy is just a disease caused by a lack of vitamin c. But for centuries it was not really understood what caused it, and it has resulted in countless millions of deaths throughout the centuries. Some people would discover the cure, but it never really stuck around. Part of this is because it sounds so absurd that e.g. eating limes is a way to stop an otherwise aggressive and deadly disease. Imagine I suggested you eat apples to stave off the flu. Sounds, at best, 'folky.'

And this was also further complicated by the fact that lime juice can lose its nutritional character in some situations (such as certain sorts of storage), and so some experiments in using lime juice as a cure/prophylactic failed. It was also complicated because there's also high quantities of vitamin C in various fresh meats, and so crews that had access to these meats, but consumed minimal citrus, would also never seem to be affected. Tricky to nail down!

As a fun factoid, vitamin c is ascorbic acid, but it wasn't always called that. It was originally named hexuronic acid. It was renamed ascorbic (against scurvy) acid once it was confirmed that it was indeed absolutely what was treating and preventing scurvy. Another fun one is that this is also related to the slang term for a Brit - a 'limey'. The nickname came from the fact that the British navy was one of the first to start dosing their sailors with lemon/lime juice to ward off scurvy.

So the point of this is that if a whole bunch of people are suggesting something works, to the point of it becoming a meme, there may actually be something to it - even if it can be difficult to isolate the exact reason why, or why it may not work in 100% of cases. Definitively solving the mystery of scurvy took about 3,500 years from the point of it being formalized. So a bit of patience is probably justified for these sort of things.

There is no evidence for scurvy causing "millions of deaths". Thousands is more plausible.

I'm curious why you'd say something so completely wrong so authoritatively. Please do share your motivations and thoughts if you would. The countless deaths by scurvy are some of the most well documented there are. Especially during the age of sail death by scurvy was a regular and inevitable part of attrition. The convenient thing here is that these deaths would occur at sea, or recently at sea, and are heavily documented through captains'/physicians'/etc logs. Literally just about any captain's log from this era and an international voyage will reference large numbers of deaths from scurvy. It was a normal part of attrition.

As literally every single source you might find will affirm this, I'm at a loss for what to cite. Here [1] is a source that seems well written and informative, including some of the countless first person accounts as well. You can also look up the voyages of any famous trader/explorer/voyager you might be aware of. For instance Vasco de Gama, Magellan, Columbus, etc - you'll find horrid tales of rampant scurvy when you actually look into their voyages.

[1] - https://www.sciencehistory.org/distillations/magazine/the-ag...

Populations were much smaller then, and only a small fraction of the population went on sailing voyages long enough to suffer from scurvy. So your estimate of millions of deaths from scurvy is implausible on the face of it.

Of course I agree with you. I was initially quite surprised to discover how many deaths it caused. It's a world we can't even imagine when good chunks of your crew dying was just a regular part of a job. But of course intuition should never replace facts. Maybe next time a more productive idea would be to ask for a source? I'm certain you're far from the only person who found the fact surprising!

> Not sure why you are being junked?

Because he's making glib claims about a very important topic that aren't supported by the evidence. The only studies I could find on keto and depression were conducted on rats; I couldn't find anything on the paleo diet and I'm not even sure we agree on a definition of what paleo is. Veganism may actually make matters worse, because there's a real risk of developing a vitamin D or B12 deficiency if you aren't careful.

The evidence linking diet and depression is really very limited. Serious malnutrition can cause depression, a sensible balanced diet won't do you any harm, but any other statement about depression and diet has little or no basis in fact.

>The evidence linking diet and depression is really very limited.

I’d say the opposite is true there are many available studies on dietary inflammation (ie chronic inflammation) and depression being linked.

See the inflammatory hypothesis of depression, also interesting is data is beginning to reveal a link between inflammation and the 1/3 of patients who do not respond to antidepressant medications. Generally when working antidepressants have an anti inflammatory effects.

It should also be noted that the diets mentioned Keto/carnivore/vegan all generally emphasize the removal of inflammatory foods (ie refined sugars, refined carbs, fried foods, artificial trans fats, etc...).

>I’d say the opposite is true there are many available studies on dietary inflammation (ie chronic inflammation) and depression being linked.

We still don't have any real idea of the causal directionality between inflammation and depression. The best available evidence (and the best available evidence is very weak) suggests that depression causes inflammation rather than vice-versa; depressive illness predicts levels of inflammation markers, but inflammation markers do not predict depression.

Some antidepressant drugs do have anti-inflammatory properties, but the reverse is not necessarily true. Several clinical trials of anti-inflammatory drugs have failed to show efficacy in the treatment of depression.

Presently, the inflammatory hypothesis is distinctly hypothetical; while some basic neurobiological research in mice support it, we have no real clinical evidence to suggest that reducing inflammation has any meaningful effect on depressive illnesses.

https://www.sciencedirect.com/science/article/pii/S088915910...

https://www.biologicalpsychiatryjournal.com/article/S0006-32...

https://onlinelibrary.wiley.com/doi/abs/10.1002/hup.2444

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.

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.

a ton of neuro transmitters is made in the gut then there was the experiment where they swapped mouses gut contents and that lead to the mice switching their anxiety/calmness

The common thread between all of those diets is they require paying careful and constant attention to what you eat. Calorie counting can have a similar impact. It's very easy to just eat "whatever" and fall into bad routines.

But no matter how precise and intentional a diet, I don't think it can ever provide the euphoria that aerobic exercise provides.

I'm high after I eat my food pretty much at least once a week.

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.

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.

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).

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.

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/

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193657/

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.

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

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