I also question the universality of it. No amount of exercise changed my depression or made life any less miserable. Anti-depressants finally helped me get past the trauma I was unable to properly process otherwise.
I’ve been diagnosed clinically several times in life with depression and the pills never did anything for me. Sometimes exercise worked, sometimes it was of little or no use.
With retrospect, all of my episodes of depression were a function of environment. As a child, growing up in a broken home situation and bad school environment, of course there is going to be depression. Life sucks. Further, no pill or weight lifting schedule is going to fix that either. Only breaking out of that situation will.
As an adult, I’ve absolutely had and broken out of a long episode of depression with exercise. Bad breakup, startup failure, then introduce chronic drinking and subsequent weight gain. Guess what, cutting back on drinking, bicycling to work 30 minutes each way, doing martial arts in the evenings, it was a great fix. It enhanced self image, added a new community of positive people, and broke a cycle of depression.
I have a page long list of failed psychiatric regimens that included drugs alone and drugs combined with talk therapy. None of them effective.
I won't say that I'm cured of depression now or will ever be. But a strict and persistent exercise routine lessened it to the point where I can function day to day. This was never achieved with presrciption drugs or therapy (of which I have developed a dim opinion).
Exercise is a side effect free treatment that works for some people so it’s worth a shot because it sometimes works.
I wouldn't knock the effectiveness of any of them with the caveats that: (1) you can get anti-depressants from you primary care doc, the best practice is to start on something, ramp up your dose and try something different if it is not working or you don't like the sides. I really thought Vanlafaxine was a comfortable ride but it raised my blood pressure to the "go to the ER" range. Call on the phone and lean in about adjusting your meds. (2) Getting an appointment for talk therapy can take a while these days. (3) In a hard case you can get a more complex medication cocktail from a psychiatrist but the wait could be worse than the talk therapy. (4) People in the military do insane amounts of cardio because it helps dealing with insane amounts of stress. 2 hours a day of cardio helped me deal with a business development process that went on for years before ultimately failing.
SSRIs are not well understood. Their side effects are not great. Getting off them is miserable. I had them. I felt dead inside. Mission accomplished. Depression was gone, so was my desire to eat, have sex, or do anything else. I wasn’t depressed, I was a zombie. 8 adjustments and medications later I got off them and realized they’re yet another pill to fix a problem 98% of people can fix other ways if they tried.
I do not understand this intense desire to be medicated. Exercise, go outside, talk to people. Get good sleep. Once the rest of your life is squared away get some meds if necessary. Psychiatrists and psychologist walk the razors edge of quackery every single day. Talk therapy is a program to take tremendous amount of money from people and funnel it into their account. It’s absolutely nuts the average talk therapist bills at over 300 dollars an Hour. There is no reproducibility in mental health. in their “science”. Therefore, there’s no reason to believe their magical pills will fix problems they barely understand at a biological level.
As a final note people in the military do a ton of cardio because running and rucking is hard work you train for. It is certainly not to “stay sane”.
Would you rather take a pill and keep working while you sort things out or would you try to rebuild everything after you burn it all down? Talk therapy and exercise may be just as effective or more so long term, but may not be effective enough in the short term.
I did get the sexual side effects but because men often come too quick it can be a blessing as much as a curse, personally I found it took longer to orgasm and when it did happen it was a much more complex and richer experience with a definite periodization I haven't had before or since.
When I was taking ADs I did have problems I blamed on the ADs that really had to do with the "non-drowsy" antihistamine I was taking crossing my blood brain barrier anyway.
When I did stop ADs I tapered over a month and the physical effects were not bad at all. It was the beginning of a time of personal growth that I can look back on now and think it worked out great but was challenging for the people around me for a while.
You've been a good contributor to HN for a long time and most of your comments aren't like this, but there is also a long history of us asking you to stop posting personal attacks:
https://news.ycombinator.com/item?id=46012112 (Nov 2025)
https://news.ycombinator.com/item?id=21867262 (Dec 2019)
https://news.ycombinator.com/item?id=21327013 (Oct 2019)
https://news.ycombinator.com/item?id=17371604 (June 2018)
https://news.ycombinator.com/item?id=16017705 (Dec 2017)
Moreover, your account has continued to be in the habit of posting aggressive comments recently, including personal attacks (e.g. https://news.ycombinator.com/item?id=46478121, https://news.ycombinator.com/item?id=46463522). This is not cool.
I don't want to ban you but it's important to preserve this place for its intended purpose of curious conversation (which depends on thoughtful, respectful comments), so if you'd please review https://news.ycombinator.com/newsguidelines.html and stop doing this going forward, we'd be grateful.
[1] https://ebm.bmj.com/content/27/2/69.abstract
[2] https://ebm.bmj.com/content/25/4/130.abstract
[3] https://link.springer.com/article/10.1186/1744-859X-12-26
[4] https://doi.org/10.1192/bjp.bp.116.187773
[5] https://jamanetwork.com/journals/jama/article-abstract/18515...
However, since this takes time, and most depression is temporary, it is hard to know if you really are tailoring the medication to the person in many cases, or it has just been long enough you are seeing regression to the mean (or a placebo response, which is still strong even in treatment-resistant depression https://jamanetwork.com/journals/jamanetworkopen/fullarticle...).
There aren't really any double-blinded or even just properly placebo-controlled / no-treatment controlled studies to test this, but the closest thing to looking at the sequential approach also doesn't find very impressive results (https://bmjopen.bmj.com/content/13/7/e063095.abstract).
I do believe the drugs help some people, and almost certainly take some experimentation / tailoring. The average effects are just very weak.
This is giving the military way too much credit for organized stress management. If military people give the impression of doing "insane amounts of cardio" it's because that's what the physical fitness tests are biased towards.
And we also won't talk about the fact that getting a psych diagnosis, especially in fields like aviation, can end your career, while managing stress via alcohol gets a wink and a nod as long as you don't have an alcohol-related incident.
it might help with stress too, but that isn't as clear
But in general, humans just work better when we're regularly putting our bodies under reasonable physical load.
Exercise is a crucial part of dealing with it, but it is not a panacea.
Honest question, but what do you mean by this?
I've played competitive team sports my whole life and have a very competitive drive. If its not team sports, its rock climbing where I feel like I'm competing against myself or my brain trying to solve a route. If I'm hiking, I'm competing against the clock or how far I can go. If I'm lifting weights, its about how many sets I can do and what weight in order to push myself.
So even in what most people deem "non-competitive" activities I'm still competing against a clock, or my body, or my brain.
I'm just curious what you meant is all.
EDIT: Typical HN. Ask a question and get downvoted. Logging off the day - thanks.
Someone might train for marathons, body building, etc. I don't.
Exercise forms the foundation of a biologically healthy brain which is required for all conditions. For some conditions it’s all you need for others it’s not enough
The article doesn't claim exercise is a universally effective treatment, so whose statements are you questioning?