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Comment by PedroBatista | Hacker News Reader

Just because a thing is true doesn't mean you can apply it. There are vast numbers of active ingredients discovered or developed that are effective in curing many deceases but there aren't "drugs"/pills with it because we haven't found a delivery mechanism for them to be effective where they should in the human body.

Going back to the subject: Have you ever been clinically depressed or dealt with people in that predicament? Getting up from the bed is already a huge win for that day, let alone exercising and doing it consistently and regularly. Even taking medication regularly can be a hit or miss.

So, yeah the prescription is easy to write and thank god it's real and effective, but that's only ~5% of the work.

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Exercise is great on the days I can do it, I love going for a walk. But sometimes when I hear that suggestion - I wonder if those people have ever lain in a totally uncomfortable position in bed for 45 minutes because they felt paralyzed, unable to will their muscles to reposition themselves into something more comfortable. From that perspective, even light exercise seems like walking on the moon; merely a thought, not real.

I appreciate your difficulties but have always wondered at our lack of support for preventative measures as a society here in Australia and possibly worldwide.

Would a personal trainer or paid or not training buddy or something of the sort help your motivation?

It's a good question. I could see it working for some people (accountability, companionship) but at least for me, one of my parents is a certified PT and while she has helped a bit, the problem is just more deeply rooted than that unfortunately, at least for me.

But, again, everyone's experiences are different.

Hear, hear. I've fortunately not had to personally deal with depression, but have been around those who have, and "just go to the gym" is right up there with "have you just tried not being sad?" on the list of unactionable plans.

See also: "Why don't more people with ADHD get treatment?" "Because if they were able to initiate and follow through a complex plan of meeting with care providers, arguing with insurance, and having prescriptions filled, they probably wouldn't need it."

Bingo. It took years to get an ADHD diagnosis after severe issues with productivity and executive function.

I finally get a medication to try, and on the way home it falls out of my pocket. Don’t realize till I’m home and go back and find it… smashed in the street, run over by a car. Lol. So yeah, it’s a real struggle.

That just about broke my heart. I can imagine how awful and hopeless I'd feel in that situation, at least as a first reaction. Great. Just I'll just plan on not planning until I can get the doctor to send a new prescription, which they might not do because FDA.

There's a reason I pick up my refills exactly on time, even if I still have some of the old prescription left. That little overlapping buffer gives me great peace of mind.

The healthcare system in the United States is deeply, horribly broken.

Recently, my wife was going to be out of the country about a week-and-a-half. Her prescription for a medicine to manage arthritis would run out at the very beginning of that time. But insurance company policies refused to allow her to fill it even a little bit early. As a result, her only option was to go without the medicine for several days.

Policies should be set by organizations whose primary goal is to provide effective health solutions, not organizations whose primary goal is to minimize costs in order to make a profit.

> her only option was to go without the medicine

She could've gone to her provider to discuss adverse side effects. Sometimes they will prescribe a new medication that could be filled immediately.

She could've got a pill cutter and cut the tablets in half, or space out the doses, or otherwise take less than the specified dose for a few weeks.

She could've asked the pharmacist about OTC treatments which could be safely substituted during the gap time.

She could've gone to the emergency room or urgent care in the destination country, and tell the provider "I have run out of medication!" This would be covered by the traveller's insurance that you purchased for the trip.

You sound like you would be a great patient advocate. His wife would have been lucky to have someone like you help navigate that situation, but it would be even better if people didn't need to waste their brainpower coming up with these tips and tricks to work around this fucked up adversarial system in the first place.

Or we could have healthcare that doesn't profit off human misery such that his wife could take her full, prescribed medical dose.

The idea of someone cutting pills in half because their insurer is reporting record profits drives me nuts.

The article says that 41% of mental health professionals never recommend exercise. Is it really the case that these 41% have only patients with the severest forms of depression who struggle to get out of bed at all? Or do they have many patients who get out of bed for work and such, and could force themselves to exercise, but don't know that it's worth the hurdle because they haven't been told about the mental health benefits?

I don’t know a single person in my life who thinks exercise isn’t worth it. I think it’s widely known that exercising is one of the best things you can do for your health, but actually making it a habit is extremely hard.

Perhaps I’m atypical, but when my doctor gave me an exercise regimen and told me I must do it in order to treat a joint issue I was having, I found that much easier to maintain than any workout schedule before or since. Knowing it’s good in general is different than confidence it’ll treat some specific problem.

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