This is an almost absurd criticism ("be careful telling people to sleep, people I know who were depressed followed that advice and slept for 12-14 hours every day").

Let's fix it by being more specific, so we don't accidentally cause any more problems: "daily moderate-intensity cardiovascular exercise" (or, if you prefer, "resistance training 3x week"). Or even, "a healthy level of exercise".

I agree that therapy is a good idea, but you shouldn't need a therapist to figure this one out. A reasonable amount of exercise is good for pretty much everyone.

> you shouldn't need a therapist to figure this one out. A reasonable amount of exercise is good for pretty much everyone.

People with clinical depression aren't those who _can_ easily hit the gym for that dopamine rush. "Some sport is usually not a bad idea" is not the hard part, getting to the point where it can be implemented is.

And if that is the problem, and none of the pep talks on hacker news over the last few years helped, why not try the therapist?

I understand where you're coming from, but I'll just point out that you can reverse the activities and make the same point:

"People with depression aren't those who can easily just hit up a therapist and continue going and get well. If that's too much of a social burden, why not try just going for a bike ride?"

keywords: "And if [getting sports implemented] is the problem"

I never said not to do sports (neither did the article: it merely pointed out that telling people to "_just_ do sports" may not be helpful) and I never tried to sell a silver bullet.

This is unlike the inevitable influx of comments in the style of "ignore therapy, just imitate my sports routine, and if you can't, just try harder". Those appear under _every_ depression-related submission on hacker news.

Those comments are harmful: therapy already comes with stigma, so it's not the obvious route - unlike, as you can see here, sports. Everybody proposes sports, healthy eating habits and regular sleep (btw: what about the depressed who can easily sleep 20 hours a day, should they just get one more nap?). Reinforcing the stigma around therapy discourages folks from taking a route that might help them.

The "just try harder" angle that's all too often seen in such comments is also harmful: What do you think did those people do (often for years) before they consciously consider that something might be wrong with them? Exactly: they buckled up and tried harder - and they will continue until they crack unless something changes fundamentally.

> People with clinical depression aren't those who _can_ easily hit the gym for that dopamine rush.

This is not accurate, depression is just not clear cut like that. A depressed person can be fully high-functioning from the outside, even...

Quite a few people don't exercise for other reasons (time, aversion), in fact, I'd say those are all much more likely reasons than depression, but may also lead to depression.

It's almost like there's not a single good answer like saying "all ya gotta do is go out there and buck up and excercise!!".

Like any sickness, you talk to a health professional and figure out what treatments work. Going your own sucks and is a bad time regardless of how highly-functioning you are.

> This is an almost absurd criticism. [...] A reasonable amount of exercise is good for pretty much everyone.

"Ok, if you say so" and "of course". But the general advice to do some exercises and the advice to exercise "to counter depression" are two completely different things.

I'm trying to be as neutral as possible here: If a friend of yours needs help, please don't tell them that they "shouldn't need a therapist to figure [out a way out]". Psychology ain't an exact science even though most "science journalism" wants you make to believe that. So, whatever "wisdom" one picks up, treat it with a grain^Wbag of salt.

EDIT: parent was edited the substantially & while my principal response still holds, I would not even have responded to a response as hyperbolic as the parent is now.

Sometimes you need a therapist and/or meds to figure out that you need to (or even can) figure it out, and it's possible to overdo just about anything, certainly including exercise and sleep. Depression puts you at the bottom of a well, and by definition not thinking clearly. You're dangerously close to telling people to just deal with it on their own, which is harmful and cold.

Certainly. I have been in the position before where I was at the bottom of my own personal pit and was unable to begin exercising on my own (severely depressed and obese, not a great combination to begin an exercise program). It's not an easy thing to get started doing _anything_ when you're depressed, habits are hard to change. People shouldn't be expected to change these things (purely) on their own, as a lot is a function of environment/genetics/overall life situation, but...

I can recall clearly what it would have been like (for me personally at least) were I in a strongly depressive state: I'd read the comment warning me about exercise, then I'd be afraid to exercise at all.

By framing exercise as a risky behavior based on a few exceptional anecdotes, the poster does depressed readers a disservice. It's relatively established that depressed people are more risk averse in general[1][2], and exercise also has well established benefits in treating symptoms of depression (I shouldn't have to cite sources for this one). The benefits far outweigh the risks.

1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2590786/

2: https://www.nesda.nl/nesda/wp-content/uploads/2015/07/Wiersm...

No need to treat depressed people like children and withhold info about risks. They’re still humans after all.

I believe you misunderstood the point. The problem is that the "risks" of exercise are blown out of proportion.

I don't think it is absurd. I have a genetic disorder. All of the standard diet and exercise advice failed me in every metric until I had a proper diagnosis.

Lots of people have unidentified health issues. Underlying health issues can cause low energy, which can be mistaken for depression.

I didn't read the criticism that way; seemed like a warning against "one size fits all" thinking when dealing with a complex system like a human brain.

Maybe you are both right!

I agree it was phrased poorly. What I took him to mean is:

If you have depression, and regular exercise and good diet doesn't help you, look for other solutions.

Too many people assume that getting the right balance of both will solve the problem, so they keep tweaking and tweaking the wrong solution.

Agreed. Not to mention hitting the gym for an hour every night closes a lot of access to self-medication.

This is the most ridiculous and irrelevant warning I can imagine. Almost nobody us at risk of over exercising if they haven't started yet.

It's like saying "Don't eat salad, I know someone that ate so much lettuce they got sick."

I fail to see the connection between ~"don't see exercising as a golden bullet against depression" and what you claim I've said.

you said "[exercise] might be good for a lot of depressive people, but definitely not for all."

Which is dead wrong. Exercise is good for humans, depressed or not.

You also said, "Before I turned twenty I met two people my age who took your advice and exercised until ambulances had to pick them up (literally). "

...apparently as a warning that exercise is dangerous. But as you can see, it's a ridiculous statement.

Sure, people should see a therapist. They should also exercise. Go for a walk. Move around. They should also gain some sleep discipline. Those are easy to start with. There's no mutual exclusion here. Just because someone is exercising and sleeping right, does not mean they cannot talk to a therapist.

i read it as "might be good enough", which is entirely closer to the meaning that parent was trying to get at, I think.

Also I don’t think gp was trying very hard (at all?) to understand this point

It's easy to become dependent on exercising, push too hard, get injured, and struggle while you can't exercise. Moderation can be difficult for some of us even with something like running.

Here is where the benefits of promoting exercise far outweigh any risks that people who exercise may experience. There is no need to hedge here. Exercise might not cure your depression or even help it, but in general, exercise has been shown over and over again to be one of the most effective things that you can do for mental and physical health.

I can't really agree with this, there are definitely lots of negative avenues from exercise if not done right.

Generally, hopefully, most people will do exercise more or less "right", but this is not a safe assumption.

That could be said of almost any healthy thing.

It's very easy to over exercise if you haven't started yet, I seriously hurt myself after a couple of weeks of running, as my body was nowhere near prepared for it.

> Careful with that advice. [...] Whatever you do to counter your depression, have a trustworthy, knowledgeable aid at your side: a therapist.

Quoting the UiA, "One [1988] study indicates that 70% of therapists had seen for treatment at least one patient who had had sex with a previous therapist. Of the latter, 96% were male." [1]

I guess the moral of my comment is - be careful giving advice (period)

1: http://encyclopedia.uia.org/en/problem/143464

I'm not sure how this page is meant to work but I can't find the study this claim came from? It's linking to a book?

The source is a training book on how to sue psychiatrists, I can't find the study anywhere. Even if it does exist, it's saying that a lot of therapists have seen a client who had sex with a therapist. If someone wanted to have sex with a therapist, they would visit a lot of therapists.

This explores the topic in a more meaningful way, and links sources. https://kspope.com/sexiss/research5.php#a8studies

I assumed the study is referenced in the book (and that the quote is from the book) -- but honestly I have no idea

I've tried to find help for something like depression for almost two decades from therapy. As much as I have wanted it to be, I haven't found therapy to be particularly powerful.

Running is weak also, but insomuch as all you can do is fight and claw your way out of depression[^], long runs, in my experience, can aid to some degree.

[^]Which may very well be a symptom of something(s) we don't understand yet, rather than a disease.

Have you tried not fighting?

What does not fighting look like on a practical level?

For me, it was months jobless and isolated at a parent's house in the middle of nowhere.

For others, not battling means not getting out of bed, and for people facing other "demons" (what a bad word) not fighting might mean to continue to consume drugs or alcohol, or to keep not eating, or eating too much.

> What does not fighting look like on a practical level?

For me, it goes "I'm feeling depressed. Okay, I feel depressed. That's interesting. Now what is it that I must do right now at this moment? Get out of bed. Okay, done. I'm still depressed, but what's next?"

In other words, I don't bother fighting it or avoiding it. I just acknowledge it and then figure what needs to be done next.

I think we are in agreement that taking constant little actions is the wise course.

To me, that is fighting.

For me depression comes from thinking I should feel differently than I do, so fighting only makes that worse, whereas not fighting is better.

Could be this is a cultural problem. In our culture we’re supposed to like work and everybody is expected to shut up.

We're treating psychological problem like pathological ones. Mental health is not a pathological problem necessarily, but rather an physiological responsive one. As such giving medications as to "treat mental health" is the wrong perspective, and more proper perspective would one were certain physiological responses to certain environmental conditions are deemed as negative. As such to an extent the physiological responses and the interpretation of whether those responses are good or bad are dependent on social perspectives.

Therapy can work entirely without medication.

There's a difference between psychologists and psychiatrists, and the article even spells it out.

Therapy works on the physiological aspects of the human by influencing the environment. Again it's not pathological.