I don’t think depression is a universal root-cause diagnosis so I’m inclined to agree.

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 definitely agree, there are two fundamental forms of "depression"--internal and a reaction to a bad external situation. Very different causes, what works for one doesn't work for the other. And I don't even like the "depression" label for bad situations--as with the previous post about willpower. We have a limited ability to cope with bad, when it's exceeded (or our efforts are misapplied resulting in the same end) we get "depression". No, we get reality! That's why things like forcing rehab does nothing about addiction--it doesn't remove what drove the person to the drugs in the first place.

And I'm the counter anecdotal case of your anecdotal case.

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).

I'm a non-competitive athlete, and yes exercise can help depression, but no, it will not be sufficient for anything but your mild to average case of it.

Exercise is a crucial part of dealing with it, but it is not a panacea.

>> I'm a non-competitive athlete

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.

I'm not competing against anyone but myself, I'm not trying to meet any specific weight/size/etc cutoff for competition, the point is exercise and improvement and not any official or unofficial competition.

Someone might train for marathons, body building, etc. I don't.

True. I ran my but off in 2025 but it was mainly holding my anxiety over finding a job at bay.

Depression is an umbrella term that covers lots of underlying biological conditions.

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

And you think the effects of drugs is universal?

Exercise is a side effect free treatment that works for some people so it’s worth a shot because it sometimes works.

I'd argue that depression kills and optimal therapy is: anti-depressants, exercise AND talking therapy and the time to start is NOW.

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.

Or avoid medication for anything but treatment resistant depression.

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”.

yeah... i did forget to add meaningful community and spiritual activities to that list but people can have just as strong objections to them as they do to the other things on my list!

100% I have found the same, SSRI's definitely make things worse and I stay away from them, and regular exercise has offered the biggest consistent/persistent improvement in mood.

Medication is the fastest way to make some positive progress before you completely spiral and majorly fuck up your life.

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.

You clearly are completely and totally incapable of reading.

Whoa, you can't post like this to HN, regardless of how wrong someone is or you feel they are.

We ban accounts that do this, and I'm afraid you've been breaking the site guidelines (https://news.ycombinator.com/newsguidelines.html) in other places as well, including other personal attacks: https://news.ycombinator.com/item?id=46530967.

It also looks like you've been using HN primarily for ideological battle, which is not something we allow here (see https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme... for past explanations of this point).

Would you mind reviewing https://news.ycombinator.com/newsguidelines.html and sticking to the rules? We'd appreciate it. You're welcome here as long as you do that, but we really need commenters to stay respectful, avoid posting in the flamewar style, and (above all) use the site primarily for curiosity, not smiting enemies.

Your experience is not the same as other people. No one cares if you don’t understand their own life and choices. Get off your high horse and stop assuming that “those dumb depressed fat people just need to sleep better, eat better, and exercise and obviously it’s just that easy”. If you had success with whatever method, that’s great. We’re thrilled for you. But what works for you is not a universal solution.

Thanks for the strawman.

I won’t argue against you. It’s clear you would’ve been in complete support of the lobotomy craze. Exercise, diet, sleep, and good company are the most universal cure for the average form of depression. I specifically called out treatment resistant depression as requiring medication. Surely your basic bitch depression caused by being overworked, underfed, and slammed with bills can’t be fixed with anything but a simple pill.

You missed the greater point that medicines are overprescribed and OP all but made a Pfizer ad out of their post. HNers lack contextual reading ability, and life experience. It’s a shame really. The over prescription of drugs is a tremendous problem in the west.

My “high horse” is supported by actual medical science. Unlike the entire field of mental health.

Pfizer ad or not I'll say my AD experience was positive. I got it prescribed by a psychiatric NP in a time when my job situation was about to go to hell but I was planning to tough it out till I got the project done.

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.

Please don't respond to a bad comment by breaking the site guidelines yourself. That only makes things worse.

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

We've asked you to stop posting like this to HN. I understand that the topic is sensitive and personal, but being this aggressive in HN comments is not ok and we ban accounts that do it.

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.

As a long time Usenetter, I don't care about the first two sentences being abrasive, but the material in quotes is insinuating that the replied-to grandparent at some point contained that verbatim text. I have a hunch that it did not, which is not cool. Particularly because the text is negative, making the false attribution defamatory, which is a different category from insults.

Yes, using quotation marks to make it look like you're quoting someone when you're not is a trope of internet aggression and something we've long asked HN commenters not to do: https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que..., and is one of the reasons why the GP comment was abusive.

Dunno why you are being downvoted, probably cope. It is well known by now that antidepressants are only marginally effective on average [1-2]. You're right they should probably only be prescribed for quite severe or treatment-resistant depression. Although the treatment-by-severity effect has been somewhat disputed [3-4], it has rough support [5], and makes sense since it is dubious that we should be giving ineffective medication with serious costs and side-effects to people with moderate depression.

[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...

My take is pessimsitic estimates of AD effectiveness assume you get one Rx and don't follow up and adjust dose and medication choice. I was lucky when I took ADs to have a good primary care doc who had a psychiatric nurse practitioner working at his office and being a good self-advocate.

The "sequential treatment" or "tailored treatment" approach is at least plausible and what is done in practice, yes, if the prescribing doctor is good, and if this is feasible for the patient.

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.

> People in the military do insane amounts of cardio because it helps dealing with insane amounts of stress.

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.

The military does insane cardio because when the enemy knows where you are sometimes you have to run hard and fast in hopes you can get to safety before they can kill you. I've known people who likely would have died in Afghanistan without that insane cardio.

it might help with stress too, but that isn't as clear

The poster you responded to didn't claim that drugs were universally helpful. I think the main point is that there is no universal that works for everyone. For some exercise works, for some drugs, for others therapy. And "works" isn't a yes/no, one might work a little for you, one might work super great.

The poster questioned the universality of exercise. And the went on to say that drugs worked for them in the next sentence. Clearly the two statements are related.

Anecdotal data isn't sufficient to infer a universal rule. The point of my comment wasn't to argue for drugs. It was to push back against the idea that drugs like anti-depressants are unnecessary and bad, which I see all the time when this topic comes up. A common take is "why use or prescribe drugs when apparently exercise works fine against depression?"

i think they are merely saying what worked for them. it is working for me too, despite my misgivings about “just taking a pill”. YMMV.

Depression isn't monocausal so it'd be far too simple for it to have a single solution.

But in general, humans just work better when we're regularly putting our bodies under reasonable physical load.

> I also question the universality of it.

The article doesn't claim exercise is a universally effective treatment, so whose statements are you questioning?

There's no universality on anything linked to mental health.

I hesitate to ask but what is your gender? I think there may be very gender specific effects in this comparison. I would also be very curious the type and intensity of exercise and whether you had comorbidities that impact ability to train (obesity, low testosterone, etc).

I'm male. I've done everything from cycling to 5-10k running to heavy weightlifting. The only other thing I have is ADHD, no other comorbidities.

Thanks for the response and the useful (to me at least) data point. Glad the AD helped and sorry to hear you didn’t find all that exertion useful. Goes to show how individual we all are in terms of mental health.

Yeah, any of these studies that show “X works better than Y” are inevitably operating on averages. Not everyone will respond the same way. Not to mention that the very existence of the structure and human interaction required for these studies makes a huge difference in their outcomes.