New paper just published reviewing exercise’s effect on depression. Specifically, how exercise compares to antidepressants. The paper is short and sweet, so I encourage you to read it if this is something you’re interested in.
Based on existing evidence, it would be very difficult to say that exercise is better than medication for depression. Many folks with large audiences have made variations of this claim, though interestingly, none of them have any clinical training. Weird, eh?
In any case, the best and latest evidence shows that exercise can reduce depressive symptoms significantly, with a number needed to treat (NNT) of 2. When compared to antidepressants exercise and antidepressants have similar effects when used as monotherapy in non-severe depression.
While some isolated trials may make it seem like exercise outperforms antidepressants as monotherapy, that’s not what the bulk of the data shows. It’s also an interesting way to think about clinical care, i.e. using only a single treatment when multiple ones are likely to be more effective without increasing risk.
In this context, medications seem to reduce symptoms with a known risk:benefit profile, and exercise is likely to reduce symptoms further without any significant increase in risk. Exercise also has the potential to improve health in many other ways, which is why it should be recommended (and facilitated) whenever possible.
To summarize, por que no los dos? Why not use both medication and exercise in a population who would benefit from it?
Also, would generally recommend against listening to podcasters with little to no relevant expertise.
Two personal examples may be illuminating. Many years ago I suffered deep depression and took heavy therapy of anti-depressants for 2 years. It cured me, i.e. my brain began to manufacture its own dopamine, but my emotional state remained occasionally wobbly. A few years ago I began weightlifting (low load/high volume) and have never had mental instability since then, not ever, not even once. Lesson learned: medicines treat symptoms but have other risky side effects (see statins’ effect on mitochondria) while weightlifting perhaps does not heal or cure, yet certainly maintains mental health very well and without side effects.
Happy to hear you’re feeling better now, Jeffrey. That’s great.
We agree that exercise can be used as an adjunct treatment for major depressive disorder with some success. I would like to clarify that depression isn’t really caused by dopamine deficiency and anti-depressants don’t really increase that neurotransmitter either. Statins do not really affect mitochondrial function either. Finally, their are risks and costs to exercise that would count as side effects. We definitely think exercise is awesome and would advise anyone who can train to do so, but that doesn’t mean medicine should be viewed/characterized as bad.
This is not a study, certainly not one that shows statins negatively impact mitochondrial function in most people leading to negative clinical effects.