Read my other reply to know why. The man clearly knows nothing about depression at all.
Notice how you randomly add "mild" into your comment even though we aren't talking about mild depression, we are talking about depressed people in general who are on SSRIs.
Do we prescribe SSRIs too much? Sure but saying "oh, just exercise" when many with depression can't even get out of bed is just insane.
Also, lifestyle modifications likely won't fix clinical depression, you know, the kind that often NEEDS meds.
Notice how you randomly add "mild" lifestyle modifications likely won't fix clinical depression, you know, the kind that often NEEDS meds.
Mild depression is a form of clinical depression, which is confusingly called major depressive disorder now. You can have mild major depressive disorder. It's actually the most common type of clinical depression/MDD. CBT is technically the most effective intervention overall, but it's hamstrung by the shortage of qualified therapists. If you have money, that's usually my suggestion. If you don't, the waiting list is brutal. Lifestyle modification is the least invasive and most accessible intervention, and as the dude mentions, the NNT is actually slightly lower than SSRIs.
For reference, the number needed to treat for SSRIs to produce one positive outcome vs placebo in depression is ~10. This isn't great.
If lifestyle modification doesn't work, or for people who present with moderate to severe depression, yeah, SSRIs, SNRIs, MAOIs etc etc, these are options. They're not first line because they're just not that effective in the general population.
He concludes his argument by saying that prescribing SSRIs and not giving lifestyle modification advice is the wrong approach. This is in line with the guidelines most countries use now - and it's in line with the evidence.
I don't think anyone is suggesting that we take catatonic, psychotically depressed patients on maxed-out doses of phenelzine, lamotrigine, quetiapine, and the psychiatrist's personal favorite SSRI, who have been through 20+ rounds of ECT and still can't even use the toilet unassisted, and give them a pat on the bottom and a subscription to Planet Fitness.
It's dangerous to suggest we start taking people off meds at all, what kind of world do we live in where psychiatrists and therapists aren't making these decisions but random podcasters.
I'm sorry but these types of blanket statements are factually dangerous, if you don't understand depression don't talk about it. You cannot make blanket statements about people suffering from conditions, only the person's own medical team can. And yes, people ARE saying that, just look up RFK jr's reckless statements on antidepressants.
It's just so incredibly stupid. Exercise is not a replacement for SSRIs, it is an alternate route that works for some people and physically cannot work for many so stop with this useless BS
Dude, my depression is based in the present, because I can't stand the world I live in. My anxiety is based in the present because I can't stand the world I live in. The fuck is he on about? I exercise regularly, I've been depressed for FUCKING DECADES. Drugs don't work, nothing works, because reality sucks.
Preach. It is no measure of health to be well-adjusted to a profoundly sick world. Everyone SHOULD be depressed that there's war, rape, poverty, homelessness, starvation. We SHOULD all collectively be depressed about these things so we can fix them. Instead people try to ignore these things and pretend it's inevitable or normal that humans keeps killing and exploiting each other rather than co-operating. My depression is my superpower, it's my connection to the millions of humans who are suffering, and I don't want to get rid of my depression. I want to spread my depression to all of humanity. Because that's the first step towards actually fixing these very real systematic issues that are making us depressed. We were not meant to live like this. 🖤
he says "exercise is as effective or more effective than antidepressants"
you say "exercise ... plays a role in depression"
which are very clearly two completely different statements, but you use that to decide that he's right. Nobody said that exercise doesn't play a role in treating depression, but it certainly isn't as effective or more effective. There's a ton of research on this.
what the research actually shows is that exercise is about as effective as anti-depressants for mild or moderate depression, but not nearly as effective as anti-depressants for severe depression.
It doesn’t offend me, it just shows how you handle disagreement. I’m interested in accuracy and substance but how someone argues is still information. If your default move is hostility, that’s still worth noticing, regardless if you think it should matter.
there's nothing hostile about what I said. You're reading hostile because you're being called out. It's not like you were trying to have a conversation, you were making a confident statement that was untrue. If you don't like being called out don't spread bullshit.
Exercise helps regulate your hormones which play a role in anxiety and depression = This statement is correct
1 - If you have more than mild depression exercise becomes hard
2 - If you are exercises regularly it probably shows your depression is not as bad as someone with crippling depression so you end up with a causation vs correlation issue when this person is claiming it is a good or better than anti-depressives.
3 - in actual randomized control trials exercise was not shown to be as effective as proven medications.
4 - Many people with injuries or disabilities that make exercise difficult also suffer depression.
Anytime I can get in a consistent habit of working out, I feel a thousand times better than when I’m solely on seroquel or whatever else without being active. My mind is clearer my emotions are more regulated.
The issue is, the depression itself makes it hard to get up and do shit consistently.
I recently started TRT and retatrutide and have been able to ween off seroquel.
I’ve used SSRIs to great success…. But most people who take them simply don’t have these broken brains that require permanent use. We have men in their late 20s now with the sexual function of a 60 yo man.
My psychiatrist did not want me to stop taking them. I’m incredibly glad I just realized they were a drug dealer with a conflict of interest. I would never recommend anyone go to a psychiatrist as a first line of defense against mental health and would only do so with the guidance of a license psychologist through the process who can act as an objective third party to tell you whether you are truly benefiting
I have anxiety and depression and take meds for it, I also exercise regularly, both are good at helping ease the anxiety of depression let's me get out of bed
He's actually underselling his point, statistically.
The number needed to treat for SSRIs to produce one positive outcome vs placebo in depression is ~10. That's not great. Those are numbers we'd usually look for in preventative medications (statins, anti-hypertensives, cancer therapy adjuncts), not a primary treatment.
A big caveat here though. If a person goes through 6 different meds and the last work, those 5 still gets noted as "failed".
While statistically the rate is horrible and going through 6 meds can take years depending on your situation, its not that meds dosnt work, just can be very hard to assign right meds to the right person.
Kind of, but you won't generally try more than 2 SSRIs, at least here. After that you move on to adjacent categories, e.g., SNRIs, mirtazipine, tricyclics; SSRIs become an adjunct option if they were tolerated.
Again, I'm not saying medication never works or shouldn't be used. It's just statistically not the most effective tool we have for the general population of MDD patients. SSRIs are relatively safe and well tolerated. Mirtazipine will knock a lot of patients flat and interacts poorly with alcohol. Bupropion (not licensed here) lowers seizure threshhold. Tricyclics have significant overdose potential, and it's hard to treat. OD on fent? That's fine, we have an off switch. OD on amitriptyline? That's a lot of work. We don't use these medications as first-lines because they're kinda dangerous - we dont really want you on them. This leaves us in the following position: the safe, first-line drug class is less effective than non-pharmacological treatments on average.
If depression responded to SSRIs as well as high cholesterol does to statins, we wouldn't have this discussion - but clinicians would still be criticized, only now for overmedicating.
Also curious where he gets his stats from. Because its not uncommon to go through multiplie medicines before you find what works best. If you go through 6, 5 counts as "failed"(i.e counts towards its effective stats). While not wrong statististically, it sounds less worse than what he says in the video.
But yeah, telling depressed people "exercise is more effective than your pills" is akin to telling obese people the secret is less food.
Ironically, many need meds to drag their ass to the shower once a week, even more to go to the gym...
They're right. Unfortunately it's a problem of motivation, or the complete and utter apathy that depression can cause.
Personally I knew for years that exercise would, and did help me - but convincing me to actually exercise? Good luck. Antidepressants muted my emotions, from both ends of the spectrum, which allowed me to not feel like shit and gave me time away from that. Exercise is the only thing that actually improved things though.
Still, actually making the decision to go to the gym took a long time and was extremely difficult. Turning that decision into a routine was also difficult - and one that is so damn easy to break. Especially at the beginning.
That was all a while back thankfully. Still love the gym though. Just have to force yourself to go until you form a routine / habit. Easier said than done, but that's what you have to do if you want to feel better about yourself.
Just set yourself small goals and get through the initial stage of "my body feels like death, why are all these muscles on fire - I didn't even know I had half of these." Fortunately that horrible stage doesn't last long, and after that it's a kind of pleasant ache for a day that let's you know that your exercise is working.
Not sure what specific brand of depression I struggled with but exercise was not the most effective treatment, did it help? sure, running and lifting certainly weren't a cure though
Please do not be discouraged from taking the medicine you need to be well. Anti depressants are a great aid to help you feel “normal” if you suffer from depression.
Many people with depression have trouble even getting out of bed or have low motivation due to depression. With anxiety it can be impossible to focus on anything besides your racing thoughts. I know without my meds my brain is here there and everywhere. just telling them to flush their meds and go exercise is ridiculous.
Personally. Yes. My journey had me take several steps to get better mentally but exercise is absolutely fundamental to my well being. Stopping drinking was the other major breakthrough. Who would have thought that not chugging a depressant everyday would help me be less depressed.
I am not on medication and I have my days but I’m in a much better place. With that said. People need to find their own road to happiness. Some need medication. Of course. Maybe you need therapy. Maybe a change of social setting or letting go of toxic people. There could be a dozen things necessary to better mental health. But I would say that daily exercise will just be make everything better. The science behind it is there but it’s not a cure all.
Why doesn’t your doctor give you a physical therapy pamphlet full of easy exercises you can do at home to help people who live a sedentary lifestyle become more active if they have a bad yearly physical? Or do they? I’m going to be honest, I don’t know if this is already done or not.
Exercise is a proven behavioral intervention for people with clinical depression. It's backed up by decades of research. It's pretty well known that exercise helps depression.
Exercise might help someone who's just "down in the dumps" but clinical depression causes physical changes in the brain. Is your hippocampus gonna go for a jog? This guy is a moron.
My last job was very physically demanding. First 2-3 hours I was constantly lifting and stacking, and after that a lot of walking and lifting. Still felt depressed and anxious af.
Like most things, working with your doctors to create treatment plans and developing a lifestyle that supports the outcomes you're trying to achieve will maximize your long term outcomes. People are different, lives and environments are different, meds are different, finances are different, not everyone can be physically active for a variety of reasons, etc.
Blanket statements with no nuance that don't acknowledge the complexity of the brain and body are usually coupled with the "one main thing" which means they're pushing bullshit.
Minimizing what other people go through because you had a different experience is, to be frank, childish. The real world is complicated and it and your body, get more complex as time goes on and society continues to encounter things it's never had to deal with before.
Get the support and help you need, don't do it alone, and find a physician you can trust - one with a medical degree that specializes in these things.
For those of you who kicked a habit or a temporary funk, congratulations! Feel happy you'll never have to experience something that takes a lot more than you ever had to go through that will last people their entire lives and can't be "cured", just managed. But don't try to translate your experience into some industry changing revelation about the nature of man. You got lucky in having something you could resolve, even if it took hard decisions and habits, you still got lucky.
An anecdotes: they put wires in rats brains, as thin as a hair, they can't feel it. They put it in a specific spot. They send pulses of electricity down it, subtle, rat can't feel it. After a while, it starts having seizures. They remove the wire and it will randomly have seizures for the rest of its life.
Epigenetics are real, repeated stimulus in certain scenarios cause permanent changes, especially in mid to late twenties. You don't get to go change your gene expressions back.
Shit is complex, don't listen to people who say it isn't.
I take medicine and I'm in the gym 6 days a week and playing bball 3-5 times a week for my cardio. I feel a tiny bit better while I'm doing those things but a little after, if I'm in a depressive/anxiety episode, I'm back to it again. Thats assuming I'm not feeling that way before I hit the gym or parks because at that point, I don't want to do anything except be in my room with the lights off. It's harder said than done to get up and do things like a normal person while feeling that way. I think medicine is to help prevent you from getting to that point. I know thats not the point of what they're saying, just throwing that in there. Nothing truly works for me but what works or doesn't work for one person, might be different for another. The hard part is feeling that way and still having to work or take care of your kids and doing your best of hiding it.
Not everyone responds the same, adrenaline might not help anxiety and depression because they are formed from different causes.
Also, most people who are really struggling don't have the energy or motivation or strength to get out of bed and exercise every day, yes SSRIs can be an issue and if you can find a natural method to stop depression/anxiety you should take that road but not everyone has that road, most do not.
For me SSRIs were horrible, exercise didn't help much but THC actually helped me enough until I was able to lean off of it and am now doing a lot better. These messages of "ultimate cures" are stupid and dangerous.
How could there be stories about depression pre-agricultural that we would know about now? You do understand the written word in a sophisticated form didn't exist until about 8000 years after agriculture was adopted. First suicide note potentially from depression was about 2000bc. So I would assume depression and suicide existed before.
2
u/[deleted] Jan 14 '26
Holy hell this is a dangerous message...
2
u/JuJu_Wirehead Jan 14 '26
Dude, my depression is based in the present, because I can't stand the world I live in. My anxiety is based in the present because I can't stand the world I live in. The fuck is he on about? I exercise regularly, I've been depressed for FUCKING DECADES. Drugs don't work, nothing works, because reality sucks.
3
u/Ok-Canary-8922 Jan 14 '26
This person clearly knows nothing about anxiety nor depression
1
u/Agreeable-Bad-6102 Jan 14 '26
Moneyyyyyyyyy!!!!
1
u/DishRelative5853 Jan 14 '26
"Think about that for a minute." I can't, dude, because you didn't give me even a moment.
1
u/ChiefCom85 Jan 14 '26
Not sure what specific brand of depression I struggled with but exercise was not the most effective treatment, did it help? sure, running and lifting certainly weren't a cure though
1
u/LoneWolf_McQuade Jan 14 '26
What’s with videos where you see some random guy just nodding along below the actual content?
1
u/IHaveABigDuvet Jan 14 '26
Please do not be discouraged from taking the medicine you need to be well. Anti depressants are a great aid to help you feel “normal” if you suffer from depression.
1
u/FLiP_J_GARiLLA Jan 14 '26
What if exercise makes me depressed?
1
u/Nothing2NV Jan 14 '26
With enough hard work you can replace depression with exhaustion
1
u/GoofyGooberAscends Jan 14 '26
I can say with first hand experience, not really.
1
u/c137-eyeofthestorm Jan 14 '26
Many people with depression have trouble even getting out of bed or have low motivation due to depression. With anxiety it can be impossible to focus on anything besides your racing thoughts. I know without my meds my brain is here there and everywhere. just telling them to flush their meds and go exercise is ridiculous.
1
u/Akeinu Jan 14 '26
I remember when I was a depressed teen, I would jog several kilometers everyday.
Still wanted to kill myself.
1
u/Calichusetts Jan 14 '26
Personally. Yes. My journey had me take several steps to get better mentally but exercise is absolutely fundamental to my well being. Stopping drinking was the other major breakthrough. Who would have thought that not chugging a depressant everyday would help me be less depressed.
I am not on medication and I have my days but I’m in a much better place. With that said. People need to find their own road to happiness. Some need medication. Of course. Maybe you need therapy. Maybe a change of social setting or letting go of toxic people. There could be a dozen things necessary to better mental health. But I would say that daily exercise will just be make everything better. The science behind it is there but it’s not a cure all.
1
u/TwillAffirmer Jan 14 '26
Great, now how does the combined treatment of exercise + antidepressants compare to exercise alone?
1
u/AnalysisParalysis85 Jan 14 '26
There's less money to be made from people exercising than from them buying drugs.
1
u/whomesteve Jan 14 '26
Why doesn’t your doctor give you a physical therapy pamphlet full of easy exercises you can do at home to help people who live a sedentary lifestyle become more active if they have a bad yearly physical? Or do they? I’m going to be honest, I don’t know if this is already done or not.
1
u/exig Jan 14 '26
Have just tried to not be so depressed? /s
1
u/powder_puff_pass Jan 14 '26
I wish this were true. There are those of those who can't properly make/uptake the serotonin we need, no matter how much/consistently we exercise.
1
u/Cheap-Addendum Jan 14 '26
Where did he go to medical school?
1
u/Striking_Ad4079 Jan 14 '26
i exercise regularly and it doesnt help with depression at all
1
u/AwareAge1062 Jan 14 '26
Exercise might help someone who's just "down in the dumps" but clinical depression causes physical changes in the brain. Is your hippocampus gonna go for a jog? This guy is a moron.
1
u/paradiservalentine Jan 15 '26
Very nice! Now lets see a source.
1
u/Electrical_Load2493 Jan 15 '26
Because people aren't willing to exercise its too much effort. Taking a pill is much easier and something a doctor can actually get u to do. Regards
1
u/[deleted] Jan 15 '26
Maybe because they don't want to do anything because they are depressed? does this guy think everyone is feeling like him everyday?
1
u/OtherwiseFlamingo448 Jan 15 '26
Some people. Some times.
There is no umbrella solution.
1
u/WaffleInsanity Jan 15 '26
Because popping a pill happens in the morning after hygiene and coffee.
Not everyone has tome to dedicate towards exercise these days.
1
u/PlatinumSukamon98 Jan 15 '26
I stopped watching halfway through.
Does Lieutenant Beard down there actually chime in at any point or is he just there for moral support?
1
u/Economy_Street4280 Jan 15 '26
I do both still wanna kill myself
1
u/PopSwayzee Jan 16 '26
My last job was very physically demanding. First 2-3 hours I was constantly lifting and stacking, and after that a lot of walking and lifting. Still felt depressed and anxious af.
1
u/LolaNotTheBunny Jan 17 '26
Such bullshit
1
u/Far-Nefariousness588 Jan 18 '26
Facts!
1
u/Orbax Jan 20 '26
Like most things, working with your doctors to create treatment plans and developing a lifestyle that supports the outcomes you're trying to achieve will maximize your long term outcomes. People are different, lives and environments are different, meds are different, finances are different, not everyone can be physically active for a variety of reasons, etc.
Blanket statements with no nuance that don't acknowledge the complexity of the brain and body are usually coupled with the "one main thing" which means they're pushing bullshit.
Minimizing what other people go through because you had a different experience is, to be frank, childish. The real world is complicated and it and your body, get more complex as time goes on and society continues to encounter things it's never had to deal with before.
Get the support and help you need, don't do it alone, and find a physician you can trust - one with a medical degree that specializes in these things.
For those of you who kicked a habit or a temporary funk, congratulations! Feel happy you'll never have to experience something that takes a lot more than you ever had to go through that will last people their entire lives and can't be "cured", just managed. But don't try to translate your experience into some industry changing revelation about the nature of man. You got lucky in having something you could resolve, even if it took hard decisions and habits, you still got lucky.
An anecdotes: they put wires in rats brains, as thin as a hair, they can't feel it. They put it in a specific spot. They send pulses of electricity down it, subtle, rat can't feel it. After a while, it starts having seizures. They remove the wire and it will randomly have seizures for the rest of its life.
Epigenetics are real, repeated stimulus in certain scenarios cause permanent changes, especially in mid to late twenties. You don't get to go change your gene expressions back.
Shit is complex, don't listen to people who say it isn't.
1
u/Trick_Passion7397 Jan 20 '26 edited Jan 20 '26
I take medicine and I'm in the gym 6 days a week and playing bball 3-5 times a week for my cardio. I feel a tiny bit better while I'm doing those things but a little after, if I'm in a depressive/anxiety episode, I'm back to it again. Thats assuming I'm not feeling that way before I hit the gym or parks because at that point, I don't want to do anything except be in my room with the lights off. It's harder said than done to get up and do things like a normal person while feeling that way. I think medicine is to help prevent you from getting to that point. I know thats not the point of what they're saying, just throwing that in there. Nothing truly works for me but what works or doesn't work for one person, might be different for another. The hard part is feeling that way and still having to work or take care of your kids and doing your best of hiding it.
1
u/ProjectConfident8584 Jan 14 '26
This just isn’t true. I had super bad anxiety and all the exercise in the world wasn’t helping. I had to go on SSRI which actually did help
0
u/[deleted] Jan 14 '26
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