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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on November 27, 2009, at 4:07:34
In reply to Re: I'm an exercise skeptic, posted by mtdewcmu on November 26, 2009, at 23:15:33
I think that this is another case of needing to acknowledge the interindividual differences that exist in the presentations of what we are all calling "depression". I never tried performing vigorous aerobic exercise every day for 3-4 weeks. I have lifted tons of weight, though. My exercise schedule comprised 4 times a week with alternating muscle groups. I did this for years without gleaning any benefit for my depression. There was a time when I did take brisk walks of 5 miles every day. Again, no help.
I think one needs to respect the potential for depression to render one nearly motionless with paralyzing psychomotor retardation and suffocating anergia. To intimate that a person with such a presentation can exercise if they were only to try hard enough can insinuate that they perhaps are somehow inferior and simply do not want to do what might be necessary to get well. Of course performing exercise is generally a good thing. But that doesn't mean that everyone is capable of it. Fortunately, there are other ways of treating depression. Exercise is not a necessary component of most treatment regimes. Actually, there are a few doctors who believe that intense anaerobic resistance exercise like weight-lifting can make someone feel worse instead of better - something about depleting brain amines. I don't know if I agree with this, though.
- Scott
Posted by Netch on November 27, 2009, at 10:02:25
In reply to Re: I'm an exercise skeptic, posted by SLS on November 27, 2009, at 4:07:34
> I think that this is another case of needing to acknowledge the interindividual differences that exist in the presentations of what we are all calling "depression". I never tried performing vigorous aerobic exercise every day for 3-4 weeks. I have lifted tons of weight, though. My exercise schedule comprised 4 times a week with alternating muscle groups. I did this for years without gleaning any benefit for my depression. There was a time when I did take brisk walks of 5 miles every day. Again, no help.
>
> I think one needs to respect the potential for depression to render one nearly motionless with paralyzing psychomotor retardation and suffocating anergia. To intimate that a person with such a presentation can exercise if they were only to try hard enough can insinuate that they perhaps are somehow inferior and simply do not want to do what might be necessary to get well. Of course performing exercise is generally a good thing. But that doesn't mean that everyone is capable of it. Fortunately, there are other ways of treating depression. Exercise is not a necessary component of most treatment regimes. Actually, there are a few doctors who believe that intense anaerobic resistance exercise like weight-lifting can make someone feel worse instead of better - something about depleting brain amines. I don't know if I agree with this, though.
>
>
> - ScottWell written Scott.
Exercise might help some with mild depression, but claiming exercise would cure depression would only be disrespectful to sufferers of severe depression.
Posted by mtdewcmu on November 27, 2009, at 12:06:37
In reply to Re: I'm an exercise skeptic, posted by SLS on November 27, 2009, at 4:07:34
> I think one needs to respect the potential for depression to render one nearly motionless with paralyzing psychomotor retardation and suffocating anergia. To intimate that a person with such a presentation can exercise if they were only to try hard enough can insinuate that they perhaps are somehow inferior and simply do not want to do what might be necessary to get well. Of course performing exercise is generally a good thing. But that doesn't mean that everyone is capable of it. Fortunately, there are other ways of treating depression. Exercise is not a necessary component of most treatment regimes. Actually, there are a few doctors who believe that intense anaerobic resistance exercise like weight-lifting can make someone feel worse instead of better - something about depleting brain amines. I don't know if I agree with this, though.
>I agree. Therefore, only less-depressed people will tend to exercise, which constitutes one form of bias. The other bias is, of course, the placebo effect.
For all the attention exercise gets vis-a-vis depression, you would expect there to be more controlled experiments to determine what are the exact benefits of exercise. It would be challenging, but not necessarily impossible, to find an adequate placebo for the control group in order to maintain blinding.
Posted by bulldog2 on November 27, 2009, at 13:09:41
In reply to Re: I'm an exercise skeptic, posted by SLS on November 27, 2009, at 4:07:34
> I think that this is another case of needing to acknowledge the interindividual differences that exist in the presentations of what we are all calling "depression". I never tried performing vigorous aerobic exercise every day for 3-4 weeks. I have lifted tons of weight, though. My exercise schedule comprised 4 times a week with alternating muscle groups. I did this for years without gleaning any benefit for my depression. There was a time when I did take brisk walks of 5 miles every day. Again, no help.
>
> I think one needs to respect the potential for depression to render one nearly motionless with paralyzing psychomotor retardation and suffocating anergia. To intimate that a person with such a presentation can exercise if they were only to try hard enough can insinuate that they perhaps are somehow inferior and simply do not want to do what might be necessary to get well. Of course performing exercise is generally a good thing. But that doesn't mean that everyone is capable of it. Fortunately, there are other ways of treating depression. Exercise is not a necessary component of most treatment regimes. Actually, there are a few doctors who believe that intense anaerobic resistance exercise like weight-lifting can make someone feel worse instead of better - something about depleting brain amines. I don't know if I agree with this, though.
>
>
> - ScottI agree with you Scott. I've fallen into depressions while involved in both cardio and combination resistance training programs. I recall once involved in a hiking program and I recall how poor my mood was and I did not respond to the program. The reality for me is I often have a desire to exercise when coming out of an depressive episode but exercise does not lift me out of depression.I to question how someone with a severe depression could complete the program that morganator describes. If you are capable of such intense activity are you just suffering from a milder form of depression or perhaps the depression is already lifting and one now has the ability to exercise??
I think my p-doc has a good equation in that good eating and exercise contribute perhaps 20% to ones recovery program. That is what he has seen with his patients. So perhaps as one starts to lift out of their depression the exercise may speed up the recovery?
Posted by morganator on November 27, 2009, at 14:57:13
In reply to Re: I'm an exercise skeptic, posted by mtdewcmu on November 26, 2009, at 23:15:33
> > Good therapeutic exercise and manual labor are two different things.
> >
> > Whether it gives to a significant boost in mood or not, you cannot deny the health benefits. So, why not exercise??? Unless you don't want to be healthy. The best exercise is interval training like they do in spinning classes. This type of exercise is best for your heart and lungs.
> >
> > Exercise vigorously and properly for 30 to 40(maybe longer if you are including weight training) mins 4 to 5 days a week for 6 weeks and stretch your whole body properly for 10 to 20 mins after your workout, then come back and tell me that you think exercise has a placebo effect.
>
> You must not have read the part of my message where I wrote that I took up exercise during my worst depressive episode and it didn't help.
>You may only respond to exercise when a medication is relieving at least 60 or 70 percent of you symptoms. I don't believe exercise alone can have a significant enough impact to wipe out depression, though it does work for some people experiencing more mild forms of depression. Also, when you are depressed you are less likely to exercise the way you would need to in order for it to have some benefit.
BTW, the best exercise for your heart and lungs is high intensity interval training. Of course you may have to exercise for a few weeks or a month before you are ready for interval training. Like I said before, spinning classes are a good example of this type of training.
There is another high intensity type training called Crossfit. This will get you in amazing shape without having to spend a lot of time at the gym.
If you do everything properly, including breathing correctly, exercise should help. There is a way to exercise vigorously or more relaxed where you breath from your diaphragm through your lungs using your mouth and nose in a meditative way. If you can do this you will benefit from exercise much more. If you take some air through your nose you are putting straight to your brain brain where it is needed. Just try it it's worth it. Sometimes I find myself in a zone where I'm just breathing through my nose. I often start off taking air through my mouth and finish off through my nose. This might sound a little ridiculous but it works for me and other people I know. You need to try to meditate in a way while you exercise, whether the exercise is intense or moderate.
Posted by morganator on November 27, 2009, at 15:03:31
In reply to Re: I'm an exercise skeptic, posted by bulldog2 on November 27, 2009, at 13:09:41
I agree that very severe depressives may not be able to exercise or even benefit much from it if they do. That said, I believe that if symptoms are relieved considerably and some depression and anxiety still exists, exercise help tremendously.
Scott, why not try cardiovascular exercise? I believe that is the type of exercise that really helps and creates changes in our brain chemistry. Again, I can not emphasize enough the benefits of intense exercise for those that are at a point where they can do it.
Posted by SLS on November 27, 2009, at 16:12:36
In reply to Re: I'm an exercise skeptic, posted by morganator on November 27, 2009, at 15:03:31
Hi.
> Scott, why not try cardiovascular exercise?
If we are talking about aerobic CV exercise, I simply cannot get myself to do it. It feels like it would be too much effort. I don't have that kind of energy reservoir to work with. I am happy to have returned to the gym for two workouts this past week. I have the motivation to perform resistance exercises, which are anaerobic. I can handle the sort of energy expenditure necessary to get through a workout. One can progress through the exercises at his own pace and allow for recovery of energy in between them. If I get to feel better and better, I will see if other types of exercise attract me.
- Scott
Posted by bulldog2 on November 27, 2009, at 16:49:11
In reply to Re: I'm an exercise skeptic, posted by morganator on November 27, 2009, at 15:03:31
> I agree that very severe depressives may not be able to exercise or even benefit much from it if they do. That said, I believe that if symptoms are relieved considerably and some depression and anxiety still exists, exercise help tremendously.
>
> Scott, why not try cardiovascular exercise? I believe that is the type of exercise that really helps and creates changes in our brain chemistry. Again, I can not emphasize enough the benefits of intense exercise for those that are at a point where they can do it.I agree with part of what you are saying that exercise can benefit those who are already recovering. But one has to be careful about the intensity of the exercise and the severity of the exercise. One has to find exercise that helps one recover and rebuild. If one's exercise plan is to intensive you risk sending the person back into the pits of depression.Remember that the depressed person is dealing with a lack of pyschic energy and the last thing you want is to deplete that energy.
Now this does not deal with depression but maybe makes my point. I recently had a hip replacement operation. Rehab was almost like learning to walk again as if one was a child learning to walk. To much intensity could have damaged the leg.
Posted by morganator on November 27, 2009, at 19:17:15
In reply to Re: I'm an exercise skeptic » morganator, posted by bulldog2 on November 27, 2009, at 16:49:11
I totally agree that you have to work your way up to being able to do certain types of exercise. One should take it slow in the beginning. It may be a few months of progressing for mild to moderate to more intense exercise.
Posted by morganator on November 27, 2009, at 19:28:15
In reply to Re: I'm an exercise skeptic, posted by SLS on November 27, 2009, at 16:12:36
> Hi.
>
> > Scott, why not try cardiovascular exercise?
>
> If we are talking about aerobic CV exercise, I simply cannot get myself to do it. It feels like it would be too much effort. I don't have that kind of energy reservoir to work with. I am happy to have returned to the gym for two workouts this past week. I have the motivation to perform resistance exercises, which are anaerobic. I can handle the sort of energy expenditure necessary to get through a workout. One can progress through the exercises at his own pace and allow for recovery of energy in between them. If I get to feel better and better, I will see if other types of exercise attract me.
>
>
> - ScottI hear ya. Maybe just going slow in the beginning would help. You could start walking on the treadmill or taking a slow stationary bike ride for 10 minutes. Hopefully you find a way to build up your conditioning and reap the benefits of cardiovascular exercise.
Posted by Phillipa on November 27, 2009, at 20:17:30
In reply to Re: I'm an exercise skeptic, posted by mtdewcmu on November 26, 2009, at 23:13:35
No when I ran it was starting up that was hard to do but after about l0 minutes got into the rhythm and kind of meditated as one thought or part of a song would be in my head and after cooling down if I had been thinking of an answer to a problem. Click it would just be there. Now at the time just anxiety as have Gad. I loved running. If only I could again. Love Phillipa
Posted by Phillipa on November 27, 2009, at 20:21:39
In reply to Re: I'm an exercise skeptic, posted by mtdewcmu on November 27, 2009, at 12:06:37
There was a psychiatrist in the 70's or 80's that conducted his sessions with depression while running with his patients and found they got better faster. Think the name began with a K? I will google later. Phillipa
Posted by Phillipa on November 27, 2009, at 20:26:36
In reply to Re: I'm an exercise skeptic, posted by SLS on November 27, 2009, at 16:12:36
Scott seriously as boring as it is treadmill or eliptical. There you can program into the machine your own ability to excercise pace, speed, time, intensity. Phillipa
Posted by Phillipa on November 27, 2009, at 21:16:31
In reply to Re: I'm an exercise skeptic, posted by SLS on November 27, 2009, at 4:07:34
Yeah I found it the book I read. I know four posts in a row but worth it. Read and decide. Phillipa boy this link better work!!!!
http://www.time.com/time/magazine/article/0,9171,946869-1,00.html
Posted by SLS on November 27, 2009, at 21:34:59
In reply to Re: I'm an exercise skeptic » SLS, posted by Phillipa on November 27, 2009, at 20:26:36
> Scott seriously as boring as it is treadmill or eliptical. There you can program into the machine your own ability to excercise pace, speed, time, intensity. Phillipa
I usually start off my workouts by riding the bike for a few minutes - just enough to warm up my leg muscles for doing squats or leg-presses. I'll give some consideration to doing some aerobic work on my off days once I settle down into a stable exercise schedule.
- Scott
Posted by Phillipa on November 27, 2009, at 21:51:44
In reply to Re: I'm an exercise skeptic » Phillipa, posted by SLS on November 27, 2009, at 21:34:59
Scott I still have the pic from the album you once posted of buff you all pumped up with great muscles. I know you love lifting. Take it a bit slower and lighter weights and built up. Do keep up the bike or one other. Regular walking do you like that outdoors? When I moved up here from the beach I started old lady jogging as I call it sidewalk uneven fell and broke wrist as protected myself with my arm. And now the osteo. So probably had it then. But the thought I was jogging again was a good one. I really do miss it. I feel for me it kept anxiety and low grade depression at bay as even in 20's if sat for two days started to feel down so ran three miles and felt well again. Love Phillipa good luck you'll figure it out.
Posted by mtdewcmu on November 28, 2009, at 0:17:49
In reply to Re: I'm an exercise skeptic » mtdewcmu, posted by Phillipa on November 27, 2009, at 20:21:39
> There was a psychiatrist in the 70's or 80's that conducted his sessions with depression while running with his patients and found they got better faster. Think the name began with a K? I will google later. Phillipa
Placebo effect. Something like 60% of depressed people get better on placebo alone in studies of antidepressants.
Posted by morganator on November 28, 2009, at 3:15:34
In reply to Re: I'm an exercise skeptic, posted by mtdewcmu on November 28, 2009, at 0:17:49
Dude! How can you say it's a placebo? Whether it is a form of stress relief or you take time to try to be positive during your workouts or there are some actual changes taking place in your brain, exercise helps to alleviate anxiety and depression for many many people.
I seriously doubt that the 60 percent of depressed patients stay better. They may feel better for the duration of the study, but I seriously doubt that even if they continued to take the placebo they would stay in remission.
Are you sure it's 60 percent?
If you are on a medication that is relieving at least 65 to 70 percent of your symptoms, I challenge you to start doing cardiovascular exercise 4 to 5 days a week and stretching for 15 minutes. During both the exercise and stretch, breath and meditate, closing your eyes at times, especially when breathing in through your nose.
I am just very surprised that you think the benefits of exercise are mere placebo for everyone that experiences them. It's almost like saying the same for medications, herbal remedies(SJW for example), and various forms of therapy. You are denying that exercise does not have a positive effect on the brain. Did you read the article posted in the thread below?
Also, if you get in shape and feel good about yourself you are more likely to just feel good in general.
Posted by Alexanderfromdenmark on November 28, 2009, at 6:46:02
In reply to Re: I'm an exercise skept » mtdewcmu, posted by morganator on November 28, 2009, at 3:15:34
Exercise was always my nr. 1 antidepressant.
I would say that for severe depression though, it is not enough and can be impossible to do. For me moderate exercise was a very good antidepressant.
Posted by SLS on November 28, 2009, at 7:02:16
In reply to Re: I'm an exercise skept » mtdewcmu, posted by morganator on November 28, 2009, at 3:15:34
We might have a slight problem.
"I think that this is another case of needing to acknowledge the interindividual differences that exist in the presentations of what we are all calling "depression".
I am convinced that many people are unresponsive to exercise as a treatment for depression. I am one such person. Also, there are plenty of people who do respond to exercise. I don't see anyone here who is being anything but a fine human being who wants to help others. Each person is passionate in their beliefs. However, these beliefs seem to be based upon one's own experiences, and it is hard for anyone to accept as globally applicable the beliefs of another. I think the majority of people who do benefit from exercise want very badly for their experience to be global. That way, they can contribute to the attainment of wellness in others. Those people for whom exercise has no beneficial effect on their illness may not want to be told that they can do something that they actually cannot. It is altruistic to want to prevent others from feeling somehow inferior if they, too, don't respond to exercise. It is a vindication.
Just like atypical major depression often presents with reactive mood (improvement of mood based upon positive external events), I think that many people are reactive to exercise. Perhaps there is some overlap. My guess is that melancholic depression and bipolar depression are not responsive to exercise, especially when psychomotor retardation is present. This is nothing more than conjecture on my part, though. Of course, it may not be globally accurate.
If we were all the same, we would respond to the same one drug. If everyone were to respond to exercise, why would we need drugs at all?
- Scott
Posted by SLS on November 28, 2009, at 7:07:00
In reply to Re: I'm an exercise skept, posted by Alexanderfromdenmark on November 28, 2009, at 6:46:02
Hi Alexanderfromdenmark.
> Exercise was always my nr. 1 antidepressant.
What kinds of exercise do you find effective?
Thanks.
- Scott
Posted by mtdewcmu on November 28, 2009, at 8:13:26
In reply to Re: I'm an exercise skept » mtdewcmu, posted by morganator on November 28, 2009, at 3:15:34
> Dude! How can you say it's a placebo? Whether it is a form of stress relief or you take time to try to be positive during your workouts or there are some actual changes taking place in your brain, exercise helps to alleviate anxiety and depression for many many people.
>If it is a form of psychological stress relief, or you engage in positive thinking during your workouts, that could be construed as placebo effect, depending on what kind of effect of exercise you were expecting to find. Researchers are saying that exercise somehow rewires your brain as if you were taking a drug. If that's the kind of effect you are looking for, then all other effects could be construed as placebo.
> I seriously doubt that the 60 percent of depressed patients stay better. They may feel better for the duration of the study, but I seriously doubt that even if they continued to take the placebo they would stay in remission.
>
> Are you sure it's 60 percent?
>I don't have a particular study in mind, but I could find one and get back to you.
> If you are on a medication that is relieving at least 65 to 70 percent of your symptoms, I challenge you to start doing cardiovascular exercise 4 to 5 days a week and stretching for 15 minutes. During both the exercise and stretch, breath and meditate, closing your eyes at times, especially when breathing in through your nose.
>
> I am just very surprised that you think the benefits of exercise are mere placebo for everyone that experiences them. It's almost like saying the same for medications, herbal remedies(SJW for example), and various forms of therapy. You are denying that exercise does not have a positive effect on the brain. Did you read the article posted in the thread below?
>
> Also, if you get in shape and feel good about yourself you are more likely to just feel good in general.I don't dispute that exercise may have psychological (not biological) effects in some people which cause their depression to improve. People might derive the same psychological benefit from, say, joining a group of people who play bridge regularly. That could produce a sense of accomplishment and camaraderie. However, since bridge doesn't directly affect the brain, whatever benefits it has could be considered placebo effect.
The reason people get better when taking a sugar pill during antidepressant trials is presumably because they believe they are doing something about their depression, being in a clinical study might make them feel important, the study doctors may be especially charismatic, etc. That's the sort of thing that is termed placebo effect, and it has been shown to be powerful.
Posted by morganator on November 28, 2009, at 14:21:07
In reply to Re: I'm an exercise skept, posted by mtdewcmu on November 28, 2009, at 8:13:26
>However, since bridge doesn't directly affect the brain, whatever benefits it has could be considered placebo effect.
Actually, pleasurable social interaction has been shown to have healing benefits that are NOT placebo.
> The reason people get better when taking a sugar pill during antidepressant trials is presumably because they believe they are doing something about their depression, being in a clinical study might make them feel important, the study doctors may be especially charismatic, etc. That's the sort of thing that is termed placebo effect, and it has been shown to be powerful.
I understand what placebo effect is and how it works. I just don't think that this sugar pill placebo effect would last continue to be successful as long as the medication that has the same success rate. Now I sound like I'm just trying to argue.
I still think that unless you have tried all forms of exercise- including meditative yoga and bikram yoga(this is expensive), and you stick with it for at least a few months, you cannot say for sure that exercise/stretching/yoga(yes now I'm including yoga) will not benefit you. That is, unless you are suffering from major depression and you don't have the support system and medication treatment necessary to give you the strength to exercise or the base to benefit from it.
Scott, I agree with much of what you said. I still think that everyone should exercise if they can. And if they can and do it for a while, just feeling good after a workout and feeling good about being in shape may at least give temporary or mild relief from one's depression. Now I think I'm being redundant.
Posted by zana on November 28, 2009, at 17:24:10
In reply to Re: I'm an exercise skept, posted by morganator on November 28, 2009, at 14:21:07
I actually agree with a lot of what Scott says. I think if you can get yourself to exercise, you are not as depressed as the group that can't. If you can get yourself to the gym or out the door to jog, you're ahead of the game aleady. That being said, I think excercise of almost any kind has some psychological benefit. Now if I could only get myself to the gym. I always found jogging and weight lifting good for my mood. When I could do it....
Zana
Posted by Phillipa on November 28, 2009, at 18:57:23
In reply to Re: I'm an exercise skept, posted by zana on November 28, 2009, at 17:24:10
I do agree the level of depression has an effect. Since my major complaint has always been anxiety and dx is Gad that for me excercise relieves the stress and eliminates the need for meds. For me at first was very hard to jog. Had gained baby weight. But I wanted to teach Aerobic dance and one of the qualifications for being cerified was running only l.25 miles in under 12 minutes. I started doing what had to be done and hated it at first but the weight fell off and soon the biggest upper was running. Not with docs by myself. I loved it. Now unfortunately age prevents it. I do remember one man who came into the Y in Westport and actually cried there as he could no longer run as had injured self and now he had to swim which he said just didn't do it. And I do completly relate with that. Need another link on excercise. Will look now. Love Phillipa
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