I wouldn't go that far, but there was a now-famous study (Princeton?) that showed that doing aerobic exercise for maybe 30 mins every day, about five days per week, was equally effective at alleviating depression symptoms.
There's one big problem with that - getting seriously depressed people to do 30 minutes of exercise (or anything else) five days a week. "Get more exercise" is excellent advice for someone who feels a bit down, but it's absolutely useless for someone who can barely summon up the strength to eat or brush their teeth.
It gets even harder if you offer them the alternative of just taking a pill. For widespread health policy, we should want the proportion of depressives who will never learn to manage it themselves because a pill is offered to be smaller than the proportion for whom the pill is effective. I had always assumed these pills were effective enough but studies like these make me wonder.
They are by no means mutually exclusive. If you want depressed people to get more exercise, then a really useful starting point is to give them a pill that could rapidly increase their energy and motivation. The idea that people will be stuck on those pills forever is just lazy psychiatry; ongoing maintenance treatment is often the best option for patients with a history of severe depression and a high risk of relapse, but antidepressants are equally useful as a stepping-stone towards self-management.
Bluntly, if someone is capable of actually starting and sticking with an exercise routine, then they aren't very depressed and should not be offered medication as a first-line treatment. Antidepressants are markedly less effective in patients with milder illnesses, so psychotherapy and lifestyle interventions are a far better initial treatment option. It's only when these treatments fail - or when engaging with them is severely impaired by the severity of the illness - that medication becomes the favoured option.
It’s always frustrating to see the implication that people just need to exercise to solve their mental health struggles. It might not be your intention, but it's a take I see a lot online from influencers.
I say this as someone who is extremely fit. I've worked out religiously since high school. While exercise is integral to me feeling somewhat normal and provides a short-term boost, that is just not how it works for everyone. Some of us have 'broken brains' that cardio can't fix.
Exercise manages my baseline, but sertraline is what helped me finally bridge the gap. It allowed me to regulate my emotions and anxiety in a way that no amount of exercise ever did. And the introspection from being on it helped me make lifelong changes.
To be honest, fearmongering from folks online is what stopped me from taking it sooner, but I wish I had. It was fairly life-changing.
