Skip to main content

Hills not Pills

My article in this month's TGO is called Hills not Pills and looks at the psychological benefits of exercise in the outdoors. (some references for the piece are here) Others have written about this recently - like Chris Kresser - but one of the things that prompted me to write was learning just how many people rely on antidepressants.  It is true here in the UK but also across the world as this graphic shows.


Created by: MedicalBillingAndCodingCertification.net

Just go outside for a walk
Labels:

Comments

Purposelessness said…
I agree that antidepressants (and axiolytics, for that matter) are overprescribed.

But on the other hand I believe that the anti-antidepressant (hehe) sentiment is troublesome too - personally, I was in a place where I couldn't bring myself to exercise or even go outside, and taking ADs enabled me to go for brisk walks and engage in psychotherapy in the first place. After which I could discontinue the AD.

ADs have, as medications go, a low success rate (~30%, or if you try multiple drugs maybe 50%), but they have their place IMHO.
The chochrane review, on which most "SSRIs are no better than placebo"-sentiments are based had problems, which have been adressed many times (in journals, not on the internet, alas)..

I believe the drugs themselves are not the problem (though prescribing antipsychotics for depression, which seems to be common practice as second line treatment, is utter madness IMHO - but thats another topic..), but how the whole treatment of depression is handled. The problem is that prescribing drugs is much cheaper and easier to do than psychotherapy or getting your patient to exercise.. Takes much less time also.
IMHO the first line treatment for depression should be CBT (cognitive behavioral therapy), which should enable the patient to start exercising/moving more and making other important lifestyle changes (getting outside more, more social engagement, less TV, junkfood etc), and if that fails to treat depression sufficiently, drugs.

So, in an ideal world, drugs should be far less important in the treatment of depression, but in the real world you often have the choice between an AD and no treatment at all - and here, ADs are, whithout question, preferred..


Sorry for the rant!
February 8, 2012 at 12:15 AM
Chris said…
The rant is ok - you make some great points.
February 8, 2012 at 12:22 AM
Phil Bear said…
Great article - reminds me of a favorite quote of mine:
"A man's health can be judged by which he takes two at a time - pills or stairs."
February 8, 2012 at 7:25 AM
Steve Parker, M.D. said…
Americans in general are indeed over-medicated. Doctors have a pill for every complaint you make. So be careful. It's often easier for the doc to jsut write a prescription and send you on your way than to get to the source of the problem.

-Steve
February 8, 2012 at 7:27 AM
Post a Comment

Popular posts from this blog

Dry January

I mentioned a few weeks ago that I was taking part in "Dry January".  I didn't make a big song and dance about it, but I decided to go for a calendar month or so with no alcohol.  A few people have asked me about my experience, so here are a few points. Why take a break from drinking? Alcohol is an interesting topic.  As a drug it is widely accepted in society, central to so much of our socialising and leisure.  There seem to be lots of health benefits - so we are told - yet there are also a lot of problems in terms of health, relationships and lifestyle that come from drinking. Over a few years I'd begun to become aware and then concerned that I was drinking too much and too regularly.  I am in a busy and stressful job and sometimes a glass of wine after work to relax is really helpful.  But over time, one glass became two.  Two glasses became ....I might as well finish the bottle.  A habit got established....and was starting to get too e...
7 comments
Read more

So where have I been?

You will have noticed that this blog has been quiet for a while....  There are a few reasons for that, reasons that I thought I'd list here: WORK -  my day job has been incredibly busy and stressful this year. Working 10-14 hour days the last thing on my mind when I got home was putting something on here.  FACEBOOK/TWITTER - I suppose I've been using other channels to do some of what I used to do here. Quick fire posts pointing to interesting studies or news etc tend to get posted to Twitter (@chrishighcock) or to the Facebook Hillfit group http://www.facebook.com/groups/263083947097000/  REASSESSMENT - I've found myself less comfortable with some of the positions I've taken in the past. Sometimes I'm embarrassed by some of the things I've promoted. I'm not Paleo or low carb. I think Tabata and intervals are misunderstood and misapplied. I cannot really claim to be HIT.   I find myselfunable  honestly to post things on here and pretend that I am some sort o...
12 comments
Read more

Taking up space for a brief update

I've a couple of posts in draft that I will get up soon -  an update / reflection on Dry January and some thoughts on the scheduling benefits of short workouts if your life is busy.  Before that though, I am pointing to something else. However, I wanted to highlight something that is coming this weekend that I've been involved in.   Amber Rogers (Gokaleo and author of Taking Up Space ) has been pulling together a bundle of books from various authors with a common theme, one that I've been pushing here recently.   Keep it simple, avoid the hype, be patient, be consistent and flee the gurus.   I've talked before about how we get obsessed with pushing for more and more, when enough is OK.  I've given my view that so much of the health and fitness internet world is more like a gnostic religion than something that will benefit your life. There are other voices out there saying similar things and I'll be pointing to a bundle of books later this week ...
1 comment
Read more