Depression, exercise and twitter.

Today, Louise Mensch tweeted a link to an exercise video, and her accompanying text was:

"Self-esteem: exercise is the best anti-depressant and ANYONE can do it. Try this: (link to mini-exercise video on her website)".

I took issue with this, and wanted more than 140 characters to explain why.

Depression has been a pretty major part of my life, especially recently. I'm lucky in that my own relationship with depression has been generally both mild and temporary. I'm certainly aware of my tendencies towards it, however. My partner has coped with severe depression for many years. I'm claiming no particular expertise in the subject, but I am saying that, for various reasons, it has been a feature in my life and that it's a subject I take very seriously.

As a result of this, I feel that Louise Mensch's statement was patronising, reductive and displayed an ignorant attitude towards mental health.

Can exercise help towards mental well-being? Yes, it can. Exercise is generally a good thing to do, and getting endorphins going may, at the very least, make you feel better than you were. I'm not arguing against that point.

The issue is in saying that it's "the best anti-depressant" and that "everyone can do it". Neither of these are true statements to make in that big, sweeping way.

When I was at my worst, I didn't want to move. A major relationship had come to an end the same week I had been made redundant, and I felt very alone and very miserable. I didn't want to sleep in my bed, because the bed had too many memories. I didn't want to sleep without noise or light, because I craved distraction. I was honestly scared of what would happen if my mind started wandering unchecked.

What this meant is that I spent a long time on the sofa. For a while, I slept there with the lamp on and the TV on a music video channel. Just white noise, to be honest, but something that meant I felt safe going to sleep. Eating took effort. Going to the shops took effort. Everything took effort other than lying there, not wanting to do anything. I watched a lot of television that I didn't like because even turning the channel was something I was putting off doing.

The point where I realised I needed help was when I had a glass of wine on a table that necessitated me putting the laptop aside and standing up to reach over for, and it took me almost two hours to do. I wanted that damn glass of wine as well, and not just for the alcohol - on a basic level, I was thirsty. I wanted to reach over. But I couldn't. That simple action was, for a period of time longer than a lot of movies, beyond me. The next day, I went to the Doctor.

I could have no more gone for a jog than I could have flapped my arms and flown to the moon.

That was part of the problem. My depression manifested in almost complete inability. And, for the record, I consider my own depression to have been mild in comparison with other people who I have spoken to.

The first issue that springs to mind with Louise Mensch's statement is that in cases like mine, it confuses causation with correlation. When I did start exercising again, it was much more a sign that I was getting better than it was the reason that I was getting better.

Another problem with depression is that once someone finds what works for them, a lot of the time, they think that will work for everyone. Unfortunately, this is often not the case. What worked for me doesn't work for my girlfriend, and what works for her probably wouldn't have worked for me. But that doesn't fit our internal narrative. Instead, we realise that we've overcome our problem, so this must be the right answer, be it a specific medication, God, meditation, a particular kind of therapy, aromatherapy, music, films, books or, yes, exercise.

And when someone evangalises about what worked for them, it can make the depressed person feel worse if it doesn't work for them, or even if they have already tried that and it didn't work then.

As an example, you often hear "you get out of it what you put in", with regards to something like Cognitive Behavioural Therapy. In most cases, I think people say that in the sense that you have to actually engage with it and believe in it for it to be effective. However, this can come across as saying "if you don't get anything out of it, it must be because you didn't try hard enough". And even worse than that, sometimes it comes across as that because that's what is meant.

Mental health issues, along with other kinds of disabilities, are coming in for a lot of stick recently from the right wing. Words like 'scroungers' are being thrown around a lot more than they were a little while ago. The perception is not strong. And one of the most insiduous ways of demonising those on benefits is to suggest that they're lazy.

And while this isn't what I believe that Louise was intending to say, I do think that what she said was dangerously close in principle to saying that depressed people are so because they are lazy. After all, if exercise is the best anti-depressant, and everyone can do it, then those who are depressed are so because they aren't exercising. And we all know who doesn't exercise...

I'm not intending to misrepresent her. She didn't say that. But I do feel that what she said can feed that point of view, and that's a point of view that's getting a disturbing amount of play-time in the media at the moment, and I think that's dangerous.

Exercise will work for some people, and it may well help almost everyone to some degree or other. And if that was what was said, I wouldn't have thought of it any further than "Oh, Louise Mensch is plugging her site again". However, she said it was the BEST anti-depressant, and that ANYONE could do it.

No. For some people, it may be, but for others, the best anti-depressants are going to be actual anti-depressants, because not all depression is the same and not all treatments are the same.

You may as well try to treat depression by telling all sufferers that they should just cheer up. After all, cheering up is bound to help with depression, and we're all capable of being cheerfully happy.

Rather predictably, Mensch responded to those who criticised by portraying the anger she caused as 'sneering', and she also said that her critics were failing to differentiate between mild/moderate depression and severe depression, rather ignoring the point that it was actually her that failed to differentiate. That was the root of the problem, in fact. She also tried to paint her critics as denying that exercise could be effective. However, in the majority of responses that I saw, they were taking issue with her saying that it was "the best" anti-depressant.

She did clarify later that it didn't work for severe depression, and that it was 'the best' because it was freely available and had no negative side-effects. I hope that when she blogs on this later, that she does so in a more clear manner, because I don't think that it was the point that she was trying to make that was the problem, but the simplistic way in which she initially described it.

When you talk about depression in such a way that you make it sound like it is something very simple with a very simple solution, you are being reductive and patronising. But you are also reinforcing the dangerous stereotype that depressed people are just being lazy.

That doesn't help.

Instead, please, take the time to learn more about depression. It's an area that needs more research and more funding, because it isn't easy to treat - especially for those with long-term issues. And it's an issue that is killing people every day, and part of that is because of the stigma that surrounds it.

It isn't simple. It's complicated. That's the whole point.