My response is aimed more at BMJ's advertisement of this study in their email alert

'Exercise is good for depression, right? Wrong, according to this study... So we have no evidence to support advising depressed patients to exercise. And advising exercise may increase a depressed person’s sense of failure and guilt if they cannot follow the advice'.

The study found exercise did not improve depression. Does this mean we should not recommend exercise to people who are depressed? I would argue that the other benefits of exercise to cardiovascular health etc, would by far outweigh the theoretical downside of 'sense of failure and guilt' if they fail to achieve their goals.

Even if exercise does not help, the beneficial side effects of activity are vast. As GPs we must be mindful of the patient as a whole. They may be depressed, but they are still subject to the long term health risks caused by inactivity like everyone else.

My point is simply a reminder that even if the evidence does not support advising exercise for depression it certainly does not mean we should not be advising exercise to people who are depressed!

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Competing interests: None declared