- A recently updated Cochrane review found that exercise may provide similar results for depression as therapy.
- Exercise is a low cost, widely available option that has various other benefits. This makes it an attractive option for helping to manage symptoms of depression.
- Research indicates that exercise can have a positive impact on overall mental health.
Regular exercise offers numerous benefits, particularly for mental health.
Now, researchers say exercise may help reduce depression symptoms as effectively as other first-line treatments.
A recently updated Cochrane review found that exercise yielded similar results to psychological therapy. When compared to antidepressants, however, the evidence was less clear.
Depression is one of the most common mental health conditions in the United States, affecting around
Exercise is a low cost option for symptom management that is widely available, making it an ideal treatment option for individuals and their prescribing healthcare team.
“Our findings suggest that exercise appears to be a safe and accessible option for helping to manage symptoms of depression,” lead study author Andrew Clegg, PhD, professor of geriatric medicine at the University of Leeds said in a press release.
“This suggests that exercise works well for some people, but not for everyone, and finding approaches that individuals are willing and able to maintain is important,” Clegg continued.
The review examined 73 randomized controlled trials that included nearly 5,000 adults with depression.
The examined studies compared exercise with control interventions or no treatment, as well as with antidepressant medications and psychological therapies.
The results showed a moderate benefit of reducing symptoms of depression when compared to no treatment or controlled intervention. When exercise was compared to psychological therapy, it had a similar effect. This was based on moderate-certainty evidence from 10 trials.
The evidence in comparison to antidepressants was limited and of low certainty. However, it did show there may be similar effects on depression symptoms.
The long-term effects are still unclear, as few studies have followed participants after treatment.
“While it seems that long-term studies need to be done to further study this complex topic, this review can provide encouragement on the benefits of additional tools, such as exercise, in managing depression,” said Menije Boduryan-Turner, PsyD, licensed psychologist and founder of Embracing You Therapy, who wasn’t involved in the review.
Rod Mitchell, MC, MSc, a registered psychologist and founder of Emotions Therapy Calgary, in Alberta, Canada, who wasn’t involved in the review, agreed.
“The certainty is rated ‘low’ to ‘moderate’ due to methodological challenges — many studies lacked blinded assessors, adequate randomisation concealment, or intention-to-treat analysis,” Mitchell told Healthline.
“I’d caution against reading this as ‘exercise is just as good as therapy,’” he continued. “Therapy rewires thought patterns and processes underlying wounds. Medication adjusts neurochemistry. Exercise resets the nervous system. These aren’t interchangeable tools competing for the same job,” he added.
This review allows clinicians permission to take exercise seriously as a frontline intervention, rather than simply a “lifestyle recommendation” that is tacked on to the end of a session, Mitchell noted.
Other research supports the notion that physical activity can be beneficial for depressive symptoms.
People with high levels of activity may have a 17% lower risk of depression. Those with low cardiorespiratory fitness may also have a 64% higher risk of developing depression. This shows that a sedentary lifestyle may lead to a greater potential for developing symptoms of depression.
A 2024 systematic review suggested that there are three potential ways that regular exercise can help manage depression:
- reducing inflammation, which can be associated with symptoms of depression
- regulating circadian rhythms, which are often disrupted in people with depression
- improving sleep patterns, which can help regulate mood and energy levels
“Exercise can help people with depression, but if we want to find which types work best, for who and whether the benefits last over time, we still need larger, high-quality studies,” Clegg said in the news release. “One large, well-conducted trial is much better than numerous poor quality small trials with limited numbers of participants in each.”
The general recommendation is to use exercise in
“I believe that a combination of therapy, medication, and other methods, such as meditation and exercise, would lead to a more wholesome treatment plan,” Boduryan-Turner told Healthline.
“Most often, people feel the pressure to manage their depression with a single method, such as ‘just need medication’ or ‘just need to go to therapy.’ However, incorporating multiple modalities increases our chances of effectively overcoming our struggles,” she said.
Depression affects everyone differently, and committing to regular exercise may be more difficult for some people than others.
“It depends entirely on where someone is in their depression. For mild to moderate presentations — especially when someone still has some motivational fuel in the tank — exercise can absolutely be a primary intervention,” Mitchell said.
“However, depression is essentially a disorder of initiative. Telling someone in a deep depressive episode to exercise is like handing someone with two broken arms a life raft and telling them to swim,” he said.
Mitchell added that for people with moderate to severe depression, he would typically recommend therapy first to help build positive momentum so that exercise feels possible.
He noted that a person can then layer in movement as they stabilize their moods. It’s about sequencing interventions to meet the person where they are, not where they wish to be, he said.
Exercise can help manage symptoms of depression in physiological and psychological ways. Physical activity releases endorphins, neurotransmitters associated with positive moods and feelings of well-being.
“I recommend that individuals planning to incorporate exercise into their mental health treatment focus on quality over quantity, so that it is not so much about how long they have exercised as about engaging in some form of exercise consistently,” Boduryan-Turner said.
She added that she would encourage people to “engage in an exercise that aligns with the interests you used to have.”
Mitchell agreed. “The type of exercise matters less than we think. Walking, dancing, gardening, gentle yoga — they all send the same signal to a stuck nervous system: ‘we’re not trapped, we can still move through the world,’” he said.
Leave a Reply