Exercise has received growing attention as a way to help with depression, whether in combination with therapy and medication or, in some cases, on its own.
A new review by Cochrane, an influential nonprofit research group, examined 73 clinical trials including nearly 5,000 adults with depression, to assess how strong the evidence is that exercise can help alleviate depressive symptoms.
The review found little to no difference between exercise and established treatments such as psychological therapy or medication, when it comes to reducing symptoms such as loss of energy, sadness, trouble sleeping, and feelings of hopelessness.
“Our findings suggest that exercise appears to be a safe and accessible option for helping to manage symptoms of depression,” said Andrew Clegg, lead author of the review and professor at the University of Lancashire.
He added that the review shows the importance of finding strategies to combat depression that people are willing and able to maintain.
However, the Cochrane team warned that the overall number of high-quality clinical trials on this topic is still small, and does not offer reliable conclusions about long-term effects. The majority of the trials had fewer than 100 participants, making it difficult to draw firm conclusions, researchers wrote.
The findings come amid the growing global burden of depression, which is the leading cause of ill health and disability worldwide and affects more than 280 million people, according to the World Health Organization (WHO).
Are some exercises more beneficial than others?
While exercise may help reduce depression symptoms similarly to therapy, the review found no single type of workout that is clearly better than others.
People engaging in light to moderate-intensity workouts reported greater benefits than those doing vigorous ones. Completing 13 to 36 exercise sessions in total was also associated with greater improvement in depressive symptoms.
Mixed aerobic and resistance programmes appeared to be more effective than aerobic training alone. The analysis did not look at exercises such as yoga, qigong and stretching, which researchers say should be the subject of further investigation.
“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.
Exercise widely recommended in clinical practice
Prescribing exercise for depression is a common and widespread practice in many healthcare systems.
Several international guideline bodies recommend physical activity as a treatment option, especially for people with mild-to-moderate depression.
The European Psychiatric Association recommends physical activity to improve symptoms and physical fitness, prioritising moderate to vigorous intensity.
Similarly, the UK's National Institute for Health and Care Excellence (NICE) advises group exercise programmes, recommending one session per week led by a trained practitioner for at least 10 weeks.
The Canadian Network for Mood and Anxiety Treatments, one of the most progressive guideline bodies on the issue, recommends exercise as a stand-alone treatment for mild-to-moderate depression, and in combination with therapy and medication for more severe cases.
