Exercise Rivals Therapy and Antidepressants in Treating Depression, Major Review Finds
A new, comprehensive analysis reveals that exercise can be as effective as psychological therapy for alleviating symptoms of depression, and shows a comparable, though less certain, benefit when weighed against antidepressant medication.
Depression affects over 280 million people globally and remains a leading cause of illness and disability. The findings, published in the Cochrane Database of Systematic Reviews, highlight exercise as a readily accessible and cost-effective treatment option with added health benefits.
Significant Findings from the Cochrane Review
Researchers from the University of Lancashire meticulously examined data from 73 randomized controlled trials, encompassing nearly 5,000 adults experiencing depression. These trials compared the impact of exercise to no treatment, standard care, psychological therapies, and antidepressant medications.
The analysis demonstrates a moderate benefit of exercise in reducing depressive symptoms compared to inactivity or usual care. Notably, when directly compared to psychological therapy, exercise demonstrated a similar positive effect, based on evidence from ten trials with moderate certainty.
While comparisons to antidepressant medication also suggested a similar effect, the evidence supporting this conclusion was limited and considered to have low certainty. The long-term impacts of exercise as a treatment for depression remain unclear, as few studies tracked participants for an extended period after treatment completion.
“Our findings suggest that exercise appears to be a safe and accessible option for helping to manage symptoms of depression,” stated a lead author of the review. “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.”
Intensity and Type of Exercise Matter
The review indicated that light to moderate intensity exercise may be more beneficial than high-intensity workouts. Participants who engaged in between 13 and 36 exercise sessions experienced the most significant improvements in depressive symptoms.
No single exercise type emerged as definitively superior, but mixed exercise programs and resistance training appeared more effective than aerobic exercise alone. Further research is needed to explore the potential benefits of practices like yoga, qigong, and stretching, which were not included in this analysis.
Limitations and the Need for Further Research
This updated review incorporated findings from 35 new trials, building upon previous versions published in 2008 and 2013. Despite this expanded dataset, the overall conclusions remain largely consistent. This is primarily due to the relatively small size of most trials – fewer than 100 participants – which limits the ability to draw definitive conclusions.
“Although we’ve added more trials in this update, the findings are similar,” explained a senior researcher involved in the study. “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. One large, well-conducted trial is much better than numerous poor quality small trials with limited numbers of participants in each.”
For more detailed information, the full review, “Exercise for depression,” is available in the Cochrane Database of Systematic Reviews (DOI: 10.1002/14651858.CD004366.pub7).
