How Exercise Can Be as Effective as Antidepressants in Reducing Depression

Experiencing a post-workout mood boost is common, and a recent review highlights just how impactful this effect can be. Simple activities like walking or gardening can alleviate depression symptoms as effectively as psychotherapy or antidepressants.

“This research reinforces that exercise is a viable option for individuals suffering from depression, showing that it can rival the effectiveness of psychotherapy or medication,” states Andrew Clegg from the University of Lancashire, UK.

A prior Cochrane Library review in 2013 discovered that exercise alleviates depression symptoms comparably to standard treatments like antidepressants and cognitive behavioral therapy (CBT), which focuses on modifying thought patterns and behavior.

Consequently, health authorities advocate regular exercise for depression management. The UK’s National Institute for Healthcare Excellence (NICE) suggests engaging in aerobic activities such as jogging for ten weeks, typically in conjunction with other therapies for optimal results.

Since the 2013 review, numerous clinical trials have surfaced, prompting the Cochrane Library to embark on an updated review. “This new review nearly doubles the existing evidence base from the previous publication,” comments Clegg, a co-author of the review.

Clegg and colleagues reviewed data from 69 randomized controlled trials involving nearly 5,000 adults diagnosed with mild to severe depression or showing elevated depression symptom scores. Their analysis focused on 57 trials where participants were assigned to either an exercise group or a control group receiving no treatment.

Trial methodologies varied significantly, but usually directed participants to maintain a routine of low to moderate exercise—like gardening or brisk walking—compared to more vigorous activities like sprinting or soccer. Yoga and stretching were excluded, as these often incorporate meditative or breathing practices, which detracted from the study’s emphasis on pure physical activity.

The research indicated that exercise modestly reduced depression severity, characterized by feelings of sadness and disinterest in social activities.

“Clinically meaningful improvements were observed—individuals reported noticeable changes,” remarks Brendon Stubbs from King’s College London, who was not part of the review.

Furthermore, the team analyzed ten of the 59 trials that compared exercise to CBT and five trials involving participants on antidepressants devoid of an exercise component. Results indicated that, on average, regular exercise proved equally effective as these treatment modalities. “There was no significant difference in outcomes among the three,” emphasizes Emily Hird from University College London, who also did not partake in the study.

The research highlighted that light to moderate exercise outperformed intense workouts. This may be linked to higher adherence rates; as Stubbs explains, “Strenuous exercises often lead to dropout, thus diminishing the observed benefits.”

While the precise advantages of exercise remain under investigation, Stubbs suggests multiple potential mechanisms. Group activities could enhance social well-being, and acquiring new skills might boost self-esteem, fostering positive life changes.

Studies indicate that muscle-released chemicals, known as myokines, help reduce inflammation, which may exacerbate depression. One particular myokine, brain-derived neurotrophic factor, is known for promoting new brain cell growth, potentially aiding in the reconfiguration of negative thought patterns, as asserted by Stubbs. Interestingly, Clegg’s team discovered that resistance training, which generates more myokines, was more effective than aerobic workouts alone.

Collectively, these findings advocate for exercise as a depression treatment modality. However, since participants were aware of their group assignments, some gains might stem from placebo effects, where expectations influence symptom relief. Additionally, the majority of studies had limited participant numbers, which may impact reliability, according to Hurd.

Hurd advocates for larger studies to investigate optimal exercise types tailored for individuals and their unique challenges. “Currently, we lack clarity on who benefits most from different exercise forms,” she asserts. Individuals with severe depression might struggle to maintain exercise routines and may find more relief through CBT or antidepressants, both of which exhibit effectiveness akin to exercise in managing depression. Furthermore, some individuals may respond preferentially to specific activities based on their depression’s root causes.

Nevertheless, evidence consistently reveals the benefits of exercise for both mental and physical health. “Activities such as running, gym workouts, Pilates, and yoga all impart various positive effects. The most crucial aspect is to engage individuals in activities they enjoy,” concludes Stubbs.