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Exercise is an effective treatment for depression, and appears equally effective for people with and without comorbidities and with different baseline levels of depression, according to a meta-analysis.
The study, published in the BMJ on 14 February 2024, aimed to identify the optimal dose and type of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants and control conditions.
Researchers looked at more than 200 studies, covering just over 14,000 participants, from the Cochrane Library, Medline, Embase, SPORTDiscus and PsycINFO databases, to consider the effect of most forms of physical activity — including yoga, walking, and strength training — on depression.
They found that the most effective forms of exercise were walking or jogging, yoga, strength training and dancing. Although walking or jogging were effective for both men and women, strength training was found to be more effective for women, and yoga or qigong was more effective for men.
Yoga was somewhat more effective among older adults, and strength training was more effective among younger people. The benefits from exercise tended to be proportional to the intensity prescribed, with vigorous activity being better. Benefits were equally effective for different weekly doses of exercise, for people with different comorbidities and for different baseline levels of depression, the researchers concluded.
Current National Institute for Health and Care Excellence (NICE) guidance on the treatment of depression in adults says the condition may respond to a variety of management options, with group exercise recommended as cost effective and easy to implement, depending on the severity of the episode.
Commenting on the results of the study, Jonathan Roiser, professor of neuroscience and mental health at University College London, said: “The headline result is that all types of physical activity (especially aerobic exercise) cause a reduction in depressive symptoms; a similar conclusion to many reviews over the past decade.
“Physical activity is actually currently included in the UK NICE guidelines for depression, but unfortunately it is rarely prescribed in practice, even though we know it works.
“What is needed is a cultural shift in the way we think about treating depression, which emphasises the important role that physical activity can play, alongside standard treatments like medication and therapy. And as the authors say, we also need a lot more research in understanding how exercise works for depression, as this could potentially increase people’s willingness to consider it, and also provide important clues for the development of new treatments.”
Paul Keedwell, consultant psychiatrist and Fellow of the Royal College of Psychiatrists, said: “Some caution is needed in interpreting the findings. Many studies had small sample sizes and were not conducted in real-world conditions. Also, many depressed individuals find exercise very challenging. But, taken together, the evidence supports exercise being an important part of a package of treatments for depression, and it will help with physical health too.”
