Regular physical activity can reduce symptoms of depression about as effectively as psychological therapy, according to an updated Cochrane review. When comparing exercise to taking antidepressants, similar positive effects were observed, although the reliability of this data was lower.

Depression and the Role of Physical Exercise

Depression remains one of the most serious global health issues, affecting over 280 million people worldwide and significantly contributing to disability. Physical exercise stands out as an accessible and affordable support method that, in addition to other benefits, improves overall physical health, making it appealing to both patients and healthcare professionals.

Review of Studies

The analysis conducted by researchers from the University of Lancashire included data from 73 randomized controlled trials involving nearly 5,000 adults with depression. These studies compared the effects of physical exercise with no treatment, control conditions, psychological therapy, and antidepressant medications.

Overall, the results showed that exercise led to a moderate reduction in depression symptoms compared to no treatment. When compared to psychological therapy, exercise produced similar improvements (based on moderate-certainty evidence from ten studies). Comparisons with antidepressants also indicated similar effects, but the supporting data was limited and rated as low-certainty. Few studies followed up with participants after treatment ended, so the long-term impact remains unclear.

Safety and Side Effects

Side effects from exercise were rare. Occasionally, participants experienced muscle or joint injuries, while those taking antidepressants reported typical medication-related issues such as fatigue and digestive problems.

Expert Commentary

Professor Andrew Clegg, the lead author of the review, noted:
“Our results show that physical exercise is a safe and accessible way to help manage depression symptoms. This suggests that exercise can be very helpful for some people, but not everyone, and it’s important to choose approaches that a person is willing and able to maintain.”

Which Exercises Are Most Effective?

The review found that light to moderate intensity activities may be more beneficial than intense workouts. The most noticeable improvement in depression symptoms was seen after 13 to 36 training sessions.

No specific type of exercise showed a clear advantage. However, programs that combined different types of activity and strength training were more effective than aerobic exercise alone. Some forms of activity, such as yoga, qigong, and stretching, were not evaluated in this analysis and remain subjects for future research. As with other findings, the long-term benefits are still uncertain due to limited follow-up.

Limitations and the Need for Further Research

The updated review included 35 new studies compared to previous versions published in 2008 and 2013. Despite the expanded evidence base, the main conclusions changed only slightly. Many of the included studies were small, often with fewer than 100 participants, making it difficult to draw definitive conclusions.

Professor Clegg emphasized:
“Although we added more studies in this update, the results are similar. Physical exercise can help people with depression, but if we want to know which types are most effective, for whom, and whether the effect lasts over time, we still need larger and higher-quality studies. One large, well-conducted study is much more valuable than many small and low-quality trials with limited participant numbers.”