Study details

For the study, researchers reviewed 218 randomized controlled trials that included a total of 14,170 participants across multiple countries who were either clinically diagnosed with depression or self-reported as depressed.

The researchers measured the mental health impacts of the following activities:

• Dance
• Cycling
• Mixed aerobic exercises
• Aerobic exercise and strength
• Aerobic exercise and therapy
• Tai chi or qigong
• Walking or jogging
• Physical activity counseling
• Relaxation
• Exercising and taking SSRIs
• Strength training
• Yoga
• Cognitive behavioral therapy
• SSRIs alone

Compared to controls, "large reductions in depression were found for dance and moderate reductions for walking or jogging, yoga, strength training, mixed aerobic exercises, and tai chi or qigong," the study noted.

While there was risk for bias in the studies, the benefits of exercise, paired with data to suggest that it helps with depression, make for a strong treatment option, said Michael Noetel, senior lecturer in the School of Psychology at the University of Queensland and lead author on the study.

Overall, strength training was more effective for women, and yoga or qigong was more effective for men. Younger participants found strength training to be more effective, while older participants considered yoga more helpful.

The study also found that more exercise with a higher intensity worked better, however, any amount of exercise was ultimately helpful.

"It didn't matter how much people exercised, in terms of sessions or minutes per week," Noetel said. "It also didn't really matter how long the exercise program lasted."

While any exercise was better than none, Noetel recommended adding some challenges. "We initially thought those with depression might need to 'ease into it'," he said. "We found it was far better to have a clear program that aimed to push you, at least a little."

The researchers also found that the effect of exercise on depressed people seemed to be superior to antidepressants, and when combined with the drugs, the antidepressants' effects improved.

Discussion

According to the researchers, the study's findings "support the inclusion of exercise as part of clinical practice guidelines for depression, particularly vigorous intensity exercise. Health systems may want to provide these treatments as alternatives or adjuvants to other established interventions, while also attenuating risks to physical health associated with depression."

The study's results also align with other studies' findings on the benefits of exercise, according to Adam Chekroud, assistant professor adjunct of psychiatry at Yale School of Medicine.

In a 2018 study led by Chekroud of more than 1.2 million Americans, he found that those who exercised reported better well-being and mental health. According to Chekroud, both studies should give people confidence that exercise is a good way to treat depression alongside other options.

"None of these treatments are silver bullets. But, given how debilitating it is to have depression, almost all patients should be offered both exercise and therapy," Noetel said.

In an accompanying editorial, Juan Ángel Bellón, a professor at the University of Malaga department of public health and psychiatry, said that primary care providers "can now recommend exercise, psychotherapy, or antidepressants as standalone alternatives for adults with mild or moderate depression."

However, Bellón noted that getting the motivation to exercise may be difficult for someone suffering from depression, and said studies are needed to evaluate physical activity programs for people with depression.

Bellón urged both local and national administrations to "provide enough resources to make individualized and supervised exercise programs 'accessible' to the entire population." (Holcombe, CNN, 2/14; Bradley, Fortune, 2/15)

No organization can solve for women's health inequities on its own, but every organization has a role to play in dismantling inequities in women's care and improving outcomes. Access this cheat sheet to learn how to improve care for anxiety disorders and depression.