Exercise Can Be More Effective Than Antidepressants for Depression

...and it's about as effective as therapy

Photo by kike vega on Unsplash

Note that doubts have been raised about the quality of the data reported in the study described in this post. I’ll update the post if need be when the dust settles.

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A new review and meta-analysis of 218 studies covering more than 14,000 participants concluded that exercise is as effective as therapy in addressing depression - and that it’s often more effective than antidepressants (SSRI).

Lead author Michael Noetel summarized the findings in The Conversation.

We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as cognitive behavior therapy—one of the gold-standard treatments for depression. The effects of dancing were also powerful. However, this came from analyzing just five studies, mostly involving young women. Other exercise types had more evidence to back them.

Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants…

Antidepressants certainly help some people. And of course, anyone getting treatment for depression should talk to their doctor before changing what they are doing.

Still, our evidence shows that if you have depression, you should get a psychologist and an exercise plan, whether or not you’re taking antidepressants.

Here are some excerpts from the paper:

Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense… These forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression…

Consistent with other meta-analyses, effects were moderate for cognitive behaviour therapy alone and small for SSRIs compared with active controls…

[E]xercise showed moderate effects on depression compared with active controls, either alone or in combination with other established treatments such as cognitive behaviour therapy. In isolation, the most effective exercise modalities were walking or jogging, yoga, strength training, and dancing. Although walking or jogging were effective for both men and women, strength training was 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.

These findings mesh nicely with earlier work on the topic. A 2021 meta-analysis concluded, for instance, that exercise combined with standard treatments for depression is more effective than standard treatments alone. And a 2022 meta-analysis concluded that “Exercise is efficacious in treating depression and depressive symptoms and should be offered as an evidence-based treatment option.”

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The new paper is titled “Effect of exercise for depression: Systematic review and network meta-analysis of randomised controlled trials,” and was published in the BMJ. It’s open access, so you can read if for free here.

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