A recent update to a Cochrane review indicates that physical activity may reduce symptoms of depression as effectively as psychological therapy. The review, conducted by researchers at the University of Lancashire, analyzed 73 randomized controlled trials involving nearly 5,000 adults diagnosed with depression. The studies compared exercise interventions with no treatment or control conditions, as well as with psychological therapies and antidepressant medications.
The findings show that exercise provides a moderate benefit in reducing depressive symptoms when compared to no treatment or control interventions. According to moderate-certainty evidence from ten trials, exercise was found to be comparable in effectiveness to psychological therapy. When measured against antidepressant medication, exercise also demonstrated a similar effect on depressive symptoms; however, this evidence is considered low certainty due to limitations in the data.
Professor Andrew Clegg, lead author of the review, stated: "Our findings suggest that exercise appears to be a safe and accessible option for helping to manage symptoms of depression. This suggests that exercise works well for some people, but not for everyone, and finding approaches that individuals are willing and able to maintain is important."
Side effects associated with exercise were rare and mostly involved occasional musculoskeletal injuries. In contrast, those taking antidepressants experienced typical medication-related side effects such as fatigue and gastrointestinal issues.
The review noted that light to moderate intensity exercise might offer more benefit than vigorous activity. Additionally, participants who completed between 13 and 36 sessions showed greater improvements in depressive symptoms. No single type of exercise stood out as most effective; however, mixed programs and resistance training appeared somewhat more beneficial than aerobic activities alone. Certain forms of movement like yoga, qigong, and stretching were not included in the analysis and remain areas for future research.
Long-term effects remain unclear since few studies followed participants after treatment ended. Most included trials were small—with fewer than 100 participants—making it difficult to draw definitive conclusions about which types of exercise are most effective or whether benefits persist over time.
"Although we've added more trials in this update, the findings are similar," Professor Clegg said. "Exercise can help people with depression, but if we want to find which types work best, for who and whether the benefits last over time, we still need larger, high-quality studies. One large, well-conducted trial is much better than numerous poor quality small trials with limited numbers of participants in each."
This latest update incorporates 35 new trials into earlier reviews published in 2008 and 2013 but does not significantly alter previous conclusions due to persistent limitations in study size and quality.
