Which forms of exercise are most effective at treating depression?

Doctors who extol the virtues of exercise might consider prescribing it as an effective complement or alternative to the core treatments for depression – psychotherapy and antidepressants.

Access to treatment for many people with depression is limited. Treatment coverage for major depressive disorder ranges from 51% in high income countries to as little as 20% for low and lower-middle income countries.

But new Australian research has found exercise results in moderate reductions in depression compared with controls. The research was drawn from a systematic review and network meta-analysis of 218 studies involving 14,170 participants with major depressive disorders.

“As well as improving our physical and cognitive health, exercise is one of the best things we can do for our mental health,” says Michael Noetel, a psychologist from the University of Queensland and first author of the study published in The BMJ.

The research found that walking or jogging, yoga, and strength training were even more effective at treating depression than other exercises, with the greater the intensity of the exercise the greater its effect.

“Strength training was found to be an especially effective exercise for younger women, whereas older men received the most benefit from yoga,” says

“We know people often respond well to medication and psychotherapy for depression, but many are resistant to treatment. We found exercise should be considered alongside traditional interventions as a core treatment for depression.

“Of course, anyone getting treatment for depression should talk to their doctor before changing what they are doing, but most people can start walking without many barriers.”

Compared with active controls (usual care and placebo tablet) the study found walking or jogging, yoga, strength training, mixed aerobic exercises, and tai chi or qigong resulted in moderate reductions in depression – either alone or in combination with other established treatments such as cognitive behaviour therapy.

The researchers write that “guidelines for depression ought to include prescriptions for exercise and consider adapting the modality to participants’ characteristics and recommending more vigorous intensity exercises.”

While this study could not identify the causative mechanisms behind the trends, the researchers suggest the effect of exercise on depression is likely due to a combination of many factors.

“Different types of exercise work in different ways – some are social and get us outside while others help us become more confident or get more space from our thoughts,” says Noetel.

“But all exercise releases neurotransmitters that can change the way we are feeling.”

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