Exercise may reduce depression symptoms as effectively as therapy.

• Previous studies also show that certain lifestyle changes, such as being physically active, may help treat depression. 
• A new study reports that getting enough exercise may help reduce depression symptoms as effectively as psychological therapy.
• The study suggests this could be an alternative for people with depression who do not respond to medication or therapy.

According to the World Health Organization (WHO), an estimated 332 million people globally live with depression. 

While there are a number of treatments available for depression — including psychotherapy and medications — not all treatments work for every person. Previous research shows that at least 30% of people with depression are treatment-resistant.

Previous studies also show that certain lifestyle changes, including getting enough sleep, eating a healthy diet, staying connected, practicing mindfulness, and being physically active may also help treat depression. 

Now, a new study recently published in the journal Cochrane Database of Systematic Reviews has found that getting enough exercise may help reduce depression symptoms as effectively as psychological therapy. 

For this study, researchers analyzed data from 73 previously-conducted randomized controlled trials, encompassing about 5,000 adults with depression. 

Andrew Clegg, PhD, professor of health services research at the University of Lancashire in the U.K., and lead author of this study, said he and his team decided to examine how exercise may help treat depression because the Cochrane review, which was first published in 2008 and last updated in 2013, was out of date as new studies had been published subsequently. 

“It’s important to ensure that the evidence that underpins guidance provided by policy bodies (and) health professionals, and that is used by patients to make decisions about their care, is up to date,” Clegg told GMHCN. “As such, we undertook the update of the review and identified an additional 35 randomized controlled studies.”

At the study’s conclusion, scientists found that exercising can have a moderate benefit on reducing depression symptoms when compared to no treatment or control intervention. And exercise’s effect on depression symptoms was very similar to that of psychological therapy.

“This means that people have a range of treatment options to consider with their health professionals’ guidance, as patient choice is important,” Clegg said. 

Additionally, researchers discovered that light to moderate intensity exercise seemed to be more beneficial in treating depression symptoms than vigorous exercise. They also found that a mixed exercise program and resistance training were more effective than just aerobic exercise by itself. 

“Exercise provides an option for people experiencing depressive symptoms, along with pharmacological and psychological treatments,” he added. “(People) should be able to choose the appropriate option that suits them. If they decide to use exercise, they should choose the type they will enjoy.”

GMHCN spoke with Raphael Wald, PsyD, neuropsychologist with Marcus Neuroscience Institute, part of Baptist Health South Florida, who commented that these findings further solidify what we have known for many years — exercise is an effective treatment for depression.

“Many people with depression have symptoms that do not respond to medication or therapy,” Wald continued. “We have to continue to find alternative treatments for this reason. This is especially true given that depression can present differently from one person to the next.”

GMHCN also spoke with Karmel Choi, PhD, Mass General Brigham clinical psychologist in the Center for Precision Psychiatry at Massachusetts General Hospital, and assistant professor at Harvard Medical School, who agreed this research provides further support for exercise as a tool for alleviating depression. 

“Some patients may shy away from standard treatments like pills or therapy due to perceived side effects or stigma,” Choi explained. 

When asked what he would like to see as next steps for this research, Wald said he would like to see researchers continue to isolate the effects of different forms of exercise on depression is important. 

“For example, if we discover that CrossFit is more effective than other exercise regimens, it would help us create protocols to include for people with depression,” he added. 

Choi commented she would also like to see more studies comparing these active treatments head-to-head as this evidence is promising but still relatively limited, based on a handful of studies with low-to-moderate certainty.

“We also know that once depression develops, it is hard to treat and currently less than 50% respond to initial treatment,” Choi continued. “How do we increase the success of our treatments across the board? And importantly, can we also prevent depression before it happens? We and others have shown that physical activity could be a powerful way to reduce the onset of depression in the first place.”

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