Growing Evidence Suggests Physical Activity May Alleviate Depression as Effectively as Therapy

There is increasing evidence that moving the body could relieve depression nearly as well as therapy, without the need for a prescription. A comprehensive review of studies suggests that exercise can alleviate depression with effectiveness comparable to psychological therapy. When compared to antidepressants, exercise showed similar benefits, though the evidence was less conclusive. Researchers found that light to moderate physical activity across multiple sessions was most effective, with few side effects. While not a cure-all, exercise can be a powerful and accessible tool for many people.

Exercise may reduce symptoms of depression as effectively as therapy, and possibly even antidepressants, according to a major review of clinical trials. An updated Cochrane review indicates that regular physical activity can alleviate symptoms of depression with effectiveness similar to psychological therapy. When comparing exercise to antidepressant medication, researchers observed similar benefits, though the certainty of this evidence was lower.

Depression remains a significant global health issue, affecting over 280 million people worldwide and contributing substantially to disability. Exercise stands out as a cost-effective and widely accessible option that also improves physical health, making it appealing to both patients and healthcare professionals.

Inside the Cochrane Review

The analysis was led by researchers at the University of Lancashire and drew on data from 73 randomized controlled trials involving nearly 5,000 adults diagnosed with depression. These studies examined comparisons of exercise to no treatment or control conditions, as well as to psychological therapies and antidepressants.

Overall, the findings showed that exercise produced moderate reductions in depressive symptoms compared to no treatment. When compared to psychological therapy, exercise yielded similar improvements, according to moderate-certainty evidence from ten trials. Comparisons with antidepressants also suggested comparable effects, but the supporting evidence was limited and considered low-certainty. Few studies followed participants after treatment ended, leaving the long-term impact uncertain.

Safety and Side Effects

Reported side effects were infrequent. People participating in exercise programs occasionally experienced muscle or joint injuries, while those taking antidepressants reported typical medication-related issues such as fatigue and gastrointestinal problems.

"Our findings suggest that exercise appears to be a safe and accessible option to help manage symptoms of depression," said Professor Andrew Clegg, lead author of the review. "This suggests that exercise works well for some people, but not for all, and it is important to find approaches that people are willing and able to maintain."

What Type of Exercise Works Best?

The review revealed that light to moderate-intensity physical activity may be more beneficial than intense workouts. Greater improvement in depressive symptoms was observed when completing between 13 and 36 exercise sessions. No single form of exercise clearly outperformed others. However, programs combining different types of activity and resistance training proved more effective than aerobic exercise alone. Some activities, such as yoga, qigong, and stretching, were not assessed in this analysis, leaving areas for future study. As with other findings, long-term benefits remain uncertain due to limited follow-up.

Why Conclusions Remain Cautious

This update added 35 new trials to previous versions of the review published in 2008 and 2013. Even with the expanded evidence base, the main conclusions barely changed. Many of the included studies were small, often with fewer than 100 participants, making it difficult to draw definitive conclusions.

"Although we have added more trials in this update, the findings are similar," said Professor Clegg. "Exercise can help people with depression, but if we want to determine which types work best, for whom, and whether the benefits last over time, we still need larger, high-quality studies. One large, well-conducted trial is much better than numerous small, low-quality trials with a limited number of participants each."

Source: Andrew J Clegg, James E Hill, Donncha S Mullin, Catherine Harris, Chris J Smith, C Elizabeth Lightbody, Kerry Dwan, Gary M Cooney, Gillian E Mead, Caroline L Watkins. Exercise for depression. Cochrane Database of Systematic Reviews, 2026; 2026 (1) DOI: 10.1002/14651858.CD004366.pub7