Exercise to treat depression yields similar results to therapy

(Press-News.org) Exercise may reduce symptoms of depression to a similar extent as psychological therapy, according to an updated Cochrane review. When compared with antidepressant medication, exercise also showed a similar effect, but the evidence was of low certainty.  

Depression is a leading cause of ill health and disability, affecting over 280 million people worldwide. Exercise is low-cost, widely available, and comes with additional health benefits, making it an attractive option for patients and healthcare providers. 

The review, conducted by researchers from the University of Lancashire, examined 73 randomized controlled trials including nearly 5,000 adults with depression. The studies compared exercise with no treatment or control interventions, as well as with psychological therapies and antidepressant medications. 

The results show that exercising can have a moderate benefit on reducing depressive symptoms, compared with no treatment or a control intervention. When compared with psychological therapy, exercise had a similar effect on depressive symptoms, based on moderate-certainty evidence from ten trials. Comparisons with antidepressant medication also suggested a similar effect, but the evidence is limited and of low certainty. Long-term effects are unclear as few studies followed participants after treatment.  

Side effects were rare, including occasional musculoskeletal injuries for those exercising and typical medication-related effects for those taking antidepressants, such as fatigue and gastrointestinal problems.

“Our findings suggest that exercise appears to be a safe and accessible option for helping to 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 everyone, and finding approaches that individuals are willing and able to maintain is important.” 

The review found that light to moderate intensity exercise may be more beneficial than vigorous exercise, and that completing between 13 and 36 exercise sessions was associated with greater improvements in depressive symptoms.

No single type of exercise was clearly superior, although mixed exercise programmes and resistance training appeared more effective than aerobic exercise alone. Some forms of exercise, such as yoga, qigong and stretching, were not included in the analysis and represent areas for future research. Long-term effects are unclear as few studies followed participants after treatment.

This update adds 35 new trials to previous versions published in 2008 and 2013. Despite the additional evidence, the overall conclusions remain largely unchanged. This is because the majority of trials were small, with fewer than 100 participants, making it difficult to draw firm conclusions.

“Although we’ve added more trials in this update, the findings are similar,” said Professor Clegg. “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.”

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