Depression and Exercise

Introduction

When you have depression, exercise can often be the last thing you want to do. But when you find the right type of exercise for you and make it a habit, it can make a substantial difference. Exercise has emerged as a powerful tool to aid in managing depressive symptoms, offering both physical and mental benefits.

In this article, I will explore the science of Depression, the types of exercise and their benefits, and the evidence supporting exercise as an effective intervention for depression.

Depression

We all experience low mood from time to time, it’s a normal part of life. However, Clinical Depression goes beyond the realm of occasional low mood. Clinical Depression can leave people feeling empty, hopeless, and with a lack of interest for most, if not all activities they used to enjoy. (DSM-5 Criteria for Major Depressive Disorder, n.d.)

The World Health Organisation states that depression is common, and a leading cause of disability worldwide, and with the ever-changing world, depression is only getting worse (World Health Organisation, 2023). In 2023, the NHS spent £217.5 million on medication to treat depression and anxiety with more than 1 in 7 UK adults reporting their mental health to be either currently bad or the worst it has ever been (Mental Health Statistics 2024, Forth).

It is often said that depression is caused by chemical imbalances in the brain, and although this can be true, it is a lot more complex. Rather, depression can be caused by stressful life events, genetic vulnerability, and faulty mood regulation by the brain. Although chemicals are involved in this process, it’s not a simple matter. There are millions of chemical reactions that are involved in your mood and perceptions. With this level of complexity, we can see how two people both experiencing depression can respond to different treatment options completely differently (Harvard Health, 2022).

What exercise?

The NHS advocates that any type of exercise is useful providing it suits you and you do enough of it. This is because exercise should be something that you enjoy, so that you are motivated to do it regularly. But what is “enough” exercise? The NHS advises that adults should be doing approximately 150 minutes (2.5 hours) of moderate-intensity exercise weekly. However, when you’re starting out, any exercise is better than none – even a short walk in fresh air can help to clear your mind and allow you to relax (NHS Inform, 2023).
Starting to exercise can seem daunting at first. It’s okay to build up your confidence by exercising alone or at home. Some great exercises to begin with include walking, swimming, yoga, Pilates, cycling and Thai-chi. All of these can be done without a gym-membership or going to any classes. There are plenty of YouTube videos with great yoga, Pilates and Thai-chi routines.

If you’re a little more confident and want to try something new, weight training, climbing, and taking running/cycling/swimming to a competitive level. Furthermore, if you’re a member of a gym, investing in a personal trainer to take your training to the next level, or even training to compete in powerlifting could be a great way to bring more excitement to exercising (NHS Inform, 2023).

Evidence

Several research studies and systematic reviews provide substantial evidence supporting the effectiveness of exercises in reducing depressive symptoms. One meta-analysis indicates that physical exercise is an effective treatment for unipolar depression, and that exercise compares favourably to no intervention. Additionally, this study found that exercise is comparable to psychotherapy and antidepressants for depression. Therefore, this meta-analysis recommends exercise to be a viable adjunct and augmentation to antidepressants, alongside a useful alternative to established treatments when on a waiting list (Kvam et al., 2016).

Another network meta-analysis and systematic review of 218 unique studies seek to identify the optimal dose and modality of exercise to treat major depressive disorder compared with psychotherapy, antidepressants, and control conditions. This analysis revealed exercise to be an effective treatment for depression, with walking, jogging, yoga, and strength training to be more effective than other modalities of exercise, particularly when intense. Furthermore, exercise appeared to be equally effective for those with comorbidities and those with different baseline levels of depression. As such, these forms of exercises could be considered alongside psychotherapy and antidepressants as main treatments for depression (Noetel et al., 2024).

These findings have been supported across all age groups. Several studies have focused primarily on the effect of exercise on depression for children and adolescents, with a meta-analysis of 35 randomised controlled trials finding exercise to significantly improve depression symptoms in children and adolescents. They also found that aerobic exercise had the most significant effect. Specifically, a 12-week, 3 times a week 40–50-minute exercise intervention was found to be more effective in younger children and adolescents (Li et al., 2023). Research has also shown aerobic exercise can significantly improve the mood of elderly patients with depression (Jiang & Jiang, 2023).

Conclusion

In conclusion, a wealth of scientific evidence demonstrates that exercise can be an effective treatment for depressive symptoms regardless of the modality of exercise chosen. The main notion of this article is that any exercise can be beneficial for reducing depressive symptoms as long as you do enough of it, and you enjoy it. Whether used alone or alongside therapy or medication, exercise can be a powerful tool to improve your mental health.

Written by Erica, St Albans practitioner

Depression and Exercise

Introduction

Depression

What exercise?

Evidence

Conclusion

References

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