Depression and anxiety affect millions of people around the world.
While treatments such as medicine and psychotherapy (sometimes called talking therapy) can be very effective, it is it’s not always an option. Obstacles include cost, stigma, long waiting lists for appointments, and potential drug side effects.
So what about exercise? Our new research, is published todayconfirms that physical activity can be as effective for some people as therapy or medication. This is especially true when it is social and led by a professional, such as a fitness class or running club.
Let’s take a look at the details.
What we already knew
Physical activity has long been promoted as a treatment option for anxiety and depression, mainly because it helps release “Feel good” chemicals in the brain that help boost mood and reduce stress.
But the evidence can be confusing. Hundreds of studies with varying results make it unclear how much exercise is beneficial, what kind, and that helps most.
Over the past two decades, researchers have carried out dozens of separate meta-analyses (studies that combine results from multiple trials) examination of the exercise for depression and anxiety. But these still leave gaps in our understanding of how effective exercise is for different age groups and whether the type of exercise matters.
Many studies they have also included participants with confounding factors (influences that can distort research findings), such as other chronic diseases, for example, diabetes or arthritis. This means that it may be difficult to apply the findings more widely.
What we did
Our research aimed to resolve this confound by conducting a ‘meta-meta-analysis’. This means we systematically looked at the results of all existing meta-analyses – there were 81 – to determine what the evidence actually shows.
Together, this meant data from nearly 80,000 participants in more than 1,000 original trials.
We considered several factors that could explain why their results differed. These included differences in:
who they studied (for example, people with diagnosed depression or anxiety versus those who are just showing symptoms, different age groups and women during pregnancy and after birth)
what the exercise involved (for example, comparing aerobic fitness with resistance training and mind-body exercises such as yoga, whether it was professionally supervised, intensity and duration)
whether the exercise was individual or group.
We also used advanced statistical techniques to precisely isolate and estimate the precise impact of exercise, separate from confounding factors (including other chronic diseases).
Our data examined the impact of exercise only on depression and anxiety. But sometimes people also use antidepressants and/or therapy – so further research will be needed to investigate the effect of these when combined.
What did the study find?
Exercise is effective in reducing both depression and anxiety. But there is a nuance.
We found that exercise had a high impact on depressive symptoms and a moderate impact on anxiety, compared to being inactive.
Benefits were comparable to, and in some cases better than, more widely prescribed mental health treatments, such as therapy and antidepressants.
Importantly, we found out who was most helped by exercise. Two groups showed the greatest improvement: adults aged 18 to 30 and women who had recently given birth.
Many women experience obstacles in postpartum exercise, including lack of time, confidence or access to appropriate and affordable activities.
Our findings suggest that becoming more accessible could be an important strategy to address the mental health of new mothers during this vulnerable period.
How you exercise matters
We also found aerobic activities – such as walking, running, cycling or swimming – were best at reducing both depression and anxiety symptoms.
However, all forms of exercise reduced symptoms, including resistance training (such as weight lifting) and mind-body practices (such as yoga).
For depression, there were greater improvements when people exercised with others and were guided by a professional, such as a group fitness class.
Unfortunately, no data were available on group or supervised exercise for anxiety, so we would need more research to know if the impact is similar.
Exercising once or twice a week had a similar effect on depression as more frequent exercise. And there didn’t seem to be a significant difference between vigorous or low intensity exercise – all were beneficial.
But for anxiety, the best improvements in anxiety symptoms were when exercise was done:
consistently, for up to eight weeks, and
at a lower intensity, such as walking or swimming laps at a gentle pace.
So what does all this mean?
Our research shows that exercise is a legitimate and evidence-based treatment option for depression and anxiety, particularly for people with diagnosed conditions.
However, simply telling patients to “exercise more” is unlikely to be effective.
The evidence points to structured, supervised exercise with a social component it is best for improving depression and anxiety. The social aspect and accountability can help keep people motivated.
Clinicians should keep this in mind, offering referrals to specific programs – such as aerobic fitness classes or supervised walking and running programs – rather than general advice.
The findings also suggest that this type of exercise may be particularly effective when targeting depression in younger adults and women who have recently given birth.
The takeaway
For people hesitant about medication or facing long waits for treatment, supervised group exercise can be an effective alternative. It’s evidence-based and you can start at any time.
But it’s even better to get advice from a professional. If you have worry or depression symptoms, you should talk to your doctor or psychologist. They can advise you where exercise fits into your treatment plan, possibly alongside therapy and/or medication.
