Exercise Found To Be As Effective As Medication And Therapy For Depression: Study

Depression is a common mental disorder that affects nearly 5.7 per cent of adults globally, according to the World Health Organization (WHO). A recent review of evidence by the Cochrane collaboration - an independent network of researchers - found that exercise can provide similar results as that of psychological therapy. For the study, the researchers analysed 73 randomised controlled trials that included about 5,000 people with depression, many of whom also tried antidepressant medication.

Andrew Clegg, a professor at the University of Lancashire in the U.K. said, "We found that exercise was as effective as pharmacological treatments or psychological therapies as well. Our findings suggest that exercise appears to be a safe and accessible option for helping to manage symptoms of depression."

He further said, "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."

Dr Stephen Mateka, medical director of psychiatry at Inspira Health said, "This new Cochrane review reinforces the evidence that exercise is one of the most evidence-based tools for improving mood." He also shared how exercise reflects some of the effects of medication. He adds, "Exercise can help improve neurotransmitter function, like serotonin as well as dopamine and endorphins. So there is certainly overlap between exercise and how antidepressants offer relief."

This explains that exercise helps to release chemicals in the body that are known to improve mood. Dr Nicholas Fabiano of the University of Ottawa says that there's another powerful effect too, exercise can trigger the release of brain growth factors. He says depression can decrease neuroplasticity, making it harder for the brain to adapt and change.

Fabiano explains, "The brain in depression is thought to be less plastic. So there's less what we call neurotrophic factors, or BDNF." He calls it the Miracle-Gro for the brain. He adds, "And we know that exercise can also boost it. So I think exercise is a fundamental pillar we really need to counsel patients on." Fabiano adds that medications and therapy are important tools but exercise is recognised as a preferred treatment for depression. "Exercise has been adopted as a first-line treatment in guidelines for depression globally with good acceptability and safety." However, exercise remains underappreciated and underutilised, he says.

Fabiano says, "It's much easier for a primary care physician to prescribe medication to a patient. You just write it on a pad." It's harder to prescribe exercise, which takes time and effort and can be difficult to start for people who are depressed.

Fabiano further said that exercise can work best as part of a combination of treatments. He adds, "We can start someone on an antidepressant - maybe that improves their mood, and they're able to engage in therapy. And from there, maybe now they're more interested in starting some of these lifestyle habits like exercise."

The study highlights that light to moderate exercise can be as beneficial as vigorous or intense exercise, at least early on. He says, "Ultimately you want to work your way up. But going from completely sedentary to even just going for a walk every day, that's where you start seeing those exponential gains."

A combination of aerobic exercise and resistance training appears to be more effective than aerobic alone, the study found. The meta-analysis also found that between 13 and 36 workouts led to improvements in depressive symptoms, though long-term follow-up was rare.

Mateka says, "When it comes to exercise, it's about just finding the exercise that works for you, such as something like yoga or tai chi versus something like walking and jogging." You should pick something that you enjoy or go back to or a sport you liked as a child.

"Exercise is something that is extremely low cost. It's very accessible. It has very minimal side effects. And it has the opportunity to impact you positively, mentally, emotionally, socially and physically," Mateka says.

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