A new Cochrane Library review of dozens of trials confirms that regular exercise can alleviate depression symptoms as effectively as antidepressants or cognitive behavioral therapy. Even light activities like walking may provide significant benefits. Researchers analyzed nearly 5,000 adults with depression, finding moderate reductions in symptoms across various exercise types.
An updated review published by the Cochrane Library has strengthened evidence that exercise offers a viable treatment for depression. Building on a 2013 analysis, this latest examination nearly doubles the data, drawing from 69 randomized controlled trials involving almost 5,000 adults diagnosed with mild, moderate, or severe depression, or scoring high on symptom scales.
In 57 trials, participants assigned to regular exercise showed moderately reduced symptoms—such as persistent sadness or loss of interest—compared to those on waiting lists or without treatment. Exercises ranged from low-intensity gardening and brisk walking to vigorous sprinting or football, excluding yoga or stretching to isolate physical activity effects. Sessions typically occurred weekly for weeks to months.
The review also compared exercise directly to other therapies. Across 10 trials against cognitive behavioral therapy (CBT) and five against antidepressants alone, exercise performed equally well. "There wasn’t a difference between them," notes Emily Hird at University College London, who was not involved in the study.
Light and moderate exercises appeared more effective than intense ones, likely due to better adherence. "If you start going hard, then people drop out and stop exercising," explains Brendon Stubbs at King’s College London. Potential mechanisms include social benefits from group activities, boosted self-esteem, and muscle-released myokines that reduce inflammation and promote brain cell growth, especially in resistance training.
Guidelines from bodies like the UK’s National Institute for Health and Care Excellence already endorse aerobic exercise, such as 10 weeks of jogging. However, limitations persist: participants knew their group assignments, risking placebo effects, and many trials had small samples. Larger studies are needed to pinpoint optimal exercises for different depression severities. "The most important thing is empowering people to do something they enjoy," Stubbs adds.
