A new study, published in the British Journal of Sports Medicine, found that exercise was just as good at treating depression as antidepressant drugs, at least for those with mild or moderate symptoms. Adding antidepressant drugs to exercise did not increase effectiveness—exercise alone was just as good.
The researchers write, “Exercise alleviates symptoms of depression to a similar extent as antidepressant treatments alone or in combination with exercise.”
They add, “These results suggest that exercise may be used as an alternative treatment approach for the management of non-severe depression in adults.”
They note that guidelines in Europe, Canada, the UK, and Australia already list exercise as a potential initial treatment for depression. However, the US guidelines have lagged behind, featuring only antidepressant drugs and psychotherapy as initial treatments.
The study was a network meta-analysis of 21 randomized, controlled trials, including 2551 total participants. The researchers looked at the trials of exercise, antidepressants, and their combination as compared to each other or to a placebo/control group.
Since the majority of people prescribed antidepressants have mild-to-moderate symptoms, and antidepressants have significant adverse effects, the researchers suggest that patients should be informed that exercise is a legitimate alternative that could provide just as much relief, with far fewer harmful effects.
The problem, they suggest, is that exercise requires more effort.
“Exercise is physically demanding and harder to implement in comparison to standard pharmacological treatments. On the other hand, antidepressant treatments are associated with greater adverse effects, higher costs and social stigma,” they write.
Perhaps for this reason, people were more likely to drop out of the exercise group than the antidepressant group before the end of the study, which the researchers took to indicate that exercise was less acceptable as an intervention.
However, adverse effects were reported by 22% taking antidepressants, compared to only 9% doing exercise.
The findings were robust, with the conclusion remaining consistent after the researchers controlled for study quality and other factors.
“Results were corroborated through stringent sensitivity analyses that accounted for the quality of studies as well as types of participants and interventions,” they write.
The finding is consistent with a study from earlier this year in which exercise was associated with a 25% lower risk of depression. In another study, those who exercised had significantly lower relapse rates after 10 months than those taking antidepressant drugs.
One major limitation of this study is that it focused only on mild-to-moderate depression—so we still don’t know if exercise would be as good as antidepressants for those with severe symptoms. However, a 2016 study found that exercise had a large effect on improving even severe depression.
The researchers also didn’t include any studies on yoga, tai chi, or other interventions that might have psychological aspects beyond simple exercise—so these could turn out to be even more effective.
Recchia, F., Leung, C. K., Chin, E. C., Fong, D. Y., Montero, D., Cheng, C. P., . . . & Siu, P. M. (2022). Comparative effectiveness of exercise, antidepressants and their combination in treating non-severe depression: A systematic review and network meta-analysis of randomised controlled trials. Br J Sports Med. Published online on September 16, 2022. doi:10.1136/bjsports-2022-105964 (Full text)
I’m sure the same can be said about diet, sleep and meditation just to name a few.
Depression is a disease of the immune system, your body responding to a threat, and prescribing antidepressants is like endlessly treating a fever without looking for a cause.
Any drug (NSAIDS, steriods, SSRI’S) or activity (runners high, yoga, meditation) that reduces inflammation will have the side effect of reducing depression and even triggering something similar to mania.
And those of us who chose to exercise our frustrations away – whose general happiness was misdiagnosed as “mania” – since the “mental health” workers find it unprofitable to garner insight into the reality that some people are just happy.
What does one say? Except, thank you Peter, for continuing to point out common sense to the seemingly dumber than dirt “mental health professionals.”
Let’s hope and pray the mainstream “mental health professionals” will stop advising their clients to stop exercising, some day soon. And start, instead, speaking and recommending truth, and what’s actually in their clients’ best interest, to them.
Oh! … but there’s no profit in the truth … for the scientific fraud based, drug forcing “mental health” workers.
There are “mental health workers” that advise against exercise?? Yikes, never met one but I’m sure they exist. Exercise is definitely not any kind of criteria for mania either so that’s even more frightening.
I actually think a lot of people are recommended to exercise but many people, thanks to capitalism, don’t have the time or energy to invest in exercise. Our society is not set up in a way that makes exercise easy for a lot of people. When you’re working long hours or multiple jobs, having time to actually do self-care like exercise can be hard and many times people can’t cut their hours or else that means not eating or having a place to live.
I think the biggest problem with mental health workers is that for a long time, they have placed pathology on the person with the symptoms instead of the culture that they live in. How could people not be depressed when they work 60 hours a week and still struggle to eat while and have a safe place to live? That has nothing to do with them but the world in which they live. It’s just a lot harder to treat that than it is to treat a single person’s symptoms. We need more mental health workers to be focused on action on a systemic basis because without that, there’s no hope for resolving the majority of mental health issues.
There is one guaranteed way for doctors to make Medicaid patients profitable. Improve the patients health and get them onto private insurance that pays a profitable rate.
there is no such thing as an ‘antidepressant’ and the research seems to be bunk, where does that leave us with any comparisons. People suffer because of what happens to us depression is a process of being de-pressed – pushed down, crushed and hurt. How about we deal with the cultural disorders causing so much distress and stop making it an individual issues.
How about we start changing the stupid things in society that cause depression?
Switching to standard time all year should be a no brainer when it comes to improving mental health as a society.
Another wonderful article, Peter.
I agree that excercise does improve low spirits, however, I think excercise hides a yearning for “PLAY”. All creatures play within their environments. When their bodies are shuffled around parking lots or sidewalks this is not play. Parcour was all the rage a while back and although my catasrophic thinking made me nervous of other people jumping off tall buildings I did see the joy in their balletically engaging with street furniture. It seems a taboo, being an adult who would walk on walls and spin around and around street signs. Conformity can straight jacket the body. Bodies are meant to “move” and feel moved to tears and laughter by props in the local environment. We are apes. Conformity makes invisible barbed wire that bids us only walk in straight lines. We are stared at if we wander, whether on the page or in the pedestrian walkway.
We are allowed to PLAY only if we dont call it that but instead say we are doing mechanistic sport. Sport is the grown up word for play. Sport is allowed because it has fussy little regulations to keep the straight jacket tight and snug.
Play is often amorphous in the way it evolves more and more spontaneous chapters.
I do think excercise on its own may not help severe depression. A person who has just lost the love of their life might not be impressed if told to go buy a pair of running shoes. But play often involves other people, and this other people factor can be healing for the lonesome ape within all of us.