Many previous studies have found exercise to be both preventative and a powerful treatment for existing depression. In one recent study, researchers found that one out of every two people who exercise will experience improvement—far better than the seven or more who require antidepressant drug treatment before a single person benefits. And another meta-analysis found that exercise, including walking and jogging, beat both cognitive behavioral therapy and antidepressants for treating even severe depression.
For this reason, researchers have written that exercise meets the criteria to be considered an “evidence-based treatment for depression.” Yet the psychiatric establishment continues to relegate exercise to an “add-on” for those who are already interested in it—instead clinging to the treatment paradigm that focuses on antidepressant drugs and therapy.
Now, a new Cochrane meta-analysis—reviewing the existing randomized, controlled studies on exercise for depression—has concluded that exercise is just as good as therapy or antidepressants at treating depression. Exercise beat placebo with a moderate-to-large effect size.
Cochrane is an international nonprofit whose systematic reviews are widely considered the gold standard for rigorous scientific research. The authors were based at the University of Lancashire, UK.
“Our findings suggest that exercise appears to be a safe and accessible option for helping to manage symptoms of depression,” lead author Andrew Clegg said in an accompanying statement.
The new study updates the 2008 and 2013 Cochrane publications on the subject, and the new evidence doesn’t change their earlier results: exercise looks good, holding its own compared with therapy and antidepressants.
However, the current version adds to the totality of evidence, with 35 new trials of exercise added to the Cochrane analysis. In total, the researchers included 73 trials of exercise for depression, totaling about 5,000 participants. Sixty-nine trials were able to be statistically analyzed.
The efficacy of exercise was calculated as standardized mean difference (SMD). The SMD for exercise over placebo was −0.67, which they class as a moderate-to-large effect.
The evidence that exercise is as good as therapy received a “moderate certainty” rating from the researchers, based on 10 trials that compared the two approaches. There was no difference between exercise and therapy outcomes, even at long-term follow-up.
The evidence that exercise is as good as antidepressants received a “low certainty” rating because it was based on fewer trials (five), only one of which included long-term outcomes. However, in those trials, there was no difference between exercise and antidepressant outcomes.
One of the main critiques of exercise is that people won’t do it—that taking drugs or even going to therapy is an easier sell than exercise. Yet this review found that exercise was just as acceptable as drugs or therapy, with about the same number of participants completing treatment in each group.
And exercise has much lower potential for harm—and many other benefits—compared with antidepressant drugs. (For instance, one recent study found that running was just as good as antidepressants, and that those who engaged in running ended up improving their physical health too—while those who took antidepressants had worsening physical health over time.)
“Exercise is low-cost, widely available, and comes with additional health benefits, making it an attractive option for patients and healthcare providers,” according to the accompanying statement.
The researchers found that light to moderate intensity exercise may have been slightly more beneficial than vigorous exercise. They also found that the “sweet spot” for number of exercise sessions appeared to be between 13 and 36.
In psychiatric science, one of the biggest issues is replication—can additional studies show that this positive effect is consistently true? In this case, the updated Cochrane review demonstrates that exercise’s efficacy for depression treatment is not a fluke. The additional trials since the last review serve to add consistent evidence showing the efficacy of exercise for depression.
Because participants know whether they engaged in exercise or not, they could not be blinded to outcomes. Thus, Cochrane’s editors instructed the authors to rate all the trials as having “high risk of bias” due to unblinding. But, the authors write, “in exercise trials, participants cannot be blinded to the treatment allocation.”
The limited number of trials comparing exercise to therapy and antidepressants, and the fact that these were small, short-term studies, are the biggest limitations to being able to implement these findings. Although we have consistent evidence that exercise is effective, and studies continue to find it to be at least as good as therapy and drugs for depression, there remain questions about long-term results and how trustworthy the findings are.
Because of this, Clegg calls for higher quality studies that can overcome these limitations.
“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,” Clegg said in the accompanying statement.
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Clegg, A. J., Hill, J. E., Mullin, D. S., Harris, C., Smith, C. J., Lightbody, C. E., . . . & Watkins, C. L. (2026). Exercise for depression. Cochrane Database of Systematic Reviews. Published 08 January 2026. https://doi.org/10.1002/14651858.CD004366.pub7 (Link)
I saw something just like this in NewScientist the other day, and I immediately called BS. In order for any of these studies to work, the researchers must find groups of depressive patients who, even if recruited from Asylum or Doctor’s office, have the motivation to exercise and participate in a study.
My instinct is that, especially following NewScientist’s proclamations of it being just as effective as anti-depressants, is that it’s all placebo at the end of the day, specifically targeting those who are most able to receive treatment. Where are the studies on exercise, anti-depressants, AND placebos?
I’d be excited if exercise worked on those with “treatment-resistant depression” or even those who report low energy or poor appetite. Also exercise is not controlled here well, will someone with a lone treadmill in their home, which they walk/jog on for the same duration as those who engaged in “gardening and brisk walking [presumably outside]” (see NewScientist) have the same result?
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But what is “treatment resistant depression?” All that means is that the psychiatric world is unable to help. It’s not the clients’ or “depression’s” fault if their methods are ineffective! I agree that the selection of the study and control groups is problematic, but that’s true in every study on “depression,” since there are no objective criteria to determine who qualifies for that “diagnosis,” nor is the assumption that ALL such people have the same problem in any way a valid one. Basically, studying DSM diagnoses is not ever going to be scientific until we have real study groups that are not so massively heterogeneous to study.
A better title might be: “Go for a walk. It just might help.”
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I absolutely do understand people feeling resistant to being told to ‘just go exercise, it will improve your emotional state etc, look at the studies that prove it!’ – on its face it definitely feels paternalistic/condescending and along the lines of ‘just think more positively!’ and other types of individualistic pull-yourself-up-by-your-bootstraps interventions.
This is, for me, why learning about it more from the learning about human evolution/anthropological human history perspective was more useful than from the ‘being prescribed exercise’ angle of it. When I took a college class learning about this, it was much more helpful for me to re-orient my perspective about ‘exercise making you feel better’ by learning about the environment our bodies and brains evolved in. As hunter gatherer nomads, which what humans were for 95% of our existence, and the environment our brains and bodies adapted to survive in, we were generally VERY physically active. there were rest periods sure, but as literal nomads we would be walking up and down harsh terrain all day, and as gatherers we were going all around pulling up roots and climbing trees for other sources of nutrition.. not to mention setting up camp, building fires, caring collectively for children and the infirm/elderly…hunting was less common but when it happened was absolutely a source of physical activity.
Anyway I learned that our brains EVOLVED to just take for granted/expect these high levels of physical activity and essentially to rely on the way exercise can do things like cleanse your brain of stress hormones and stimulate endorphins that calm you and make you feel happy. So modern sedentary humans are essentially trying to exist in a deficit of these moderating brain chemical influences from high physical activity, that all of our brains evolved to exist in.
But also while taking a nice little 20 minute walk may make you feel mildly better, when you’re profoundly depressed/anxious/etc it may feel not worth it, which is what I always felt until I took that class and had a better reason to believe I should invest in this idea. again, a nice little walk is barely scratching the surface of what our ancestors did. It wasn’t until I started swimming laps regularly , like 80 laps freestyle/crawl stroke a day, 4 days a week, that I began feeling a real difference.
I get why people don’t want to hear it, or that it sounds fake. I thought that too for a while. and just like any other type of drastic life change, especially when you’ve been struggling with severe depression or anxiety or anything else, it sounds impossible and unattainable when it’s tossed at you like some easy thing. I also agree that these types of studies are a little too specific about it and presented in a way that is not convincing. I think cross cultural research could be more helpful and to instead do studies involving looking across societies and people who live in walkable cities and are moving around a lot, or people who are already engaged in a high level of physical activities, or people in professions involving a lot of walking, to try to demonstrate the positive mental effects from physical activity.
As a final note, before I started swimming I was, for years, an absolute wreck mentally. In high school I was one of those white teenaged middle-class girls who was both anorexic and a ‘cutter’ and was scratching up my arms with safety pins and x-acto knives and kitchen knives- this landed me in outpatient mental health treatment where I was put in on tons of overzealous doses of antidepressants, mood stabilizers, and antipsychotics. The psychiatrist who was prescribing perhaps did not know that part of the reason my ‘affect seemed so flat’ at appointments was I was being dragged there by an emotionally abusive mother who at home would scream and swear and slam doors, or collapse into fits of crying. In college I had multiple mental breakdowns and panic attacks, semi-manic episodes, spoke and dressed like a crazy person and weirded out most people I interacted with, was bullied and ostracized, gained a lot of weight, got into multiple unsafe relationships with controlling and abusive men, dropped out of college twice, managed to not get pregnant or die in a car accident despite a habit of going 100 mph down the turnpike….before going off all my psych meds, re-enrolling in college, and taking that fateful class that led me to start swimming.
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Even a brief walk can loosen the mind’s grip on negative thoughts …and the body releases the tension it’s holding.
No studies are necessary. That’s the beauty of it—unless the preference for clutter outweighs the desire to feel better.
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Some degree of exercise is good for every body. Were we arranged differently and living closer to the Earth (and closer to home), daily chores might provide adequate exercise on a daily basis to keep healthy.
While the health benefits of exercise can’t be ignored, recent developments suggest that microdosing marijuana also offers benefits to those experiencing anxiety and depression.
https://l.smartnews.com/p-707fNDlT/xtJceB
https://recovered.org/marijuana/microdosing-thc
Others show it helps with Alzheimer’s as well:
https://pmc.ncbi.nlm.nih.gov/articles/PMC9277875/
Nature’s remedies have co-evolved with humanity for hundreds of thousands of years. Though regarded as “substances” to be avoided by the Big Pharma lobby (et al), it seems the relatively new pharma psych drugs are the ones to be avoided.
By the way, what research was conducted to illegalize and vilify marijuana use in the first place? Surely before incarcerating people, labeling them as addicts, or trashing their careers (and lives) for using marijuana, there MUST have been very compelling evidence.
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It strikes me as common sense that regular moderate exercise would help a person more than the psych neurotoxins, but sadly it’s not common sense for the psych workers. I know because my psychiatrist tried to get me to stop exercising. But there’s no money in telling a person to take a walk.
Wow, it’s been a headache trying to get a not hired by me, narcissist, criminal computer / phone / email hacking psychologist out of my phone, computer, and emails. I sure wish the psych workers would learn what ‘live and let live’ means. But then again, they certainly don’t understand what the word NO means either.
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As much as I love seeing alternatives to the drug-based approach, there is one caveat I want to add here based on my own lived experience. Hopefully this won’t come across as a re-enactment of the “bean soup” video, but I have a feeling I’m not the only one out there who feels this way, so I’m just gonna share my perspective.
As an eating disorder survivor, I cringe a bit every time I see a headline about exercise as a treatment for depression because of the things that I was told during my own struggle with these so-called mental “disorders.” When I would go in for my depression/anxiety checkups, my doctor or psychiatrist would often ask me if I was exercising, or encourage me to exercise. They didn’t consider the idea that exercise could be part of the problem in my case– and in the case of many eating disorder patients. I was already exercising 1-2 hours per day, nearly every day, on top of eating very little. This combination of undernutrition & overexertion was contributing to my mental distress, which they were busy trying to treat with drugs for a fictitious “chemical imbalance” I didn’t have. Yet I kept hearing “keep exercising” or “exercise more.” This was VERY HARMFUL!!! I don’t think I can emphasize enough how harmful it was.
So no, exercise is not “virtually risk-free” for everyone. I think it is very important to consider how much a person is ALREADY exercising, whether they are eating enough, and if they have a past or current eating disorder. This may sound like a very niche issue to some, but I think it’s important to discuss, because so many people with eating disorders end up with a dual-diagnosis of depression/anxiety, or vice versa. It’s not as rare as people think.
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I am also an eating disorder survivor, although I will say I am 38 and seem to be unique for this disorder in that I only struggled with the actual food restricting part of it when I was 15-16, although my whole life I’ve struggled with terrible body dysmorphia and compulsive jumping out of pictures, covering mirrors, hiding from my reflection, etc, crying for hours after seeing a picture of myself. My daughter is almost 4 and the amount of pictures of me with her are less than a dozen. But as a teenager I essentially stopped eating for about a year and at my lowest weighed 89 pounds (I’m 5’2′). I didn’t exercise as part of it but the restricting was very severe. I’m not really sure why I never ‘fit the profile’ of people/women who suffer from the disorder for much longer periods and more relapses. More on that in a second.
I eventually got a Master’s Degree in Psychology and it always felt to me like anorexia/bulimia (as well as cutting/self harm, which I also struggled with, that one continued well into adulthood) felt so left out/ out of place by the rest of the mental disorders. There was so much about it that it felt like the entire field of psychology and psychiatry were just scratching their heads and just kind of doing a cartoon ‘????’ in a speech bubble, then shunting these disorders to the side in the hopes that no one will call attention to the fact that they struggle to treat it, explain it, or understand it. The worse thing they would do it lump them in with borderline personality disorder, which is another dark spot in psychology that really threatens to collapse the whole house of cards.
The thing that anorexia, bulimia, self harm/cutting, and borderline personality disorder tend to have in common is that they are almost exclusively women’s disorders, they are VERY western disorders, they often skew very white/caucasian, and they are almost certainly ’caused’ by living in an oppressive patriarchy in a modern world where from a young age women are bombarded by onslaughts of sexist media about how society will judge your entire worth as a human being if you’re a woman based on how attractive or sexy you look . These disorders are HIGHLY culturally specific, and psychologists and the mental health treatment system don’t like to talk about or examine cultural influences. They don’t want to admit or talk about the fact that mental disorders like these that are essentially caused by and continue to ‘thrive’ in a culture, can be near-impossible to treat, because you can’t just take away someone’s culture or take them away from their culture.
I say all this because your comment raises a very good point that we should all be more willing to pause and really think about. Why aren’t we thinking about anorexia in this discussion of exercise unilaterally improving mental health? Anorexia is a disease of the patriarchy and of western society, media, of white western culture. Anorexia is a canary in the coal mine of a sick society. You CANNOT treat a culturally-created phenomenon on an individual level. People’s personalities are created by the cultures they grow up in and live in . If their particular form of mental distress was specifically ‘grown’ by their culture, it’s going to be much more difficult, next to impossible, to ‘treat’. Honestly, in a way drug addiction is a similar problem. I have worked with people struggling with heroin addiction, and one of the reasons we were unable to address in the mental health treatment system is once being a drug user is part of someone’s personality and identity, it’s not something they can just ‘overcome’. It’s who they are. If someone can connect to a peer support group like AA, one of the reasons that can be so successful is because they can retain their identity of a drug user or alcoholic, in the form of grieving the active status of that identity with others who are the same.
The book ‘ Crazy Like Us: The Globalization of the American Psyche’ by
by Ethan Watters was the biggest eye opener for me on this. The first chapter was about anorexia in China. There were a few isolated cases of young Chinese teenaged girls who stopped eating and one who died from complications related to undernutrition. The thing is none of these girls stopped eating because they felt they needed to be thinner. They were all experiencing this profound disgust around the physical sensation of having food in their stomachs, and feeling like even if they ate a tiny bit that their stomach felt so grossly full that they just didn’t want to eat. But when the one girl died from this, there was a media firestorm and all these public awareness campaigns all of a sudden, informed by western psychology, about anorexia and signs of it and famous women who have suffered from it etc. So after all those ‘awareness’ campaigns, there was a huge upsurge in young chinese women who started restricting their food intake specifically because they felt like they needed to be thinner. There was no evidence this was a problem, even an ‘untreated problem’ before these awareness campaigns. So, western psychology norms basically ‘created’ an epidemic of anorexia in China.
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Golly-gee, Peter Simons, thanks a bunch: Just when we thought we couldn’t possibly be any more depressed, you explain to us that it’s just because we are so damn lazy, in the first place?
Or maybe we are too depressed to figure out that, while it’s now many years since Bob Whitaker pointed out what a great marketing trick it was to come up with “antipsychotics” for “psychosis,” like antibiotics [and other antibacterials] for nasty bacterial infections, so, too, with those other nice “medicines” or wonder drugs – “antidepressants” for “depression” or, better still, for “clinical” (and even for “subclinical!!!!!!!”) “depression,” we still have not come to terms with the simple, obvious fact that, as surely as there can be almost any number of causes and if combinations of causes for folks to be depressed, the one certain fact of the matter is that “depression,” itself, either clinical or subclinical or manic or psychotic, cannot POSSIBLY be one!
Are we all still so depressed as to be too stupid to see that to suggest that “depression” is the reason for one’s feeling depressed is even stupider than explaining that the reason a person is jaundiced is “because they have jaundice?!”
You see, if one IS jaundiced, we can be pretty certain, at least, that there is some underlying disease/disorder condition/s, be it/they pre-, post- and/or intrahepatic going on.
If one is depressed, we can by no means be sure, until we verify the facts, that there is any actual, organic illness involved, at all.
One thing we can be certain of, however, is that no mood, thoughts, thought pattern/s or behavior/s are or can be a disease or disorder, that, as Thomas Szasz pointed out “is not what diseases ARE!”
If one is depressed because he/she is an overworked galley slave, rowing (or cooking) away all day/night, then one’s best antidepressant may be a lot less exercise.
If one spends all one’s leisure hours sitting around indoors, doom scrolling, then some exercise out in “Nature” and sunshine might be one’s best antidepressant.
And if one is seriously deficient in, say, Vitamin B 12, or iron…or companionship, or creative outlets, or sleep, or security, or hope, or solace, or sympathy, or consolation, or, or…then, guess what…
But, Peter, maybe Western Civilization’s best antidepressant may be to wake up the fact of the flake that Peter “the Rock” was (until he awakened) and why even he, after some ?3 long years with Jesus, no more got the Zen Jesus tried so hard to preach, to teach and to demonstrate than we do after some 2,000 more?
All my love and thanks, and more, Petr and MIA!
And now to grab me some exercise. And music.
Tom.
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