This week Mad in America explores three studies related to exercise as a treatment for mental health problems. The first finds that exercise reduces symptoms of depression, the second associates exercise with improved mood and decreased distress for people in inpatient psychiatric settings, and the third links exercise to improved quality of life for people with mental health issues.
Exercise Reduces Symptoms of Depression
A new article published in Complementary Therapies in Medicine finds that aerobic exercise, resistance training, dietary interventions, and mind-body therapies are effective in reducing symptoms of depression. The current work, led by Xandra Gonzalez-Garcia from the University of the Balearic Islands in Spain, reports that the greatest benefits came from supervised moderate-intensity aerobics and resistance training. While this research mainly evaluated lifestyle interventions alongside other mainstream psychiatric treatments (such as drugs and therapy), there is also evidence that exercise alone reduced symptoms of depression.
The goal of this study was to investigate the current evidence of lifestyle interventions for the treatment of depression. To achieve this aim, the authors analyzed systematic reviews and meta-analyses of randomized controlled trials related to lifestyle interventions for the treatment of depressive symptoms. To be included in the current review, studies had to compare an adult population (18 years old or older) with a diagnosis of depression or depressive symptoms receiving a lifestyle intervention to a control group that did not receive the lifestyle intervention. Studies that included populations with other conditions that may affect the results, such as cancer, pregnancy or psychotic disorders, were excluded. In total, the authors examined 46 systematic reviews from around the world.
For people with a depressive disorder diagnosis, aerobics resulted in a moderate to large reduction of depression symptoms (standardized mean difference of -0.31 to -1.04) across all age groups. Resistance training also showed similar results with moderate to large reductions of depressive symptoms. Resistance training was especially effective for older adults. The best results for exercise based interventions were observed in programs that lasted for eight or more weeks and included between 390 to 1000 minutes of professionally supervised, moderate intensity exercise in a group setting. For participants with depressive symptoms but no diagnosis, resistance training showed the most promise in reducing symptoms. This was especially true for participants with more severe symptoms.
Mind-body therapies, such as yoga and tai chi, also showed moderate to large reductions of depression symptoms (SMD -0.45 to -1.21) for people with a depressive disorder diagnosis. While yoga was largely beneficial across all age groups, tai chi was particularly beneficial for older adults. These interventions were most effective in their dynamic movement forms compared to static meditative practices. These practices also showed moderate to large symptom reduction in participants with depressive symptoms but no diagnosis, particularly in older adults and perimenopausal/postmenopausal women.
Only two included studies evaluated dietary interventions. They both found low to moderate improvement of depression symptoms in people with a depression disorder diagnosis following a whole-food-based diet.
While most of the included studies examined lifestyle interventions as a secondary treatment alongside drugs and therapy, some looked at exercise as a standalone treatment, most typically in populations with less severe symptoms. In these studies, exercise showed similar results to drugs and therapy.
Included studies examined various forms of lifestyle interventions. The differences between studies complicated comparisons of different lifestyle interventions. This review did not include sources published outside academic journals. This means some relevant studies may have been excluded. The authors also restricted the current work to studies that examined depressive symptoms as a primary outcome. Including studies that investigated depressive symptoms as a secondary outcome may have lead to more robust data.
Exercise Linked to Improved Mood and Lower Distress in Inpatient Psychiatric Settings
A new study published in Advanced Exercise and Health Science finds that exercise reduced distress and improved the mood of people in an inpatient psychiatric setting. The current work, led by Rhiannon Dowla from the University of Sydney in Australia, also reports that participants rated exercise as highly beneficial to mental health, physical health, and overall recovery.
The goal of this research was to examine the effect of exercise on distress, arousal, and mood of people in an inpatient psychiatric setting. The authors examined data from people participating in an exercise program once or twice per week in one intensive care unit, four high dependency units, five acute units, and two rehabilitation units located in metropolitan Sydney, Australia. Participants were excluded from this program and the current study if they had a contraindication for exercise, such as severe infection or heart failure, or if they were presented a significant risk of aggressive behavior in groups settings.
In total, the authors used data from 139 participants admitted both voluntarily and involuntarily with many different psychiatric diagnoses, including schizophrenia, personality disorders, bipolar disorder, depression, and drug-induced psychosis. They collected data on participant demographics, mood, distress, arousal, and opinions of the exercise program.
A single exercise session improved scores on the Feelings Scale from an average of 1.5 to 2.6. This indicates a significant improvement of mood. There was a similar improvement observed on reported stress levels, with a single exercise session lowering scores on the Subjective Units of Distress scale from 3.4 to 2.3. This again indicates a significant reduction of distress. Exercise did not sow significant improvement in terms of arousal.
Sixty participants completed a questionnaire asking about their opinions of the exercise program. Participants generally thought exercise was highly beneficial in terms of mental health, physical health, and overall recovery. Eighty percent reported reduced boredom. Participants also reported reduced stress (71.1%), anxiety (66.6%), and anger (53.3%), and improved mood (61.7%).
As this study used a retrospective design, the authors were not able to collect additional data that may have been pertinent, such as medication dosage, duration of admission, and duration of the exercise sessions and program. The authors compared arousal, distress, and mood of participants before and after exercise sessions. The lack of a control group limits the validity of this research. Most participants presented with psychosis of some type, limiting generalizability to other populations. The small sample size and focus on inpatient units in metropolitan Sydney, Australia further limits generalizability.
Exercise Linked to Improved Quality of Life in People with Mental Health and Substance Use Issues
A new study published in the Community Mental Health Journal finds that an exercise program led by an Accredited Exercise Physiologist (AEP) was linked to improved quality of life in people with mental health and substance abuse issues. This research, led by Jane Kugelman from the University of Brisbane in Australia, reports that this enhancement in quality of life was mainly linked to improved mental health and coping skills.
The goal of the current work was to report on statistics around an exercise program for people with mental health and substance use issues, examine how this program affected quality of life, and investigate how attendance and participant characteristics affected quality of life trajectories.
The exercise program was developed over 10 years by a peer support worker and delivered by the Queensland Police Citizen’s Youth Welfare Association. The authors evaluated this program over a three year period (2020 to 2023). Anyone 18 years old or older that was receiving support for mental health or substance use issues was eligible to participate, with the exception of people that could not be medically cleared for exercise and those with an eating disorder that may be made worse by the program. Participants were referred from general practice, private clinics and the Mental Health, Alcohol, and Other Drugs service in Cairnes & Hinterland Hospital and Health Service in Queensland, Australia.
The program consisted of up to four private sessions with an AEP followed by group sessions. Group sessions had up to 10 participants and were two hours long, with one hour of exercise and one hour of health literacy. Many different types of exercise were included in the program and individual preferences and needs were considered in setting up exercise routines for each participants. Routines varied in intensity and duration, ranging between 10 to 40 minutes. Throughout the program, participants provided data on quality of life, social support, sense of belonging, physical activity, height, and weight. In total, 295 people participated in this exercise program.
This program was linked to an overall improvement of quality of life in participants of 5.8% per year of participation. This was driven mainly by improvements to mental health (7.5% per year) and coping (7.3% per year). The authors report that the upward trend in participants’ quality of life was significant despite a wide range of variance in outcomes. The authors further note that the wide range of outcomes is likely due at least in part to broad inclusion criteria and a diverse sample.
This exercise program was linked most strongly to improved quality of life in participants that scored higher in the baseline measures of social support and sense of belonging. Being female, having more than one mental health diagnosis, and a non-psychotic diagnosis were associated with more modest quality of life improvements.
There was no control group, meaning this data cannot definitively say that the observed changes were due to the exercise program. Mental health conditions were self-reported. These self-reports can be prone to errors due to misremembering. Important clinical variables were not assessed, including trauma. Participants reporting more than one mental health diagnosis were categorized based on the most severe. Social support was measured using an unvalidated tool. The study used participants from Queensland, Australia, limiting generalizability to other populations.
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Dowla, R., Woollett, P. H., Mavros, Y., Murnion, B., & Rooney, K. (2025). Exercise is therapy: A cross-sectional study evaluation of the impact of exercise on affect, arousal and distress in an inpatient mental health service. Advanced Exercise and Health Science, 2(4), 293–300. (Link)
Gonzalez-Garcia, X., Garcia, A., García-Pazo, P., Bennasar-Veny, M., Yañez, A. M., & García-Toro, M. (2026). Lifestyle interventions as adjuvant treatments for depression: An Umbrella Review of systematic reviews and meta-analyses. Complementary Therapies in Medicine, 98, 103336. (Link)
Kugelman, J., Doohan, M., Dyer, B., O’Brien, J., Kayal, M., & Chapman, J. (2025). Quality of life of people with mental health challenges and problematic substance use while engaged with an exercise physiology service. Community Mental Health Journal, 62(2), 245–256. (Link)
