Struggling with depression? Walking or jogging, yoga and strength training appear to be the most effective exercises for alleviating depression, either alone or alongside established treatments such as psychotherapy and drugs, the study suggests.
The World Health Organization (WHO) estimates that more than 300 million people worldwide suffer from depression.
Exercise is often recommended along with psychotherapy and drugs, but treatment guidelines and previous evidence reviews disagree about how best to prescribe exercise to treat depression.
The new evidence, based on a review of 218 studies involving 14,170 participants with depression and published in The BMJ, suggests that the more intense the activity, the greater the benefits are likely to be.
Researchers from Spain, Denmark, Australia and Finland noted that these forms of exercise “could be considered, along with psychotherapy and drugs, as essential treatments for depression.”
Compared with active controls, large reductions in depression were found with dancing and modest reductions with walking or jogging, yoga, strength training, mixed aerobic exercise, and tai chi or qigong.
Moderate, clinically significant effects were also found when exercise was combined with SSRIs or aerobic exercise was combined with psychotherapy, suggesting that exercise might provide additional benefits in addition to these established treatments.
Although walking or jogging was effective for both men and women, strength training was more effective for women and yoga or qigong was more effective for men.
Yoga was also more effective in older adults, while strength training was more effective in younger people.
While light physical activity such as walking and yoga still provided clinically significant effects, the benefits were greater with vigorous exercise such as running and interval training.
Exercise appeared to be equally effective in people with and without other medical conditions and with different baseline levels of depression.
Effects were also similar for individual and group exercise. The team acknowledged that the quality of the evidence was low and very few studies followed participants for a year or longer.
Many patients may also have physical, psychological or social barriers to participation, they noted.
Still, they suggest a combination of social interaction, mindfulness, and immersion in greenery that may help explain the positive effects.
“Our findings support the inclusion of exercise as part of clinical practice guidelines for depression, particularly vigorous-intensity exercise,” they said.
“Health systems may want to provide these treatments as alternatives or adjuvants to other established interventions while mitigating the physical health risks associated with depression.”
