Exercise relieves depression as effectively as medication, study finds : NPR

Even light to moderate exercise can improve mood and reduce symptoms of depression.

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If you feel relief after exercise, you’re in good company. Movement can improve mood and, according to the results of a new study, it may also help relieve symptoms of depression.

In an evidence review by the Cochrane Collaboration – an independent network of researchers – scientists evaluated 73 randomized controlled trials involving around 5,000 people with depression, many of whom also tried antidepressants.

“We found that exercise was as effective as pharmacological treatments or psychological therapies,” says Andrew Clegg, a professor at the University of Lancashire in the United Kingdom.

The findings come as no surprise to psychiatrist Dr. Stephen Mateka, medical director of psychiatry at Inspira Health. “This new Cochrane review strengthens the evidence that exercise is one of the most evidence-based tools for improving mood,” says Mateka.

He explains how this reflects certain effects of medications. “Exercise can help improve the function of neurotransmitters, like serotonin as well as dopamine and endorphins. So there’s definitely an overlap between exercise and the way antidepressants provide relief,” says Mateka.

In other words, exercise helps release chemicals known to improve mood into the body.

And there is also another powerful effect. Exercise can trigger the release of brain growth factors, says Dr. Nicholas Fabiano of the University of Ottawa. He says depression can decrease neuroplasticity, making it harder for the brain to adapt and change.

“It’s thought that the brain in depression is less plastic. So there’s less of what we call neurotrophic factors, or BDNF,” says Fabiano. He calls it the Miracle-Gro for the brain. “And we know that exercise can also stimulate it. So I think exercise is a fundamental pillar that we really need to advise patients on,” he says.

And while medication and therapy are important tools, Fabiano says exercise is recognized as a preferred treatment for depression.

“Exercise has been adopted as a first-line treatment in global guidelines for depression, with good acceptability and safety,” he writes. Yet he says this technology remains underestimated and underutilized.

“It’s much easier for a primary care physician to prescribe medications to a patient. Just write them down on a notepad,” says Fabiano. It’s harder to prescribe exercise, which takes time and effort and can be difficult to start for depressed people.

Fabiano says exercise may work best as part of a combination of treatments. “We can put someone on an antidepressant – maybe that improves their mood and they’re able to do therapy. And from there, maybe they’re now more interested in adopting some of these lifestyle habits like exercise,” Fabiano says.

How much exercise is enough?

Evidence shows that light to moderate exercise — during which your heart rate increases enough to make you feel slightly out of breath — can be as beneficial as vigorous or intense exercise, at least initially. And Fabiano says there’s nothing wrong with starting with a “low dose.”

“Ultimately, you want to progress. But as you go from completely sedentary to just taking a walk every day, that’s where you start to see these exponential gains,” he says, emphasizing the importance of starting with modest amounts.

The study found that a combination of aerobic exercise and resistance training appears to be more effective than aerobics alone. The meta-analysis found that between 13 and 36 training sessions led to improvement in depressive symptoms, although long-term follow-up is rare. Researchers say there is still much to learn about how regular exercise can help prevent depression.

Mateka says there are many options. “When it comes to exercise, it’s just about finding the exercise that suits you, like yoga or tai chi, rather than walking and jogging,” he says. For some, group activity can add to the psychosocial benefits.

Ultimately, it’s best to choose something you love or return to an activity or sport that you loved as a child.

“Exercise is something that is extremely inexpensive. It’s very accessible. It has very minimal side effects. And it has the potential to have a positive impact on you, mentally, emotionally, socially and physically,” says Mateka.