Depression: Sports are as effective as SSRIs
Data from a recent network meta-analysis suggest that physical activity should be given a much more central place in the treatment of depression.
Physical activity effectively reduces depression symptoms
- A recent meta-analysis, which considered data from 218 studies, supports the inclusion of exercise in the first-line treatment of depression.
- Good efficacy data is available for various types of exercise (walking, jogging, mixed aerobic exercise, strength training, yoga, tai chi, qigong, dancing).
- Psychotherapists can support the process by addressing the cognitive and behavioural barriers to physical activity.
The multiple benefits of exercise: what does the evidence say?
The study, led by Australian psychologists, summarised extensive data from 140,000 patients with depression from 218 controlled studies.1 Various types of sport were also compared with other common therapies.
Compared to active controls (e.g. conventional treatment, placebo), a moderate reduction in depression symptoms was evident with walking or jogging, yoga, strength training, mixed aerobic exercise, dancing, tai chi or qigong. The effect sizes of the exercise interventions were comparable to those of pharmacotherapy (SSRI) and behavioural therapy. Remarkably, there was no correlation between the effectiveness of exercise and the severity of the depression at the start of the study.
Effectiveness appeared to be proportional to dose and was greater with more vigorous activity and interventions with clear guidelines. Those who have the opportunity should therefore opt for more intensive training in a structured environment to maximise the benefits. Sports professionals or personal trainers may be helpful in ensuring a personalised, challenging and supported exercise programme.
However, many people affected by depression have very limited options. The study authors emphasise that low-intensity interventions that are associated with low costs or pragmatic barriers are also effective, particularly walking, jogging or yoga.
Exercise also works on other levels
A drastic increase in mental illnesses has been observed for several decades, which has picked up even more in recent years. The need for effective and tolerable therapeutic approaches is therefore greater than ever. A tripling of depression rates and an intensification of symptoms were reported in the first year of the coronavirus crisis alone: According to a study published in the 'Lancet', 33% of adults in the US suffered from increased depressive symptoms in 2021 (compared to 8.5% before the pandemic).3 Unfortunately, the gap in terms of basic health measures also widened even further during this period: for example, people who were already sedentary before the lockdowns tended to exercise even less. It has been proven that physical activity also helps to prevent depression.
The study authors emphasise that the emotional, quality of life, occupational and economic impact of depression on individuals and their families has increased in recent years. In addition, previous studies have documented that depression exacerbates various physical illnesses. For example, mortality from diseases such as diabetes, heart disease and cancer is increased by 50% when those affected suffer from depression.2 In addition to the positive effects on mental health, exercise also improves a variety of physical and cognitive parameters.
- Noetel, M. et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ 384, e075847 (2024).
- Bellón, J. Á. Exercise for the treatment of depression. BMJ 384, q320 (2024).
- Depression Rates Tripled and Symptoms Intensified during First Year of COVID | SPH. https://www.bu.edu/sph/news/articles/2021/depression-rates-tripled-and-symptoms-intensified-during-first-year-of-covid/.