Exercise can be as effective as therapy and medication in treating depression

For years it has been repeated that exercise “is good for your mood,” but in the case of depression that claim is not based only on intuition or personal experience. The accumulated evidence shows that physical activity can reduce depressive symptoms to a degree similar to psychotherapy and the use of antidepressants, at least on average and under certain conditions.

An updated systematic review from the Cochrane Collaboration analyzed 73 randomized clinical trials including nearly 5,000 adults with depression, either clinically diagnosed or identified through standardized scales. Compared with receiving no treatment or being placed on a waiting list, exercise showed a moderate benefit in reducing symptoms such as persistent low mood or loss of interest in activities and relationships. When compared with psychological therapies or pharmacological treatment, the average effects were similar, although the certainty of the evidence was variable and, in some cases, limited.

The exercise programs evaluated were diverse, but generally consisted of weekly sessions over several weeks or months. They included activities ranging from low to moderate intensity, such as brisk walking or gardening, to more demanding exercises. A consistent finding is that light to moderate exercise seems to be more effective than vigorous exercise. This may be partly explained by the fact that less intense activities are easier to sustain over time. In fact, completing between 13 and 36 sessions of low- or moderate-intensity exercise was associated with greater improvements in depressive symptoms.

No single type of exercise was identified as clearly superior to others. However, programs combining aerobic exercise with resistance training showed better results than aerobic exercise alone. This point is relevant, since resistance training is associated with greater release of myokines, substances produced by muscle during physical activity. These have been linked both to the reduction of inflammatory processes and to positive changes in brain functioning. Among them, the brain-derived neurotrophic factor (BDNF) stands out, related to neuroplasticity, a process often diminished in depression.

Beyond biological mechanisms, exercise can also provide psychological and social benefits. Group activity, learning new skills, and regaining routines can positively influence self-esteem and the sense of personal agency, aspects often affected in depressive conditions.

In terms of safety, adverse effects associated with exercise were infrequent and generally mild, mainly musculoskeletal discomfort. In groups treated with antidepressants, the usual side effects of these drugs were observed, such as fatigue or gastrointestinal problems. Even so, the review highlights important limitations: many studies were small, with little long-term follow-up and without blinding, which requires interpreting the results with caution.

Taken together, the findings support clinical guidelines that recommend exercise as part of depression treatment, usually in combination with other interventions such as psychotherapy or pharmacological treatment. Exercise is not a one-size-fits-all solution nor does it work the same way for everyone, but it does appear to be a safe, accessible, and potentially effective tool. More than the exact type of activity, the key point seems to be that it is something possible to start and, above all, to sustain over time.