Exercise and Psychotherapy Are Equally Effective for Depression

A recent comprehensive review and meta-analysis indicates that the benefits of physical exercise for depression are comparable to those of psychotherapy and medication. Particularly beneficial exercises were weight training, yoga, and vigorous walking or running.

A multilevel meta-analysis of 218 randomized controlled trials, involving 14,170 patients with depression, was examined by the researchers.

Walking or jogging, yoga, strength training, mixed aerobic exercises, Tai Chi or qigong, as well as combination treatments (exercise plus SSRI, aerobic exercise plus therapy, aerobic exercise plus strength training, and cycling and dance) were all compared with other common treatments for depression, such as therapy, cognitive behavioral therapy, or selective serotonin reuptake inhibitors (SSRIs).

All results were “compared with active controls” (i.e., normal care or placebo), and the standardized difference between means, or Hedges’ g, was used to evaluate effect sizes.

Regardless of the comorbidities of the participants, a number of exercises showed moderate reductions in depression: mixed aerobic exercises (effect size, −0.43; 95% CI, −0.61 to −0.24), tai chi or qigong (effect size, −0.42; 95% CI, −0.65 to −0.36), strength training (effect size, −0.49; 95% CI, −0.69 to −0.29), walking or jogging (effect size, −0.62; 95% CI, −0.80 to −0.45), yoga (effect size, −0.55; 95% CI, −0.73 to −0.36), strength training (effect size, −0.49; 95% CI, −0.69 to −0.29), and strength training (effect size, −0.49; 95% CI, −0.69 to −0.29).

Exercise had effects that were proportionate to the recommended intensity across all modalities, showing a distinct dose-response curve. However, mild exercise, such as walking and hatha yoga, could still have some clinically significant effects.

Overall, the results of individual and group exercise were comparable; however, yoga was best performed in groups, whereas strength training and mixed aerobic exercise were better performed alone.