For millions of people struggling with depression, the path to relief usually involves a prescription pad or a therapist’s couch. But a major new systematic review from the Cochrane Library suggests that regularly exercising might be just as powerful.
The analysis, which reviewed data from 73 randomized controlled trials, found that exercise consistently reduced symptoms of depression compared to no treatment. (Randomized controlled trials are considered to be among the most rigorous types of medical studies.)
More significantly, in the head-to-head comparisons available, physical activity appeared to be just as effective as cognitive behavioral therapy or antidepressant medications.
The review, which focused on high-quality evidence from nearly 5,000 adults, offers a compelling case for physical activity as a legitimate medical intervention.
While the participant count might seem small for such a prominent global health issue, the researchers limited their scope to ensure the data reflected true cause-and-effect relationships rather than simple correlation.
By pooling data from studies around the world, the researchers found that people who exercised consistently saw a greater reduction in depressive symptoms than those who did not.
How working out compares to meds
The review found little to no difference in symptom reduction between people who exercised and those who received psychological therapy.
Similarly, when researchers compared exercise directly to antidepressant medications, the results were comparable.
While the authors caution that the data comparing exercise to medication is based on a smaller number of studies, for some patients, the gym might be a viable alternative — or addition — to the pharmacy.
How you exercise may not matter, either. The review suggests that the intensity of the workout matters less than simply doing it.
While both aerobic exercise (like running or cycling) and resistance training (like weightlifting) showed benefits, the evidence highlights that even light-to-moderate physical activity can make a difference.
The key appears to be consistency rather than intensity. The study also found that side effects were rare and generally limited to minor physical issues like muscle soreness — a contrast to the potential side effects often associated with antidepressant medications.
A word of caution
Despite the promising results, the report emphasizes that exercise is not a guaranteed cure-all. The review noted that while the short-term benefits are evident, there’s less certainty about the long-term effects, largely because few studies followed participants after the exercise programs ended.
Furthermore, the confidence in some of the evidence varies. Because it’s impossible to have “blind” participants in an exercise study (in other words, participants know if they’re exercising), there’s always a risk of bias in self-reported mood improvements.
This research doesn’t suggest anyone should stop medication or cancel therapy appointments. But it does strengthen the argument for integrating physical activity into mental health care plans.
Starting a moderate exercise routine could be an immediate, accessible and effective step toward feeling better — just be sure to discuss it with your doctor first to ensure your safety.
Read more about how exercise can boost your brain health in “2 Times in Life When More Exercise May Lower Your Dementia Risk by 40% — Including Retirement.”