A newly updated Cochrane review suggests that physical activity may be just as effective as therapy in reducing symptoms of depression.
Because exercise is affordable, easy to access, and linked to many additional health benefits, it stands out as an appealing option for managing depression. A growing body of evidence shows that regular physical activity can positively influence overall mental well-being.
Researchers now report that exercise may ease depressive symptoms at a level comparable to other first-line treatments.
The updated review found that exercise produced similar outcomes to psychological therapy. However, when compared with antidepressant medication, the findings were less definitive.
Depression remains one of the most widespread mental health conditions in the United States, affecting roughly 21 million adults. In 2021, about 61% of U.S. adults living with depression received some form of treatment.
Given its low cost and broad availability, exercise offers a practical approach to symptom management for both individuals and their healthcare providers.
“Our results indicate that exercise appears to be a safe and accessible way to help manage depression symptoms,” said lead author Andrew Clegg, PhD, professor of geriatric medicine at the University of Leeds, in a press release.
He added that while exercise can be effective for some people, it may not work for everyone, making it important to identify approaches individuals can realistically maintain over time.
How exercise affects depression symptoms
The review analyzed 73 randomized controlled trials involving nearly 5,000 adults diagnosed with depression.
These studies compared exercise with no treatment or control interventions, as well as with antidepressants and psychological therapies.
Overall, exercise showed a moderate reduction in depressive symptoms compared with no treatment. When measured against psychological therapy, exercise demonstrated comparable effectiveness based on moderate-quality evidence from 10 trials.
Evidence comparing exercise to antidepressants was limited and considered low quality, though it suggested similar potential benefits.
Long-term outcomes remain uncertain, as few studies tracked participants after treatment ended.
Menije Boduryan-Turner, PsyD, a licensed psychologist and founder of Embracing You Therapy, who was not involved in the review, noted that the findings highlight the value of incorporating exercise as an additional tool for managing depression.
Rod Mitchell, MC, MSc, a registered psychologist and founder of Emotions Therapy Calgary, agreed but urged caution.
He explained that many studies faced methodological limitations, such as lack of blinded assessments or proper randomization, and warned against interpreting the results as meaning exercise can fully replace therapy or medication.
“Therapy changes thought patterns, medication influences brain chemistry, and exercise helps regulate the nervous system,” Mitchell said. “These approaches serve different purposes and aren’t interchangeable.”
Still, the review supports viewing exercise as a legitimate frontline intervention rather than merely a lifestyle suggestion added at the end of treatment.
Additional evidence on physical activity and depression
Other research reinforces the link between movement and mental health. People who engage in higher levels of physical activity may have a 17% lower risk of depression, while those with low cardiorespiratory fitness may face a significantly higher risk.
A 2024 systematic review identified several ways exercise may help manage depression, including reducing inflammation, stabilizing disrupted sleep–wake cycles, and improving sleep quality.
Despite these benefits, researchers emphasize the need for larger, high-quality long-term studies to better understand which types of exercise work best, for whom, and for how long.
Exercise alongside other treatments
Experts generally recommend combining exercise with other established treatments for depression.
Boduryan-Turner emphasized that using multiple approaches—such as therapy, medication, mindfulness practices, and physical activity—can lead to more effective outcomes.
She also noted that depression affects individuals differently, and maintaining a regular exercise routine may be more challenging for some than others.
According to the National Institute of Mental Health, even 30 minutes of daily walking or jogging can help improve mood.
Mitchell explained that exercise may be suitable as a primary approach for mild to moderate depression, but for more severe cases, therapy may be necessary first to help build momentum before introducing physical activity.
Exercise supports mental health through both biological and psychological mechanisms, including the release of endorphins that promote positive mood.
It can also help reduce stress and anxiety, boost self-esteem, and encourage social connection.
Experts recommend focusing on consistency rather than intensity and choosing activities that feel enjoyable or meaningful, such as walking, dancing, gardening, or yoga.
When to seek professional help
Anyone experiencing persistent symptoms of depression—such as difficulty functioning, social withdrawal, feelings of hopelessness, or thoughts of self-harm—should consider seeking support from a healthcare or mental health professional.
If someone is in immediate danger or experiencing suicidal thoughts, they should contact emergency services or reach out to crisis support resources right away.
