At least 1 in 10 people experience depression at some point in their lives, with some estimates as close to 1 in 4. It’s one of the worst things that can happen to someone’s well-being, worse than debt, divorce, or diabetes.
One in seven Australians takes antidepressants. Psychologists are in high demand. Yet only half of people with depression in high-income countries receive treatment.
Our new research shows that exercise should be considered alongside therapy and antidepressants. Treating depression can be as effective as therapy, but what type of exercise you do and how you do it is important.
Read more: Why are so many Australians taking antidepressants?
Get rid of depression by walking, running, lifting, and dancing
We found 218 randomized trials of exercise for depression with 14,170 participants. The analysis was conducted using a method called network meta-analysis. This allowed us to compare different types of exercise, rather than lumping all types together.
We found that walking, running, strength training, yoga, and mixed aerobic exercise are nearly as effective as cognitive behavioral therapy, the gold standard treatment for depression. The effect of dance was also powerful. But this comes from an analysis of just five studies, primarily among young women. There was a lot of evidence to support this in other types of exercise as well.
Walking, running, strength training, yoga, and mixed aerobic exercise appeared to be more effective than antidepressants alone, and were about as effective as exercise combined with antidepressants.
But of these exercises, people were most likely to stick with strength training and yoga.
Antidepressants do work for some people. And of course, people who are being treated for depression should consult their doctor before changing their behavior.
Still, our evidence shows that you should see a psychologist if you have depression and Have an exercise plan whether you are taking antidepressants or not.
Participate in the program and do your best (with support)
Before analyzing the data, we wondered if people with depression needed to be helped to “soothe their mood” with general advice such as “doing some physical activity is better than doing nothing.” I was there.
But it turns out that it is much better to have a clear program aimed at giving yourself at least a little boost. Programs with clear structures worked more effectively compared to programs that gave people more freedom. Considering that low self-esteem is a symptom of depression, exercising alone can also make it difficult to set the bar at an appropriate level.
We also found that it doesn’t matter how much exercise people exercise in terms of sessions or minutes per week. It also didn’t really matter how long the exercise program lasted. The important thing is the intensity of the exercise, the higher the intensity, the better the results.
Yes, it’s hard to stay motivated.
Caution should be used when interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they were randomly assigned to receive, which can skew the results.
Many people with depression have physical, psychological, or social barriers to participating in formal exercise programs. And getting exercise support isn’t free.
We also don’t yet know the best way to stay motivated to exercise, which can be even more difficult if you have depression.
In our study, we tried to find out whether things like setting exercise goals could help, but we didn’t get clear results.
Other reviews found that it’s important to have a clear action plan (e.g., put exercise in your calendar) and track your progress (e.g., using an app or smartwatch). However, predicting which of these interventions will be effective is notoriously difficult.
Large-scale 2021 survey of more than 60,000 gym-goers finds experts struggle to predict which strategies are likely to get people to the gym more often There was found. Making training fun didn’t seem to motivate people. But experts didn’t predict that listening to audiobooks while exercising would have such a huge effect.
Still, we believe people benefit from individualized support and accountability. Support can help you overcome the hurdles you are sure to hit. Taking responsibility keeps people going even when their brain tells them to avoid responsibility.
Therefore, when starting out, it seems wise to avoid going it alone. Instead:
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Join a fitness group or yoga studio
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Hire a trainer or exercise physiologist
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Invite a friend or family member to go for a walk with you.
By taking a few steps to get support, you’re more likely to continue exercising.
Read more: Exercise is even more effective than counseling or medication for depression. But how much do you need?
let’s make this official
In some countries, exercise is considered a back-up plan for treating depression. For example, the American Psychological Association conditionally recommends exercise as a “complementary and alternative treatment” only when “psychotherapy or pharmacotherapy is ineffective or unacceptable.”
Based on our research, this recommendation will withhold powerful treatments from many people who need them.
In contrast, the Royal Australian and New Zealand College of Psychiatrists recommends vigorous aerobic exercise at least two to three times a week for all patients with depression.
Given how common depression is and how many people cannot access treatment, other countries should follow suit and encourage exercise alongside front-line treatments for depression.
I would like to thank my colleagues Talen Saunders, Chris Lonsdale, and the remaining co-authors of the paper on which this article is based.
If you have a problem with this article, or are concerned about someone you know, please call Lifeline on 13 11 14.
