Exercise Shows Comparable Results to Therapy and Medication for Depression

Recent scientific reviews have evaluated how exercise compares to other treatments for depression, focusing on outcomes across a range of studies involving adults with depressive symptoms.

Analyses of randomized controlled trials have found that exercise interventions can reduce depressive symptoms to a similar degree as psychological therapies and antidepressant medications. The Cochrane review examined nearly 5,000 adults and reported moderate benefits for those who engaged in exercise compared to those who received no treatment.

Evidence from these studies indicated that light- to moderate-intensity exercise produced greater improvements in depressive symptoms than vigorous exercise. Programs that included both resistance and aerobic components were found to be more effective than those relying solely on aerobic activity.

Comparisons between exercise and psychological therapy were supported by moderate certainty evidence, while comparisons with antidepressant medication were based on lower certainty. A separate network meta-analysis involving over 2,500 adults with non-severe depression found no significant difference in effectiveness between exercise, antidepressants, or their combination.

What the numbers show

• 73 randomized controlled trials and nearly 5,000 adults were included in the Cochrane review
• 218 randomized clinical trials and over 14,100 participants were analyzed in the JAMA Network meta-analysis
• Walking 7,000 steps per day was linked to a 31% lower risk of depression
• Each additional 1,000 steps walked daily (up to 10,000) was associated with a 9% decrease in depression risk
• 33 observational studies with over 96,000 adults were included in the JAMA Network Open meta-analysis

Drop-out rates were higher in exercise interventions compared to those involving antidepressant medication, according to the network meta-analysis. This suggests that adherence to exercise programs may be a challenge for some participants.

Another meta-analysis published in JAMA Network, which included more than 14,100 participants, found that exercise was about as effective as cognitive behavioral therapy or medications for reducing depression. Combining exercise with antidepressant medication tended to improve symptoms more than medication alone.

Observational research has also examined daily activity levels, with a December 2024 meta-analysis reporting that walking 5,000 steps per day was associated with fewer depressive symptoms. The same study found that walking 7,000 steps per day was linked to a 31% reduction in the risk of depression, and each additional 1,000 steps up to 10,000 further decreased risk by 9%.

Adverse events related to exercise were uncommon in the studies reviewed. When they did occur, they typically involved muscle or joint issues, or a worsening of depression symptoms in a small number of participants.

* This article is based on publicly available information at the time of writing.