Exercise and increased physical activity are effective for both prevention and treatment of depression, concludes a research review in Current Sports Medicine Reports.

“The evidence of the use of physical activity and exercise for the management of depression is substantial and growing fast,” commented Felipe Barretto Schuch, PhD, of Universidade Federal de Santa Maria, Brazil, and Brendon Stubbs, PhD, of King’s College London, lead authors of the “Exercise Is Medicine” article. “Despite this substantial evidence, the incorporation of exercise as a key component in treatment is often inconstant and often given a low priority.”

Current treatments for depression focus on antidepressant medications and psychotherapy, each of which can help people but have important limitations. For example, only about half of people taking antidepressants will have a clinically significant response, and not all people will respond to psychotherapy.

“[T]here is growing recognition that lifestyle behaviors, such as physical activity and exercise, partially contribute to the risk of developing depression and can be useful strategies for treating depression, reducing depressive symptoms, improving quality of life, and improving health outcomes,” according to the authors.

Across countries and cultures, studies consistently link higher levels of physical activity to lower depressive symptoms. But those cross-sectional studies don’t answer a key question: Can starting an exercise program or increasing physical activity reduce the risk of developing depression or reduce depressive symptoms?

Schuch and Stubbs and colleagues analyzed pooled data on 49 prospective studies including nearly 267,000 participants. This meta-analysis found that physical activity reduces the odds of developing depression by 17 percent, after adjustment for other factors.

Physical activity is also an effective treatment for depression, and some studies have shown that a single exercise session can reduce symptoms in patients with major depressive disorder. The authors performed another meta-analysis of 25 randomized trials in which nearly 1,500 people with depression were assigned to exercise training or comparison groups. The results suggested a “very large and significant antidepressant effect” of exercise.

But exercise may not be equally effective for all patients. A wide range of biological, clinical, psychological, and social factors affect the response to exercise therapy, which may be helpful in matching “the right patient for the right treatment.”

Even though the evidence strongly supports the benefits of exercise, it still isn’t routinely included in clinical recommendations for the prevention and treatment of depression. “Addressing this issue and the current reliance on the two-pronged approach of talking therapies and medication is important in going forward,” the researchers conclude.

This article was adapted from information provided by Wolters Kluwer Health: Lippincott Williams and Wilkins.

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