Physical activity should be considered as front-line treatment for depression: scientific review

In this Friday, June 26, 2020 file photo, people wear masks while exercising at a gym in Los Angeles. (AP Photo/Jae C. Hong)

Suggesting someone struggling with depression or anxiety should start exercising more usually comes across as patronizing — but a new study into the powerful impact exercise can have on our mental health suggests exercise should generally be considered as the first option for treating depression and anxiety.

The scientific review, which looked at more than 95 scientific reviews encompassing 128,000 participants, found physical activity provided positive impacts across all studies, and was 1.5 times more effective in some cases than counselling or medication in tackling depression.

“Our review shows that physical activity interventions can significantly reduce symptoms of depression and anxiety in all clinical populations, with some groups showing even greater signs of improvement,” Dr. Ben Singh, researcher at the University of South Australia and lead author of the study, said in a press release.

“Importantly, the research shows that it doesn’t take much for exercise to make a positive change to your mental health.”

Researchers found exercise interventions which were 12 weeks or shorter had the most significant impact in reducing mental health symptoms.

This review doesn’t mean all a person needs to do to recover from depression is to pick up jogging — as it is an umbrella review, it provides a very broad look at a complicated subject. Types of exercise and an individuals’ ability to engage in them vary widely across populations.

But researchers say the fact that exercise had a measurably positive impact across so many studies supports the idea that it should be considered seriously as a therapeutic intervention prescribed to patients.

“Physical activity is known to help improve mental health,” Singh said. “Yet despite the evidence, it has not been widely adopted as a first-choice treatment.”

A scientific review is when researchers take a broad look at the existing scientific literature on a topic in order to create a general understanding of the research landscape.

This study is an umbrella review, which means it evaluates several scientific reviews to get an overall perspective on the topic.

The review looked at 97 other scientific reviews, including 1,039 trials with 128,119 total participants. Studies were selected to be included in the review if they looked at adults reporting mental health issues and physical activity as an intervention.

Studies were eligible regardless of the duration, frequency or type of physical activity, meaning further research is still needed to narrow down what types or duration of physical activity hold the most therapeutic value for which patients.

The review suggests exercise of all types was effective at reducing depression and anxiety symptoms across all clinical populations, but the effects were stronger for a few specific groups.

Greater benefits were seen among people with depression, pregnant and postpartum women, individuals diagnosed with HIV or kidney disease, and people who were physically healthy apart from their mental distress.

In general, higher intensity exercise was associated with the alleviation of symptoms associated with depression and anxiety, and longer periods of exercise had slightly less positive impacts than shorter durations.

Researchers noted that longer duration exercises having less of an impact seems counter-intuitive, and theorized that this could be due to participants not being able to adhere to longer durations of keeping the same exercise schedule, which could spur feelings of failure.

“It is possible that shorter duration interventions are easier for participants to comply with, whereas longer weekly duration interventions are more burdensome and that may be impacting the psychological benefits,” the review stated.

Researchers acknowledged that although their review cast a wide net, there were more studies which focused on mild-to-moderate depression included, and less that looked at anxiety and psychological distress. There also is the possibility the reviews they looked at may not have provided the clearest picture of all of the individual studies included in those smaller reviews, underlining the need for further research into the topic of physical exercise as a tool to battle depression and anxiety.