exercise in depression

Last edited 03/2024

• NICE have stated that exercise is a treatment option for mild depression (1):
  • patients of all ages with mild depression should be advised of the benefits of following a structured and supervised exercise programme of typically up to 3 sessions per week of moderate duration (45 minutes to 1 hour) for between 10 and 12 weeks
• a systematic review has been undertaken to investigate the efficacy of exercise in the management of depression (2):
  • exercise seems to improve depressive symptoms in people with a diagnosis of depression
  • mechanisms by which exercise may improve depression remain uncertain
  • study authors concluded that "...reasonable to recommend exercise to people with depressive symptoms and to those who fulfil diagnostic criteria for depression. However, we cannot give people accurate information about how effective exercise might be, nor can recommendations be made about the relative benefits of aerobic exercise, resistance exercise or mixed exercise, whether group or individual exercises are better, nor about the optimum duration of exercise. Given that the drop-out rates from exercise can be substantial, a pragmatic approach would be to recommend that patients choose a form of exercise which they will enjoy; this may improve adherence and increase the likelihood that people will continue exercise long-term.."
• a review (218 studies, 495 arms, n=14,170) found exercise is an effective treatment, with walking or jogging, yoga, and strength training more effective than other exercises (3)
  • effects appeared proportional to intensity of exercise prescribed and were stronger for group exercise
• also been shown to help prevent depression and for adults with severe or treatment resistant depression (4)

Reference:

1. NICE (April 2007). Management of depression in primary and secondary care
2. Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA. Exercise in Depression. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD0043
3. Noetel M al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ 2024; 384 :e075847
4. BMJ Editorial. Exercise for the treatment of depression BMJ 2024; 384 :q320