Exercise is an effective treatment for depression on the best evidence we have, and walking or jogging, yoga and strength training worked better than other kinds of exercise in the largest review so far. That review pooled 218 randomised trials with 14,170 participants, and it also found the evidence is less certain than the headline sounds. [noetel-2024-exercise-depression] This guide covers which types did best, whether intensity matters, what exercise cannot replace, and how to start when energy is low.
Does exercise help depression?
Yes, on the best available evidence, with an important caveat about certainty. A network meta-analysis of 218 randomised trials with 14,170 participants concluded that exercise is an effective treatment for depression. [noetel-2024-exercise-depression]
The caveat is that confidence in the findings was rated low for walking or jogging and very low for the other treatments, partly because of methodological limitations in the trials that went into the review. [noetel-2024-exercise-depression] Participants in exercise trials know which group they are in, which is a recognised limit of this kind of trial. So the finding is strong enough to take seriously and not strong enough to treat as settled. Our guide to how to deal with depression covers the wider set of options.
Which type of exercise works best?
Walking or jogging, yoga and strength training worked better than other kinds of exercise, particularly when done at higher intensity. Compared with active control conditions, the effect sizes were 0.62 for walking or jogging, 0.55 for yoga and 0.49 for strength training. [noetel-2024-exercise-depression]
Noetel and colleagues (2024): effect sizes of 0.62, 0.55 and 0.49 compared with active control conditions, shown multiplied by 100. A larger bar means a larger average reduction in depressive symptoms.
Mixed aerobic exercise and tai chi or qigong were also effective. Dancing showed a powerful effect, but it came from analysing just five studies, mostly involving young women, so it is the least reliable number in the review. [noetel-2024-exercise-depression] Yoga and strength training were also well tolerated compared with other treatments.
Does intensity matter?
It appears to. The effects of exercise were proportional to the intensity prescribed, so more vigorous activity tended to bring bigger benefits. [noetel-2024-exercise-depression] Low-intensity activities such as walking or yoga still helped, which means a gentle start is a reasonable place to begin and not a wasted one.
If you have a heart condition, a joint problem or any other health concern, talk to a doctor before you build up to vigorous exercise. The review’s finding is an average across many people, and it does not tell you what is safe for you.
Can exercise replace antidepressants or therapy?
The review does not support that. Its authors suggest that these forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression. [noetel-2024-exercise-depression]
So the safe reading is that exercise is a strong addition, and a reasonable first step for some people, not a reason to stop what you are already doing. If you are being treated for depression, do not stop or change treatment without speaking to the person who prescribes or provides it. Our guide to CBT for depression covers the therapy that builds on scheduling activity.
How do you exercise when you have no energy?
Start with the smallest version you can repeat, decide the time in advance, and do not wait to feel like it. A ten-minute walk at a pace that makes you breathe a little faster counts, and so does a short yoga video or one set of a strength exercise at home.
Depression takes energy and motivation, so relying on either is a setup for failure. Fixing a time, a place and a length removes the daily decision, and doing it before you feel ready is the point, because activity often comes first and mood follows.
A ten-minute walk
Pick a time today and a route you can do without planning, even round the block. Start the timer and walk at a pace that makes you breathe a little faster, while still able to talk.
5:00
Ten minutes is a starting size and not a prescribed dose. Stop when the timer ends even if you want to carry on, and repeat it tomorrow at the same time. If you feel unwell, stop and speak to a doctor.
Done. Notice how you feel, then do the same again tomorrow.
What are the limits of the evidence?
The main limit is certainty. Confidence in the findings was low or very low, partly because of weaknesses in the trials, and the dancing result rests on five studies. [noetel-2024-exercise-depression] The review compares types of exercise on average, and your own best choice is the one you will actually keep doing, which the numbers cannot tell you.
It is also a review of trials where exercise was prescribed and supervised to some degree. How those effect sizes translate to doing it alone, with low energy, is less clear, which is another reason to start small and to keep your doctor or therapist informed.
When to seek help
Speak to a doctor if low mood, loss of interest or a feeling that nothing is worth doing has lasted most days for two weeks or more, or if it is affecting your work, relationships or sleep. Our depression self-assessment is a screener and not a diagnosis, and it can help you decide whether to have that conversation. Our overview of depression covers how clinicians define it and what treatment looks like.
If you feel unable to keep yourself safe, contact your local emergency services or a crisis helpline.
How MyFreud can help
Whether exercise is changing how your days feel is hard to judge from memory. Daily mood tracking in MyFreud shows the pattern across weeks, so you can compare days you moved with days you did not. It does not diagnose depression and does not replace treatment or speaking to a doctor.
Download MyFreud and start today: App Store or Google Play.