Exercise May Be More Effective Than Medication for Anxiety, Depression, Study Finds
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New research shows that exercise may be even more effective than medications when it comes to treating mental health disorders like anxiety and depression.
The results highlighted that even small amounts of physical activity can make a positive impact on mental health.
Experts do not, however, recommend stopping medications. Speak with your doctor before making any medication decisions.
Exercise plays a key role in our health, and studies have shown that being active can boost your memory, lower your risk of future hospitalization, and even lower your risk of cancer. Now, there’s evidence suggesting that exercise may be more effective than medication at managing mental health disorders like depression and anxiety.
The study, published in the British Journal of Sports Medicine, encompassed 97 different analyses over 1,039 trials, involving 128,119 participants, making it the most comprehensive review to date. The researchers found that physical activity significantly improved symptoms of depression, anxiety, and distress.
Specifically, they found that physical activity is 1.5 times more effective than counseling or the leading medications (important note: the study did not indicate what medications were included in the analysis). The results also showed that introducing periods of exercise that were 12 weeks or shorter was the most effective at reducing mental health symptoms, highlighting the speed at which physical activity can make a change.
The largest benefits were seen in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy individuals. Higher intensity physical activity was associated with greater improvements in symptoms, likewise with shorter bursts of activity versus longer durations.
Physical activity is known to help improve mental health. Yet despite the evidence, it has not been widely adopted as a first-choice treatment, said Ben Singh, M.D., lead researcher, in a press release. “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.”
This study also highlighted the fact that all movement is good movement—that all types of physical activity and exercise were beneficial, including aerobic exercises such as walking, resistance training, Pilates, and yoga.
How does exercise improve mental health?
Among other things, exercise improves resilience, reduces anxiety and stress, and reduces the perception of pain, which is a major contributor to depressed mood for many, explains Amit Sachdev, M.D., director of the Division of Neuromuscular Medicine at Michigan State University.
Any attempt to exercise usually helps with our mental well-being, says Dr. Sachdev. “For those who aren’t engaged at all, doing something [active] often refocuses some of their energy. For those seeking pain relief and, by extension, depression relief, they will need to work hard to very hard to get natural endorphins released.”
It’s important to keep in mind that this study did not look at the actual mechanisms of action of physical activity on mental health, but most scientists agree there are likely multiple factors that contribute to the impact of pa on mental health and well-being, says Carl Marci, M.D., physician, neuroscientist, and author of Rewired: Protecting Your Brain in the Digital Age. “These include direct physiological factors including reduced heart rate from increased vagal tone [or activity of the vagus nerve] and the release of BDNF, [a key molecule involved in changes related to learning and memory], both of which are good for brain health.”
Then there are the psychological benefits of taking action and having a sense of accomplishment, Dr. Marci adds. “For some, there may be a social aspect to going to a gym or just getting out of the house. All of these things are likely to contribute [to your mental health].”
Can exercise replace medications for mental health disorders?
The answer is not one size fits all, and no one should stop any medication prior to speaking with a healthcare professional. But for some people, yes, says Dr. Sachdev. “The challenge is, brains are really hard to predict.”
We have many drug classes available to medicate mental health, says Dr. Sachdev. “Take anxiety for example. If we had a single nerve transmitter problem leading to all anxiety, then we would need just one drug class.” However, brain chemistry is not so simple, he notes. “I would include exercise in the routine of every patient with anxiety, but I would not be discouraged if exercise alone left a gap that still needed to be treated.”
Dr. Marci believes the consistency of the findings in this study is comparable to any review of medication or psychotherapy interventions. “Keep in mind, all three (meds, therapy, physical activity) likely work on different mechanisms and so the combination can be very complementary.”
No treatment or intervention is a perfect solution, so we have to set expectations, says Dr. Marci. “There is a difference between mild to moderate depression and anxiety and major mental illness like schizophrenia or severe bipolar disorder. I believe some form of physical activity can and should complement a comprehensive treatment plan that often includes medication, therapy, a good diet, and a commitment to setting clear and achievable goals.”
The bottom line
Good body health and maintenance more directly affect good brain health and maintenance than most would recognize, explains Dr. Sachdev. Still, that doesn’t mean that you should stop taking any prescribed medications.
If you’re currently taking medication to improve your mental health, talk to your doctor before making any decisions to exchange the daily dose for a workout. “Talk to your clinician about options and be aware that you never want to just stop taking antidepressants without medical advice,” says Dr. Marci. That said, there is an opportunity, especially for some people with mild to moderate depression or anxiety, to start an exercise program and have a goal to get off of their medication, he adds.
For some scenarios, however, like severe phobia, suicidal thoughts or panic attacks, these conditions require immediate medical attention, says Dr. Sachdev. “Moderate [mental health disorders] can be supplemented with exercise. But if you feel that you may need help, there’s never a wrong time to reach out to your doctor. A good physician can help you gain insight anytime, says Dr. Sachdev.
For those with chronic health conditions, check with your doctor before starting a new exercise routine, advises Dr. Marci. And, “when symptoms are interfering with work or relationships in some consistent or significant way, seek help.”
If you or someone you know is at risk, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text HOME to 741741 to message a trained crisis counselor from the Crisis Text Line for free.
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