Research in Review: Exercise and Depression

Depression remains one of the leading causes of disability, affecting hundreds of millions of people worldwide. Exercise has increasingly been studied as a promising and accessible treatment option. Researchers have examined exercise as a potential treatment for depression from multiple angles over time – from observational studies and individual clinical trials to large systematic reviews – and the evidence continues to show that physical activity can meaningfully reduce depressive symptoms.

In this article, I’ll summarize what the research says, drawing on two major reviews – a Cochrane Database Systematic Review and an umbrella review from the British Journal of Sports Medicine, both published in 2026. I’ll discuss the study designs, the results, where the evidence still has gaps, and what is all means clinically.

What Two Large Studies?

1. Cochrane Database of Systematic Reviews Review on Exercise for Depression

This updated Cochrane review analyzed randomized controlled trials (RCTs) examining exercise as a treatment for adults diagnosed with depression. Together, these randomized controlled trials included more than 5,000 adults diagnosed with depression and randomized to either an exercise intervention or a comparison group. The comparison group depended on the study and included other treatment options, active control, or no treatment. While some of the studies looked at exercise as a standalone treatment, others examined exercise as an add-on treatment (added to medication and/or therapy).

Key findings:

• Exercise was associated with moderate reductions in depressive symptoms compared to no treatment or usual care.
• In a smaller number of studies that compared exercise directly with psychotherapy or antidepressant medication, exercise was associated with similar improvements in symptoms.
• Adverse effects were uncommon and generally mild (for example, muscle soreness).
• Long-term benefits were unclear due to limited follow-up data.

Importantly, when the analysis focused only on higher-quality trials (those with lower risk of bias), the effect size was smaller — but still suggested benefit.

2. British Journal of Sports Medicine Umbrella Review

The more recent umbrella review published in BJSM took a broader approach. Rather than analyzing individual trials, it synthesized findings from multiple meta-analyses, which themselves had already pooled data from many trials. This “review of reviews” provides a high-level summary of the overall evidence base. It also allowed the researchers to do additional comparative analyses on age groups, types of exercise, and presence of clinical or subclinical depressive symptoms. This review purposefully excluded studies on those with pre-existing chronic physiological conditions to try to better isolate the impacts of exercise on depressive symptoms without additional barriers.

Key findings:

• Exercise consistently reduced depressive symptoms across age groups.
• All exercise types were effective. This included aerobic, resistance training, and mind-body (like yoga).
• Aerobic, group-based, and supervised exercise appeared especially effective.
• Exercise was effective for those with symptoms of depression (but no formal depression diagnosis) as well as those diagnosed with clinical depression.
• In several analyses, the effect sizes were comparable to psychotherapy or medication, particularly for mild to moderate depression.

This umbrella review strengthens the conclusion that exercise can be a clinically meaningful intervention for depressive symptoms. Importantly, since it excluded those with chronic illnesses, it may not apply to those with significant physical illnesses.

What Are the Limitations of the Evidence?

Despite promising results, these reviews have important limitations that readers should understand.

1. Heterogeneity of Exercise Interventions

The included studies varied widely in terms of how they defined and recorded exercise intensity and duration. This makes it hard to compare across studies and pinpoint which exercise prescription may be the most effective option.

2. Variation in Study Quality and Bias

Many individual trials included in the systematic reviews had methodological limitations, such as small sample sizes, reliance on self-reported depressive symptoms, and high drop-out rates. Additionally, it’s difficult to blind exercise interventions (people know they are exercising). These weaknesses can introduce bias and lower confidence in the precise effect sizes. When lower-quality trials were excluded, effect sizes were somewhat smaller — though still present.

3. Limited Long-Term Follow-Up

Most of the trials measured outcomes immediately after the exercise program ended. There is less evidence on whether benefits persist long-term (months or years later), which is crucial for understanding the sustained impact of exercise as a mental health intervention. Notably, this is a common issue across mental health research, including studies on medications.

4. Population Diversity

While umbrella analyses include broad populations, not every group has been equally studied. People with severe depression, other chronic conditions, and older adults with mobility issues may respond differently, and more research is needed in these subgroups. Additionally, as with all lifestyle interventions, it’s important to consider cultural preferences and practices, which is not typically included in studies (yet).

5. Indirect Comparisons with Therapy and Medication

Comparisons between exercise and traditional treatments (psychotherapy, antidepressants) are encouraging, but they sometimes relied on indirect comparisons across studies rather than head-to-head trials. That limits how confidently we can conclude that exercise is equally effective in every context.

What Does This Mean in Practice?

Taken together, these two large reviews show that:

• Exercise reliably reduces depressive symptoms.
• The effect appears clinically meaningful.
• Exercise is low-risk and widely accessible.

For individuals with mild to moderate depression, exercise may serve as:

• A standalone option (under medical guidance), or
• A powerful adjunct to therapy or medication

For those with more severe depression, exercise may still play an important supportive role.

What’s the Final Takeaway?

Although the research can be longer term and even more refined, at this point, exercise has emerged as an effective and accessible tool for the management of depression for some people.

I need to note – this does not mean sedentary behavior causes depression or that exercise is a cure-all. Think about it like heart disease — sedentary behavior is just one risk factor for heart disease, and physical activity is just one tool to help manage heart disease. Similarly, sedentary behavior is just one risk factor for depression, and physical activity is just one tool to help manage depression.

With the current evidence, exercise should not be considered a universal replacement for other treatments, but a complement and reasonable alternative for some people. In other words, if someone has mild to moderate depression, exercise should be offered as a potential therapeutic option, along with other options.

Although research on exercise and depression has grown rapidly in recent years, the idea isn’t new. For years, organizations like the American Psychiatric Association have recommended lifestyle changes and therapy as first-line treatments for mild to moderate depression. But, in practice, these strategies are often overlooked, and medication is often offered first. With growing research supporting exercise, there’s hope it will finally become a routine part of depression care.