Exercise can help treat depression, but what works best depends on age and gender: study

Dance is very effective at reducing depressive symptoms but more studies have been on women.(ABC Wide Bay: Brad Marsellos)

  • In short: A major study of more than 14,000 people has found some types of exercise can be better than anti-depressants alone.
  • Researchers say it doesn’t matter how many times a week you exercise, but the more vigorous the better.
  • What’s next? GPs are being encouraged to refer more patients to exercise physiologists.

Treating depression can be complicated and financially draining.

Seeing a psychologist can leave a big hole in your wallet, and anti-depressants can have such debilitating withdrawal symptoms that some people have to take them indefinitely.

But what if there was one more treatment option you could consider?

There is; it’s exercise. And a new study suggests it can actually be more beneficial than antidepressant medication alone.

But the type you do, and how you do it, matters.

The Health Report looks into treating depression with exercise.

Australian researchers recently completed a major review of 200 randomised trials on exercising to treat depression. It meant analysing over 14,000 people with clinical depression, which is characterised by at least two weeks of feeling low.

After concluding exercise was an effective treatment, they went further and compared specific types of exercise.

So let’s unpack what they found.

And just quickly, before we do that, it’s important to note anti-depressants and cognitive behavioural therapy are effective for some people and anyone changing their treatment plan should talk to their doctor.

Which activities are most beneficial?

Walking or joggingyoga and strength training are about as effective as cognitive behavioural therapy and more effective than anti-depressant medication alone.

But we can narrow it down further.

The review found yoga and qigong (a Chinese system of physical exercises and breathing control) are likely to be more effective for men, and strength training is best for women.

Yoga is somewhat more effective for older adults and strength training can lead to greater improvements among younger patients.

Dance is also great at lowering depressive symptoms.

Activities like dance where you need to focus on learning a new skill have positive cognitive benefits.(ABC: Hailey Renault)

“I think that’s because it has that social interaction, vigorous exercise, uplifting music and so it seems a really promising avenue for research,” says Michael Noetel, lead researcher and senior psychology lecturer at the University of Queensland.

However, most studies on dance are on young women so Dr Noetel says there needs to be more varied research before it’s recommended more widely.

Interestingly, the review found stretching to be the least helpful type of exercise for treating depression.

How often do I need to exercise?

The Australian guidelines suggest supervised group exercise for 30 to 40 minutes three times a week for a minimum of nine weeks.

But this new review found it didn’t matter how many minutes or sessions of exercise people did per week (as long as they did some).

The effect of exercise was also the same whether you had mild or severe depression.

However, the intensity of the activity does matter; so the more vigorous, the better.

The benefits are also greater if you participate in exercise with other people as opposed to going at it alone.

What if I don’t like any of these exercises?

There’s no point trying to pursue yoga or weight training if you really hate it.

In fact, pushing yourself to do something you get no sense of satisfaction from can actually have a negative effect, says Rhiannon White, senior lecturer at the University of Western Sydney, who was not involved in the review. 

She’s been studying the link between physical activity and mental health for 10 years and says it can be unhelpful to be overly prescriptive about what exercise people with depression should do.

High-intensity exercise can be more effective but gentle walking helps too.(Unsplash: Delphine Beausoleil)

“If we say ‘this is the best type’ and someone doesn’t feel competent doing it or can’t access that activity due to cost then exercise doesn’t feel like an option to them,” Dr White says.

“It’s good to know what types are more beneficial but then we need to guide people to find the one that gives them the biggest sense of accomplishment … that might not be resistance training, it might be a walk to the park with their dog or a friend.”

Context matters, she says, and even the time of day you exercise can alter the mental health benefits you receive.

So why is exercise good for depression?

Experts believe there are a few reasons.

When someone is depressed they can get stuck in a cycle of isolation — they withdraw socially and then find it hard to re-integrate — but exercising with others can break that cycle.

Depression can also make you feel hopeless, making it difficult to get out of bed and do the things that are important to you. This can create a loop of guilt, but exercise can break this by providing a sense of accomplishment, Dr Noetel says.

That’s why resistance training can be so effective as it’s based on the number of repetitions and it’s easy to set small goals and see progress.

Learning a new sport, like rock climbing, requires more attention which can be beneficial.(Getty Images: KoldoyChris)

There’s also a lot to be said for novel experiences. If you are learning something new, there’s a greater sense of satisfaction when you master it.

Dr Noetel suggests this could be the reason why yoga is more effective for men.

“If I think of my dad, he would not have done a downward dog in his whole lifetime … so it’s about learning something new, it’s the cognitive aspect.”

On top of that, when we exercise we get a surge of neurotransmitters like dopamine (ever had runners high?) which could be why more vigorous exercise has stronger effects.

How can I get started?

Those experiencing depression might meet the criteria for a chronic disease management (CDM) plan, which could get them up to five subsidised sessions under Medicare with an exercise physiologist.

Accredited exercise physiologists often design programs for people with anxiety, depression and post-traumatic stress disorder.

“They could support you as you start exercising and although five appointments isn’t a lot, it’s a start and starting is often the biggest hurdle,” Dr Noetel says.

CDM plans can be arranged by a GP but Dr Noetel says not many doctors use them to refer people to exercise physiologists, perhaps because the field is relatively new.

Dr White says unfortunately many GPs don’t go further than giving their patient a nudge to get moving, which isn’t much help. 

Both experts say it’s important exercise isn’t considered an “add-on” treatment and research shows patients do a lot better when they are given a structured exercise program, rather than just encouragement.

How can I stay motivated?

Depression is often characterised by days where leaving the house is an impossibility, so getting to a gym or a group class won’t be realistic.

Dr White says this is why it might be more helpful to have a support person, like a family member or friend, who can be on standby to come around and accompany you on a walk around the block on bad days.

She says online exercise videos might be preferable when symptoms are worse, as they can be done at home.

“It might not be the best exercise you’ll ever do but it’s the small steps that build a bit of confidence.”

She suggests keeping in mind three factors that determine whether we feel motivated to exercise:

  • who we’re exercising with and whether we feel supported by them
  • a sense of competence
  • value and enjoyment from the activity

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Ashley Williams
Ashley Williams
10:55 03 Apr 24
best in the business the team here are the very best at their jobs
16:52 05 Mar 24
I came to Jubilee Sports Physio for help on how to exersise and get fit without injuring myself constantly.During my initial consultation Michael said, I was standing wrong, sitting wrong and exersises I did were not suitable for my body.After four sessions, 15 minutes of daily exercises in between and I can go on hikes, lift weights and feel many years younger.I now have the life I want and very grateful to Jubilee Sports Physio, for their professionalism from booking, greeting and being able to do all I want physically.I highly recommend Jubilee Sports
Lara Mangelli
Lara Mangelli
08:56 18 Dec 23
I would like to express my sincere appreciation for the exceptional care provided by Michael and James for attending to my son, both before and after his shoulder reconstruction. Michael and James' combination of kindness and professionalism played an important role in helping my son navigate through what was his first significant life challenge.They both demonstrated an unwavering commitment to my son's well-being, providing not only expert physiotherapy but also a level of compassionate support that went above and beyond.Thank you Jubilee team for your outstanding commitment to patient care. It's reassuring to know that professionals like Michael and James are dedicated to not just addressing physical challenges but also fostering a supportive and empathetic environment for individuals facing health setbacks. The receptions ladies were kind and helpful too.
Judith Gifford
Judith Gifford
06:00 18 Dec 23
Over a period of 4 years my husband and I have had the expertise and professionalism of Michael Gabriel and staff at Jubilee Sports Physiotherapy Each of our ageing conditions required commitment to exercises to improve. When the conditions were clearly explained we gained confidence and understanding of realistic outcomes. We feel very fortunate for all of our treatments..and highly recommend Michael and staff.
Georgia Manos
Georgia Manos
12:08 13 Dec 23
The whole Jubilee team is fantastic. They are professional, knowledgeable and have always gotten me back playing football as quick as possible!
Jordan Figon
Jordan Figon
06:36 13 Dec 23
The team at Jubilee have been looking after me for over 15 years. Specially Michael with the help of Kieran. They have rehabbed me through 4 major surgeries as well as long standing injuries. It is because of these guys, I am able to still be involved in the game I love, stretching my career out as long as possible. In addition, my whole family is part of the Jubilee family
David Washington
David Washington
05:02 13 Dec 23
I have relied on Michael Gabriel for my physiotherapy needs for a number of years now. His professional work has allowed me to continue to chase the love I have for outdoors recreation.
Luke Payne
Luke Payne
22:05 12 Dec 23
Michael and his team are the best. So professional and knowledgeable and have kept me moving for years.
Diane sutton
Diane sutton
21:58 12 Dec 23
I have been a patient of Jubilee Sports Physio for many years, being treated for various injuries & chronic conditions. Michael’s diagnostic skills are excellent. I can highly recommend this practice for their care, proficiency & friendliness.
Nicole Simpson
Nicole Simpson
10:53 12 Dec 23
Micheal has helped over the years to heal and help with my injuries.. The entire team gives a five star help. I can’t praise them enough…Thank you so much
Judy Andrews
Judy Andrews
10:26 12 Dec 23
Michael has treated me on a number of occasions. He is very professional and very easy to talk to. He obviously knows his stuff and never fails to set you on the right path with his treatments
09:28 12 Dec 23
"I have been going to Jubilee Physiotherapy for many years.Very professional from the receptionists to the principal Physioswith lots of experience and straight to the point thatsave time and money"
Corinne Favaloro
Corinne Favaloro
04:09 02 Nov 23
I have been attending Jubilee physio, on and off, for many years.In fact three generations of my family are presently receiving treatment there. I have had several of the physiotherapist at Jubilee work on different problems and have found them all to be professional, knowledgeable and very caring in their treatment.
Nicole Di noia
Nicole Di noia
22:19 01 Nov 23
Thorough, professional and passionate team of physiotherapists.
Steve Chidgey
Steve Chidgey
02:04 04 Jul 23
The the treatment I received for injury was first class. Caring, knowledgeable and highly professional. The electronic home exercising provided to me showed me the required exercises so I was not let to a piece of papers directing me. Loved the app. This physio is the best I have used. Highly recommended.
Margaret Peace
Margaret Peace
01:29 01 Jul 23
I have attended Jubilee Physiotherapy for many years and have always had a positive experience. The staff are professional and knowledgeable. I always feel comfortable and safe in their care.My therapist, Samuel Leslie, knew exactly how to treat my new neck issue. As a result, I have made a very good recovery.
Angelina Mastoris
Angelina Mastoris
23:09 01 Mar 23
The guys at Jubilee are amazing! Been going for a couple years and each time I’ve had a great experience. Massive shout out and thanks to our team Physio Sam for helping me with my rehab and recovery. He’s helped improve my overall game and has made me stronger than before. He’s a legend. Would highly recommend, overall fantastic experience!
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