A large-scale review of research found good evidence to support the prescribing of exercise as a treatment for conditions such as depression
"We found that all types of physical activity and exercise were beneficial, including aerobic exercise such as walking, resistance training, Pilates, and yoga. Importantly, the research shows that it doesn’t take much for exercise to make a positive change to your mental health.” Dr Ben Singh, research fellow, University of South Australia
A new study has shown that exercise is more effective than either counselling or antidepressant medication in managing depression.
The study by Australian academics, published in the British Journal of Sports Medicine, is a review of existing research into the effectiveness of exercise in reducing symptoms in depression, anxiety and distress. The authors searched 12 electronic databases for eligible studies, and the final study covers 97 reviews, 1,039 trials and 128,119 participants.
The review showed that exercise interventions that were 12 weeks or shorter were the most effective at reducing mental health symptoms. The biggest benefits were seen among people with depression, pregnant and postpartum women, physically healthy individuals, and people diagnosed with HIV or kidney disease. The authors conclude that “physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress.”
Dr Ben Singh, the University of South Australia research fellow who led the research, said that physical activity should be prioritised as a way of supporting the growing number of people with mental health conditions: “Physical activity is known to help improve mental health. Yet despite the evidence, it has not been widely adopted as a first-choice treatment. 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.”
He added: “Higher intensity exercise had greater improvements for depression and anxiety, while longer durations had smaller effects when compared to short and mid-duration bursts. We also found that all types of physical activity and exercise were beneficial, including aerobic exercise such as walking, resistance training, Pilates, and yoga. Importantly, the research shows that it doesn’t take much for exercise to make a positive change to your mental health.”
Professor Carol Maher, another of the study’s authors, said it was the first to evaluate the effects of all types of physical activity on depression, anxiety, and psychological distress in all adult populations. “Examining these studies as a whole is an effective way to for clinicians to easily understand the body of evidence that supports physical activity in managing mental health disorders.”
According to the World Health Organization, one in every eight people worldwide lives with a mental disorder, and poor mental health costs the world economy approximately $2.5 trillion each year.
Some GPs in England are now prescribing exercise rather than medication for patients with mental health conditions. NHS England has made the biggest investment of any national health system in social prescribing – a way of helping improve patients’ wellbeing by prescribing non-clinical treatments, typically social activities such as gardening, walking and exercise classes. It is designed particularly to help people with mild or long-term mental wellbeing issues, as well as those with chronic conditions such as diabetes and heart disease.
In a pilot scheme, 11 local authorities in England have been given funding to support GPs to prescribe exercise. The funding supports free bicycle loans and lessons; walking and wheeling groups; and cycling groups and taster days. When the pilot was launched last year, Chris Boardman, the national active travel commissioner and former racing cyclist, said: “Moving more will lead to a healthier nation, a reduced burden on the NHS, less cancer, heart disease and diabetes, as well as huge cost savings. This trial aims to build on existing evidence to show how bringing transport, active travel and health together can make a positive impact on communities across England.”
This comprehensive review of research confirms the value of exercise as a treatment for conditions such as depression and anxiety. Yet as rates of mental illness continue to climb, the NHS is spending more and more on anti-depressants and other mental health medication. Spend on the antidepressant sertraline, for example, grew from £38.4m in 2019-20 to £155.8m in 2020-21. Continuing to spend more and more money on medication is not sustainable in the long-term, and we believe that a greater willingness by doctors to prescribe exercise will result not only in mental health benefits, but will have a positive impact on people’s physical wellbeing too.