A: Possibly. Exercise has been shown to be an effective treatment for depression and anxiety, often comparable to antidepressant medication And a combination of both exercise and medication can be even more effective!
A recent study got some attention for making this point. The study compared the effects of a running program (45 minutes 2-3 times per week) versus a common antidepressant, escitalopram (Lexapro) in people with anxiety or depression. The headline making the rounds is that running was just as effective as medication, with a 43% vs. 44% remission rate. Unfortunately, due to its design, this particular study couldn’t actually prove that effectiveness was the same. It does, however, serve as a useful reminder that exercise can, in fact, be medicine!
Many large randomized controlled trials have already examined exercise as treatment for mood disorders. And yes, when compared head to head, exercise often does in fact seem to be as effective as medication. The combination of medication and exercise seems to be even more effective. Exercise also has the added benefits of improved physical health. That’s pretty awesome! (Note: In almost all studies, participants were also receiving counseling or psychotherapy, which is another important treatment for mood disorders.)
The recent study was not designed to compare these two treatments head-to-head, for several reasons. It was too small, with not enough subjects. Also, participants were allowed to choose which treatment they wanted to receive, which can bias results. Lastly, because they weren’t randomized, the medication group actually had more severe depressive symptoms to start with.
What the study was able to show was that physical health improved in the running group compared to the medication group. This is not a surprise. They also found that running was difficult for most people to stick with. Only 52% in the running group completed at least 22 of the 36 prescribed exercise sessions over 16 weeks, compared to 82% in the medication group continuing their treatment for the study duration. This is also not a surprise. Taking medication every day is a much easier behavior change than exercising twice per week for 45 minutes (especially if you’re depressed!).
In summary, we do have good evidence that exercise can be just as effective as medications for depression and anxiety, just not from this particular study. This study shows us some of the physical benefits of exercise vs. medication as well as how hard it can be to stick with it.
Bottom line: Regular physical activity can be an effective treatment for depression and anxiety, either with medication or on its own. The trick is to find a way to get moving and stay with it!
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References:
Medscape News Article about the study
Twitter/X thread about article from Gideon Meyerowitz-Katz, Epidemiologist
2023 Review of evidence for exercise as treatment for depression
Large meta-analysis of exercise as treatment for depression
NIH Guidance on How to Make Behavior Changes
News article about study showing what works to motivate regular exercise
