Running regularly has been found to parallel the effectiveness of antidepressants for treating depression and anxiety. However, despite additional benefits on physical health, the exercise routine is harder to follow, a study finds.
The study, published in the Journal of Affective Disorders, included 141 patients with depression or anxiety (or both). Of those, 45 participants chose 16-week treatment with antidepressants escitalopram or sertraline, whereas 96 individuals chose two to three closely supervised 45-minute group sessions per week.
The members of the antidepressant group were slightly more depressed than those who chose running.
After 16 weeks, remission rates were similar across both groups: 44.8% among those taking antidepressants and 43.3% in the running group.
Exercising had a positive impact on physical health, as the running group saw improvements in weight, waist circumference, blood pressure, and heart function. Meanwhile, these metabolic markers slightly deteriorated in the antidepressant group.
Despite the initial preference for running over antidepressants, adherence to the protocol was lower in the running group (52%) than in the antidepressant group (82%).
"Telling patients to go run is not enough. Changing physical activity behavior will require adequate supervision and encouragement as we did by implementing exercise therapy in a mental health care institution," said Professor Brenda Penninx from the Vrije University Amsterdam, an author of the study who presented the findings.
Although antidepressants are generally safe and effective, exercise therapy could be as good or an even better choice for some patients with depression than medication, she added.
"In addition, let’s also face potential side effects our treatments can have. Doctors should be aware of the dysregulation in nervous system activity that certain antidepressants can cause, especially in patients who already have heart problems. This also provides an argument to seriously consider tapering and discontinuing antidepressants when depressed or anxious episodes have remitted. In the end, patients are only truly helped when we are improving their mental health without unnecessarily worsening their physical health,” Penninx said.
However, the study results should be interpreted with caution. Because the participants followed their preferences, comparisons between groups might be more biased than they would be in a truly randomized study.
"For example, patients in the antidepressant group were more depressed, which might be associated with less chance of persisting engagement in the exercises," said Eric Ruhe from the Amsterdam University Medical Centres.
Much lower adherence in the exercise group shows "that it is more difficult to change a lifestyle habit than taking a pill," he added.
Exercising to prevent depression
Depression rates in the United States have hit new highs in 2023, as nearly one in five Americans (17.8%) reported currently having or being treated for depression. While antidepressants and psychotherapy are the first-line treatments, research associates running and other exercise types with mental health benefits.
For instance, a small study from 2018 found that running helped to significantly decrease depression, anxiety, and stress in youth and adults with complex mood disorders.
Exercising may also work as depression prevention. A 2022 meta-analysis of 15 studies including over 190,000 participants uncovered that those who engage in physical activity — equivalent to 1.25 hours of brisk walking a week — have an 18% lower risk of depression than those who do not exercise. At the same time, activity equivalent to 2.5 hours of brisk walking per week may cut depression risk by 25%.
Another study from 2018 found that people who exercised reported having 43.2% fewer days of poor mental health than those who did not exercise.
Adults are recommended at least 150 minutes of moderate-intensity physical activity weekly or 75 minutes of vigorous-intensity activity for the most benefit.
While taking antidepressants is easier than exercising, the study findings may offer new insights into tackling the growing mental health crisis in the U.S.
As we recognize World Mental Health Awareness Day today, taking the time to lace up your sneakers and hit the pavement may be a refreshing and mentally rewarding exercise to consider.
- National Library of Medicine. Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders.
- EurekAlert. Antidepressants versus running for depression: is there a winner?
- Gallup. U.S. Depression Rates Reach New Highs.
- BMJ Open Sport & Exercise Medicine. Effects of a 12-week running programme in youth and adults with complex mood disorders.
- JAMA Network. Association Between Physical Activity and Risk of Depression. A Systematic Review and Meta-analysis.