Mental health challenges are on the rise, with nearly one billion people globally affected by disorders like depression and anxiety.
But a growing body of research suggests that the most effective therapy may not come from a pill bottle or therapist’s couch — it might come from your running shoes.
In a landmark umbrella review published in the British Journal of Sports Medicine, researchers found that exercise is 1.5 times more effective at reducing mild-to-moderate depression, anxiety, and psychological distress than standard treatments like medication or cognitive behavioral therapy (CBT).
The findings are sparking renewed calls for physical activity to be treated as a primary intervention — not just an optional add-on — in mental health care.
Exercise Delivers Fast, Measurable Improvements
The review analyzed data from 97 meta-reviews and over 1,000 randomized controlled trials, covering more than 128,000 participants. According to Dr. Ben Singh, lead author of the study from the University of South Australia, the results were consistent across all adult populations studied.
“It showed exercise is an effective way to treat mental health issues — and can be even more effective than medication or counseling,” said Dr. Singh.
Even short-term programs (12 weeks or less) delivered the largest improvements, with participants experiencing between 42% to 60% reductions in symptoms — outperforming the 22–37% improvements typically seen with medications or therapy.
Who Benefits the Most?
While all adults can benefit, certain groups saw the greatest mental health improvements from physical activity:
People with clinical depression
Individuals living with HIV or kidney disease
Pregnant and postpartum women
Otherwise healthy adults experiencing distress
Interestingly, those who were older (45+) or physically deconditioned responded particularly well to moderate activities like daily walking for 20–40 minutes.
Any Exercise Works — But Some Work Better
The review found that all forms of physical activity — from yoga and Pilates to strength training and aerobic exercise — were beneficial. However, higher-intensity workouts tended to deliver stronger mental health benefits.
Notably:
Strength training had the largest impact on depression
Mind–body practices like yoga were particularly effective for anxiety
Mixed modes (combining resistance and cardio) provided consistent improvements across the board
The common thread? You don’t need to overcommit. In fact, shorter weekly durations (under 150 minutes) were linked to better outcomes than longer regimens. This finding challenges the common assumption that “more is better” and underscores the power of brief, consistent routines.
Why Exercise Works So Well for Mental Health
According to experts, the mechanisms behind exercise’s mental health benefits are both biological and psychological.
Professor Vasso Apostolopoulos of Victoria University, who was not involved in the study, explains that physical activity stimulates a range of positive changes:
“The effects may occur through physiological and biochemical mechanisms, including endorphins, neurotransmitters, and the hypothalamic-pituitary-adrenal axis,” she said.
This includes the release of feel-good chemicals like serotonin, dopamine, and norepinephrine, as well as reduced inflammation and improved stress resilience.
The thermogenic hypothesis also plays a role — suggesting that increases in core body temperature during exercise may reduce muscular tension and alter brain activity in ways that lower anxiety.
A Shift in Global Mental Health Guidelines?
Despite the growing evidence, exercise is still underutilized in clinical practice.
In many countries, including the United States, exercise is considered a “complementary” treatment — only recommended when conventional methods fail. But Dr. Singh and his team argue it should be viewed as a first-line therapy.
“Exercise should be a legitimate first-line treatment for mental health issues and not just an ‘added extra’ as it’s often seen in medicine,” Dr. Singh emphasized.
Australia’s clinical guidelines are ahead of the curve, already recommending lifestyle interventions — including physical activity — as the initial step in managing depression and anxiety.
The Economic Case for Exercise
The financial stakes are enormous.
The World Health Organization estimates that poor mental health costs the global economy $2.5 trillion annually, with that number expected to rise to $6 trillion by 2030.
Implementing short-term, cost-effective exercise interventions could ease the burden on healthcare systems while offering faster relief for patients. And since exercise also improves physical health outcomes like cardiovascular function and metabolic health, the return on investment is hard to ignore.
Making It Work in the Real World
While prescribing medication is straightforward, prescribing movement is less so. Many healthcare providers lack training in exercise science, which limits how often it’s recommended.
Dr. Singh and Professor Apostolopoulos propose a collaborative care model where mental health specialists work closely with exercise professionals.
“A treatment plan may include a combination of lifestyle approaches, such as exercising regularly, eating a balanced diet, and socializing, alongside treatments such as psychotherapy and medication,” said Dr. Singh.
This model acknowledges that not every patient will benefit from exercise alone — but that it deserves to be front and center, not an afterthought.
Takeaway: Movement is Medicine
For people battling depression and anxiety, the path to healing may begin with a brisk walk, a strength-training circuit, or a yoga mat. The science is clear: exercise isn’t just helpful — it can be more effective than medication or therapy.
And perhaps best of all, the benefits come fast, they’re long-lasting, and they’re accessible to almost everyone.
If you’re struggling with your mental health, consult your healthcare provider. But don’t wait for a prescription to start moving. Even a small step can lead to a big shift in how you feel — mentally, emotionally, and physically.