Aerobic exercise — such as running, swimming, and cycling — was associated with improved symptoms of depression and anxiety across age groups, a large, pooled analysis found.

In an umbrella review synthesizing prior meta-analyses of randomized clinical trials, researchers reported that supervised, group-based programs provided the greatest relief from depressive symptoms, while shorter, lower-intensity exercise offered the most benefit for anxiety.

The review further suggests that all forms of exercise alleviate depressive symptoms to a degree comparable with pharmacologic and psychological therapies, although benefits for anxiety were more modest and supported by a smaller evidence base.

Because exercise is low cost, widely accessible, and associated with broader physical health benefits, it should be considered a first-line option, particularly in settings where traditional mental health care may be less accessible or acceptable, researchers argued.

“The findings support that exercise-based interventions, in all formats and parameters, can help mitigate depression and anxiety symptoms across all population categories,” lead author Neil Richard Munro, a PhD student at James Cook University, Townsville City, Australia, and colleagues wrote.

“Mental health professionals should prescribe exercise with the same confidence as traditional treatments, recognizing that all exercise formats demonstrate positive effects while tailoring programs to individual profiles and preferences,” they added.

The study was published online on February 10 in the British Journal of Sports Medicine.

Effects Strongest in Young Adults, Women

The review examined how exercise influences depression and anxiety among people with and without clinical diagnoses, including children, young adults, older adults, and perinatal women.

The researchers drew on 63 studies encompassing 81 meta-analyses, more than 1000 randomized controlled trials, and nearly 80,000 participants.

For depression, evidence came from 57 meta-analyses covering 800 trials and 57,930 participants aged 10-90 years. Anxiety outcomes were drawn from 24 pooled analyses that included 258 trials and 19,368 participants aged 18-67 years. Interventions ranged from aerobic activity and strength training to mixed programs and mind-body approaches such as yoga and tai chi.

Across analyses, exercise was linked to moderate improvement in depressive symptoms (standard mean differences [SMD], -0.61; 95% CI, -0.69 to -0.54) and smaller — thought still meaningful — gains for anxiety (SMD, -0.47; 95% CI, -0.59 to -0.36).

Benefits for people with depression were larger with group-based and supervised exercise than with individual-based activities, “suggesting that social components have a crucial role in the antidepressant effects of exercise,” the researchers wrote.

Depressive symptom relief was most pronounced among emerging adults aged 18-30 years and among postnatal women. These life stages coincide with periods of heightened vulnerability as many mental health conditions first emerge in young adulthood and postpartum depression remains both common and potentially severe, the investigators noted.

The findings are consistent with earlier research covered by Medscape Medical News, including an updated Cochrane review reporting that exercise offers symptom relief comparable with psychological therapies and medication for depression.

Implications for Practice and Research

Limitations cited by the authors included inconsistent definitions of exercise intensity and duration across studies, along with more limited meta-analytic data for anxiety outcomes. They also emphasized the need for broader representation, particularly among youth, older adults, and perinatal populations.

“Future research on intervention design and exercise prescription should prioritize the consideration of individual circumstances and needs, thereby supporting increased motivation and responses,” they wrote.

In a statement from the UK nonprofit Science Media Center, David Curtis, MD, PhD, with University College London, London, England, said a key limitation of the analysis is that participants were limited to individuals willing to enroll in randomized trials of exercise interventions.

“Patients with more severe illness would presumably have preferred other treatments that are readily available, such as antidepressants, and would simply not have volunteered to participate in the research,” Curtis said.

Also commenting, Anna Whittaker, PhD, with the University of Stirling, Stirling, Scotland, said the review offers strong evidence to encourage clinicians to prescribe exercise for some patients with depression and anxiety but noted that the optimal duration and intensity of exercise remain unclear.

She added that the findings highlight gaps in clinician confidence around prescribing exercise and point to the potential value of closer collaboration with exercise psychologists and physical activity specialists.

This study had no specific funding. Munro, Curtis, and Whittaker reported having no relevant financial relationships.