Exercise plays an active role in treating depression

The Bottom Line

  • Depression is common among older adults and has serious repercussions but is often difficult to diagnose and treat successfully.
  • Exercise can help to reduce the symptoms of depression.
  • Exercises that engage both the body and mind, such as Tai Chi, help reduce depression and are safe and gentle options for older adults and people who aren’t able to take part in more rigorous activities. 

One of the important benefits of exercise is how it can enhance mood and a sense of well being (1). Chalk it up to endorphins and other “feel good” chemicals in the brain that are released when we’re physically active. That at least partly explains why exercise is prescribed – often in combination with other therapies – to help reduce symptoms of depression (1).


This widespread, chronic and often debilitating condition is particularly common among older adults (2). To make matters worse, depression is a difficult condition to treat (3). Many people are reluctant to admit to a mental illness (4) or don’t respond well to treatment with medication (5). People who do not receive adequate treatment for depression are at increased risk of other health problems (such as heart disease), and can suffer from lowered quality of life (2;6).


Searching for solutions, researchers conducted studies to find out if exercise has the same depression-fighting benefits for older adults. Eighteen of those studies, involving more than 1,000 older adults with depression, were part of a systematic review (7). Participants engaged in various types of exercise – mostly in a supervised setting – in programs that lasted between six and 24 weeks. Their before and after depression “scores,” were compared with those of control groups who did not take part in the exercise programs (although some studies included an equal amount of social interaction) and received the usual care.


What the research tells us

Exercise was shown to have a ‘moderate’ effect in helping to combat depression in the study participants. That’s encouraging and supports recommendations for making exercise part of the treatment plans for older adults diagnosed with depression, or who are at risk of depression. According to the evidence, all types of exercise are beneficial but “alternative” programs, such as Tai Chi and Qi Gong, were found to be most effective. The review authors suggest that may be due to the emphasis on both the body and mind through slow, controlled movements, meditation, breathing and relaxation techniques.


Several other studies have demonstrated similar findings. For example, a systematic review of four randomized controlled trials found that older adults who took part in Tai Chi sessions on a regular basis reported significant decreases in depression symptoms (8). Tai Chi is a particularly good exercise for older adults as there is minimal risk and it is suitable for those with limited mobility and/or medical conditions that prevent them from engaging in more demanding physical activities (8).


Another more recent systematic review of 33 randomized controlled trials found that resistance training (a type of exercise meant to increase strength) led to significant decreases in symptoms of depression. It did not matter how much resistance training a person did, how healthy they were, or how much their strength improved—depressive symptoms were reduced regardless (9).


Depression can have severe consequences for older adults and better ways to diagnose and treat the disorder are urgently needed. Though it may not provide a cure, exercise can be recommended as an easy and safe addition to depression treatment – with few negative side effects and many additional benefits – to help reduce depression symptoms and promote a healthier outlook.


Learn more about the benefits of Tai Chi

Move it (slowly) or lose it: Tai Chi improves the mind as well as the body


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References

  1. Cooney GM, Dwan K, Greig CA, et al. Exercise for depression. Cochrane Database Syst Rev. 2013; 9:CD004366. 
  2. Blazer DG. Depression in late life: Review and commentary. J Gerontol A Biol Sci Med Sci. 2003; 58:249-265.
  3. Birrer RB, Vemuri SP. Depression in later life: A diagnostic and therapeutic challenge. Am Fam Physician. 2004; 69:2375-2382.
  4. Schomerus G, Schwahn C, Holzinger A, et al. Evolution of public attitudes about mental illness: A systematic review and meta-analysis. Acta Psychiatr Scand. 2012; 125:440-452.
  5. Cuijpers P, van Straten A, Smit F. Psychological treatment of late-life depression: A meta-analysis of randomized controlled trials. Int J Geriatr Psychiatry. 2006; 21:11-39-1149.
  6. Lopez D, Mathers C, Ezzati M, et al. Chapter 1: Measuring the global burden of disease and risk factors. 2006. Global Burden of Disease and Risk Factors - World Bank, Washington DC.
  7. Heinzel S, Lawrence JB, Kallies G, et al. Using exercise to fight depression in older adults: A systematic review and meta-analysis. Gero Psych. 2015; 28(4):149-162.
  8. Chi I, Jordan-Marsh M, Guo M, et al. Tai Chi and reduction of depressive symptoms for older adults: A meta-analysis of randomized trials. Geriatr Gerontol Int. 2013; 13:3-12. 
  9. Gordon BR, McDowell CP, Hallgren M, et al. Association of efficacy of resistance exercise training with depressive symptoms. JAMA Psychiatry. 2018; 75(6):566-576.doi: 10.1001/jamapsychiatry.2018.0572.  

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.