Physical Exercise for Treatment of Mood Disorders: A Critical Review
Open accessAbstract
Purpose of the review The purpose of this review is to critically assess the evidence for exercise as an adjunct intervention for major depressive disorder and bipolar disorder, chronic conditions characterized by frequent comorbid conditions as well as interepisodic symptoms with poor quality of life and impaired functioning. Individuals with these mood disorders are at higher risk of cardiovascular disease and premature death in part because of increased rates of obesity, inactivity, and diabetes mellitus compared to the general population. Exercise may not only mitigate the increased risk of cardiovascular disease, but could also potentially improve the long term outcomes of mood disorders.Recent findings We conducted a literature review on the impact of exercise on mood disorders and associated comorbid conditions as well as possible biological mechanisms. We found that exercise impacts both the physical health parameters of mood disorders as well as mental health outcomes. Exercise also positively impacts conditions frequently comorbid with mood disorders (i.e. anxiety, pain, and insomnia). There are multiple candidate biomarkers for exercise, with brain-derived neurotrophic factor and oxidative stress as two main promising components of exercise's anti-depressant effect.Summary Exercise appears to be a promising adjunct treatment for mood disorders. We conclude with recommendations for future research of exercise as an adjunct intervention for mood disorders.
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Lifestyle targeted behavioral interventions in depression have typically shown small-to-medium effect sizes of ~0.3-0.5, while the placebo effect of behavioral interventions is even smaller ~0.2 in RCTs.
“Lifestyle targeted behavioral interventions in depression have typically shown small-to-medium effect sizes of ~0.3–0.5 [4–16], while the placebo effect of behavioral interventions are even smaller ~0.2 in RCTs [101, 102].”
From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [7]
The Exercise for Major Depressive Disorder (MDD) section says exercise improves depressive symptoms and reports moderate-to-large effect sizes. It does not give the claimed ~0.3–0.5 range or establish that range as typical of lifestyle-targeted behavioral interventions generally. The placebo figure has separate citations in the citing sentence and is not attributed to this paper. (LLM, conf=0.85)
Experimental — accuracy not yet measuredPhysical activity/exercise, dietary modification, adequate sleep, social interaction, and mindfulness-based meditation have shown treatment efficacy in separate clinical trials of depression.
“These include physical activity/exercise, dietary modification, adequate sleep and social interaction, as well as mindfulness-based meditation, all of which have shown treatment efficacy in separate clinical trials of depression [4–16].”
From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [7]
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- [53]Sylvia LG Salcedo S Berinstein EE Baek JH Nierenberg AA Deckersbach T Nutrition, exercise, and wellness treatment in bipolar disorder: Proof of concept for a consolidated intervention International Journal of Bipolar Disorders 2013 1 1 1 7 24660139 PMC3961757
- [72]Szuhany KL Smits JAJ Asmundson GJG Otto MW Exercise for Mood and Anxiety Disorders: A Review of Efficacy, Mechanisms, and Barriers In progress
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A INFLUÊNCIA DA PRÁTICA DE ATIVIDADE FÍSICA NO ESTADO DE HUMOR DE MULHERES ADULTAS
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- Authors
- Hearing, C. M., Chang, W. C., Szuhany, K. L., Deckersbach, T., Nierenberg, A. A., & Sylvia, L. G.
- Affiliations
- Massachusetts General Hospital (US)
- Boston University (US)
- Harvard University (US)
- Corresponding author
- Sylvia, Louisa G.
- Venue
- Current Behavioral Neuroscience Reports
- Published
- 2016-10-14
- Volume
- 3
- Issue
- 4
- Pages
- 350-359
- ISSN
- 2196-2979 (ISSN-L)
- PMC
- PMC5423723
- OpenAlex
- W2530458945
- Cited by
- 137
- References
- 131
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 14 · 2023: 11 · 2022: 13 · 2021: 23 · 2020: 13 · 2019: 21 · 2018: 11 · 2017: 8
- FWCI
- 10.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Behavioral Neuroscience Reports (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health
- National Alliance for Research on Schizophrenia and Depression
- Patient-Centered Outcomes Research Institute
- American Foundation for Suicide Prevention
- Takeda
- Agency for Healthcare Research and Quality
- Brain and Behavior Research Foundation
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- physical activity, mood disorders, major depressive disorder, bipolar disorder, adjunctive therapy, comorbidities, cardiovascular risk, obesity, brain-derived neurotrophic factor, oxidative stress, exercise biomarkers, anxiety, pain, insomnia, antidepressant mechanism
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