We know that physical activity often improves our mood, but less certain is how helpful it is in recovery from depression. A review paper (Bailey, Hetrick, Rosenbaum, Purcell, & Parker, 2018) examined research published between 1980 and 2016 in order to determine the treatment effect of physical activity for depression in adolescents and young adults, aged 12 to 25 years. The review concluded that physical activity is a promising intervention for adolescents and young adults experiencing depression but further research is required to increase confidence in this finding.
Depression treatments for young people
Psychological treatments for youth depression have demonstrated small-to-moderate sized treatment effects. Compared to established psychological treatments, like cognitive behaviour therapy (CBT), there is less research evidence to support the role of physical activity in recovery from depression. Reviews of physical activity interventions for adults indicate that physical activity aids recovery from depression in adults. However, previous reviews of physical activity interventions for young people have not restricted participant samples to young people with subclinical or clinical symptoms of depression.
The impact of physical activity on depression
Physical activity was found to be effective as a standalone treatment in reducing depression symptoms in young people, including those with a clinical diagnosis. This finding for the overall participant sample was equivalent to those young people receiving a physical activity intervention showing a score on the Beck Depression Inventory of 5.38 points less than those in a control condition. This finding was mostly observed for mild to moderate symptoms of depression.
However, the researchers concluded that these effects need to be viewed with caution due to low quality of the research (such as inadequate reporting of research methods and a risk of bias within research trials examined). Nonetheless, physical activity appeared to be acceptable to young people and feasible to include as part of treatment. There was a low drop-out rate, comparable to that observed from psychotherapy interventions for youth depression. Only one research trial has compared physical activity with CBT among youth samples and equivalent effects were found for both treatments in reducing depression symptoms.
What type of physical activity is helpful?
The type of activity that is beneficial for youth depression treatment is still to be determined but common characteristics of interventions in the research trials gave some insight into this. Effective physical activity interventions are likely to include, but not be limited to, supervised aerobic-based activity that is of moderate-to-vigorous intensity, done multiple times per week for one hour sessions over at least eight weeks. This is consistent with findings from research among adult samples. The type of aerobic activity did not seem to be important (e.g., dance, volleyball, swimming), leaving flexibility for clients to choose an aerobic activity that they enjoy and feel they are good at. A supervised class may encourage continued participation rather than activities done on one's own.
How does exercise aid recovery?
It is thought that physical activity aids recovery from depression through its behavioural activation effect. It has been argued that behavioural activation interventions may be better suited to young people than ones with more emphasis on challenging thoughts (Hetrick et al., 2015). Physical activity may also be more appealing to young people than medication or psychotherapy (Jorm & Wright, 2007).
However, current treatment guidelines (NICE, 2015) recommend providing clients with general advice on physical activity involvement alongside other psychological treatment (e.g., CBT).