"More Effective than Antidepressants?" The Era of "Prescribing Exercise" Has Arrived — What Proved Effective for Depression and Anxiety Was "Surprisingly Light"

"More Effective than Antidepressants?" The Era of "Prescribing Exercise" Has Arrived — What Proved Effective for Depression and Anxiety Was "Surprisingly Light"

1) It's Not Just "Medication or Counseling"—The Concept of "Prescribing Exercise"

Feelings of depression or unexplained anxiety. Inability to sleep, concentrate, or see a bright future. Traditionally, the main treatments have been "medication" or "psychotherapy." Of course, these remain important.
But in recent years, another "prescription" has begun to gain strong evidence. That is exercise.


The UK Independent reported that exercise should be positioned as an "evidence-based first-choice intervention" for symptoms of depression and anxiety, and that experts should recommend it with the same confidence as traditional treatments. The review introduced highlighted the effectiveness of activities like running, swimming, and dancing, with a particular emphasis on the impact of aerobic exercise.


What needs to be emphasized here is that this is not a simplistic notion of "exercise solves everything." Rather,carefully designing "how to exercise" enhances its value as a treatment.


2) What Did the Research Observe: Exercise Brings "Moderate" Improvement to Depression and Anxiety

In the background of the research mentioned by the Independent, there is a large-scale review summarizing the relationship between exercise and mental health. For example, the "umbrella review" published in the BMJ-affiliated British Journal of Sports Medicine (BJSM), which is openly accessible, organizes the effects of exercise interventions targeting adults by further integrating existing meta-analyses (i.e., combining multiple studies).


In this review, it was shown that exercise (physical activity)

  • Depression symptoms: Median effect size -0.43

  • Anxiety symptoms: Median effect size -0.42

  • Psychological distress: -0.60 (in some analyses)
    indicated "moderate improvement" (compared mainly to usual care or waiting groups).


Looking solely at the numbers might not make it clear, but the key point is that "it has been replicated in a wide population." Improvements have been observed overall, even among diverse groups such as healthy adults, those with mental disorders, and individuals with chronic illnesses.


3) Group Exercise Is More Effective for Depression: The "Optimal Time" for Ages 18-30 and Postnatal

A notable point in the Independent's report is that group exercise brings greater benefits for depressive symptoms. Moreover, the groups more likely to see effects include

  • Young adults aged 18-30

  • Postnatal women
    are highlighted.

This cannot be explained by sheer willpower. Rather, the "impact of the environment" is significant.


Reasons Why Group Exercise Works (Concept)

  • Lowering the barrier to participation: When reservations, time, and place are set, the hesitation of "to do or not to do" decreases

  • Reducing isolation: The difficulty of depression is often amplified not just by "symptoms" but by "isolation"

  • Recovery of self-assessment: More than skill, the feeling of "I could go" or "I continued" boosts self-efficacy

  • Establishing rhythm: Sleep, meals, and outings are more likely to return in sync


Postnatal life often disrupts daily rhythms and increases isolation. Young adults also face mental fluctuations due to environmental changes (such as schooling, employment, and relationships). Therefore, an "exercise setting" functions as a foundation for life, not just the body. The Independent's emphasis on suggestions for "new mothers" reflects this background.


4) For Anxiety, "Short and Low Intensity" Is More Effective—The Paradox of "Less Effort Works Better"

Another interesting point is that for anxiety symptoms, short-duration and low-intensity exercise is suggested to be more effective.


When anxiety is strong, physical reactions (palpitations, shortness of breath, tremors, dizziness) are more likely to occur. The NHS also lists palpitations, dizziness, and tremors in relation to anxiety and panic.

 
Suddenly engaging in high-intensity exercise can cause changes in heart rate and breathing that resemble "anxiety's physical symptoms," which can be frightening for some. Therefore, starting at an intensity that reassures the body may be more suitable initially.


In short, the key to making exercise effective for anxiety is

  • Short (easy to start)

  • Light (not scary)

  • Easy to continue (even daily)
    These three points. Exercise is not just an event for "the day you do it," but it works as a lifestyle habit that conditions the nervous system.


5) Is "Exercise Better Than Medication" True?—The Importance of "How to Compare"

The Independent's Bulletin article includes a headline implication that "exercise is better than antidepressants," but this needs to be handled carefully.
In the research world, conclusions can change depending on the comparison target (medication, psychotherapy, waiting, usual care) and the quality of the research.


In fact, Cochrane's 2026 news also indicates that exercise shows moderate benefits for depressive symptoms, and while it may be comparable to psychotherapy, and possibly comparable to antidepressants, the evidence for direct comparison with medication is limited and uncertain.


Thus, the conclusion is:
"Not to stop medication and rely solely on exercise," but "exercise can become a pillar of treatment." And combining them individually is realistic.


6) "Prescription" from Today: Three Exercise Plans by Purpose (Examples)

From here, we bring the key points of the reports and research into daily life.


A: For those feeling depressed and struggling to leave the house

  • Twice a week: Light group classes (introductory yoga, dance, walking groups, etc.)

  • Other days: 5-10 minute walks
    The aim is "external rhythm" rather than "amount of exercise."


B: For those with strong anxiety and fear of palpitations or shortness of breath

  • Daily: 10-15 minutes of low intensity (slow walking, light exercises, relaxed swimming)

  • Start with "not raising the heart rate," and gradually increase as you get used to it.


C: For those who are motivated but can't continue

  • Three times a week: Fix the "place to do it" (gym, pool, studio)

  • The rule is "60 points is OK." On tired days, shorten the session and prioritize "continuation."


*If symptoms are severe, there are suicidal thoughts, or daily life is disrupted, it's safer to connect exercise as a "supplement" rather than a "substitute" to medical care or support.


Reactions on Social Media

  • "The idea that 'short and low intensity is more effective for anxiety' is a relief. On days when even 30 minutes of strength training is impossible, I felt guilty."

  • "I understand why group exercise works. A day I can go equals a win."

  • "But for some, being told to 'exercise' can be pressure. The way it's said matters."

  • "The idea that it helps postnatal mental health is hopeful. But the issue of having no place or time to leave the child should also be considered."

  • "It's not that medication is bad. It's good to have more 'cards to play' with both exercise and medication."

  • "It's great that 'dancing' is included among 'running, swimming, dancing.' The definition of exercise is expanding."


Reference: About the "Symptoms" Mentioned in the Article (Key Points)

The NHS advises seeing a doctor if a depressive state continues almost every day for more than two weeks. They also guide connecting to support if anxiety disrupts life or becomes unmanageable.


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