Does Exercise Work as Well as Antidepressants?

For anyone in the doldrums, few things are more annoying than being told to go for a run. Yet two large studies published in early 2026 suggest that this familiar advice may carry real scientific weight. Both papers report that regular exercise reduces the symptoms of depression and anxiety by roughly as much as talking therapy or a course of antidepressants. That is a striking claim, and the researchers behind it have their own doubts about how far it can be pushed.

The first paper, released in January by a team based in Britain and Ireland, took the form of a Cochrane review. It combined the results of 69 randomised controlled trials (RCTs) on exercise and depression. The second paper, published the following month in the British Journal of Sports Medicine, drew on more than 1,000 trials involving close to 80,000 participants. Both concluded that exercise reduces depressive and anxious symptoms about as much as conventional treatments do.

There are, however, important warnings to attach. A review can only be as reliable as the trials it brings together, and exercise trials are easy to skew. Participants always know whether they are exercising or not, so their reported mood may be shaped by what they hope the study will show. For this reason, the Cochrane authors rated every trial they looked at as carrying a high risk of bias.

The second paper has a different problem. It did not test exercise directly against therapy or drugs. Instead, the results from exercise trials were compared with the results from separate trials of antidepressants. Drug trials, unlike exercise trials, are usually well designed: patients do not know whether they are taking the real pill or a fake one, which produces strong placebo effects. That makes it harder for a drug to look clearly better than its comparison. “I don’t think it’s a fair comparison,” says Jonathan Roiser, a professor of neuroscience at University College London.

Even so, most researchers are confident that exercise helps mood. Aerobic activities like running, walking and cycling appear to be useful in almost every case. For depression, group classes or supervised sessions tend to work better than exercising alone, and the benefits build up over several months of regular practice. For anxiety, gentler, lower-intensity activity seems to deliver the best results.

Why exercise lifts mood is harder to explain. The popular story that running produces a chemical “high” by releasing endorphins, the body’s own painkillers, has surprisingly little scientific support. A 2021 study blocked the brain receptors that endorphins act on, but runners still reported the same good feelings and the same drop in anxiety after a session. Researchers now suspect that other body chemicals, similar to the active parts of cannabis, are more likely to be behind these short-term boosts.

Several other pathways also seem to matter. Exercise appears to reduce inflammation and to improve brain plasticity, the brain’s ability to rewire itself. It also increases the activity of dopamine, the chemical the brain uses to weigh effort against reward. Raising dopamine may help reverse the loss of motivation that often comes with depression. On top of that, exercise offers real psychological rewards: a sense of progress, a feeling of being in control, and, in time, a sense of skill. All of these are known to lift mood. Plenty of reasons, then, to work up a sweat.