What Exercise Can and Can’t Do for Depression and Anxiety

A psychologist answers your top questions about the role exercise can play in your mental health.

The connection between emotional health and physical activity has been the subject of plenty of research, much of it showing how much one can influence the other.

The consensus? All exercise — no matter the intensity or the type — is “highly beneficial for improving symptoms of depression, anxiety and distress,” according to a systematic review published in 2023 in the British Journal of Sports Medicine.

What creates this link, and are there limitations to how well this works? We asked New York-based clinical psychologist Brad Thomas , Ph.D., who specializes in mental health and fitness, to share some insights on what exercise can do for symptoms of depression and anxiety - as well as what it can't.

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What is it about exercise that helps those with depression and anxiety?

Movement releases feel-good neurotransmitters — namely endorphins and serotonin — and other natural brain chemicals that can boost your mood and self-esteem, says Thomas.

Participating in a regular fitness routine is a "wonderful example of behavioral activation," he adds. This means you're using adaptive behaviors to activate pleasant emotions.

“Basically, you’re creating a connection in your mind between exercise and enjoyment, and every time you work out, that connection deepens,” he says.

Walking, swimming, dancing and other types of cardio exercise, for example, have been shown to:

• Relieve stress
• Improve memory
• Aid in quality sleep 

“Even five minutes of movement can have a profound effect on your mood and your overall mental health.”

Is there anything those who’ve been diagnosed with depression or anxiety need to know about exercise before starting?

It's good to talk to your doctor before beginning an exercise program, says Thomas. If you're new to exercising, you'll want to discuss ways to start out safely to avoid injury. But even if you're not new to exercising, it's good to have a conversation to help set expectations and understand how exercise fits into your treatment plan.

Once you’ve had that talk, Thomas says he is a fan of working with a certified fitness trainer to customize a plan that’s manageable for your schedule and lifestyle, challenging for your fitness level and fun.

Group classes, like the ones offered by SilverSneakers, are another option he often recommends. “Classes bring in a social component, which is hugely helpful for mental health,” he says.

Journaling can also be a great way to track your progress and advocate for yourself. Write down what you’re thinking and feeling before, during and after different activities. “That can take the intensity out of difficult emotions and create greater awareness for how exercise is affecting you,” he says.

Can exercise take the place of therapy or other managed care?

In a word, no.

“A multitude of studies have shown the relationship between exercise and improved mood,” says Thomas. “But simply having an uplift in mood or even an improvement in symptoms of depression and anxiety doesn’t qualify as treatment. Therapy can get to the root of what may be causing those issues.”

In addition, many mental health struggles come from biological components, such as regions of the brain that are over- or underactive. Sometimes, a neurotransmitter imbalance is to blame. Neurotransmitters are your body's chemical messengers. Serotonin, dopamine, and norepinephrine the common ones that regulate mood.

“These underlying physiological components can be helped by exercise to some degree but may be better addressed with medication, depending on the situation,” Thomas explains.

That’s why it’s important to stay in close contact with your doctor about any symptoms and emotional struggles you’re experiencing.

"Exercise can be a fantastic way to alleviate symptoms enough to make you feel comfortable talking about what's going on, and that can bring some therapeutic breakthroughs. But it doesn't replace existing treatments for depression and anxiety," he says.

Do certain types of exercise work better than others for relieving or managing symptoms of depression and anxiety?

"The most important aspect of all this is what you look forward to doing," he says. "If you are doing an activity you love, that lights up your brain as well as your body, and it can have a considerable impact for your mental health."

Are there considerations that older adults should keep in mind? 

"Don't be afraid to challenge yourself a bit," says Thomas. "Mental and physical benefits come from creating just enough stress on your body to help you progress in your fitness, while still maintaining your safety.

"Exercise is often touted for its physical effects, and for good reason," he continues. "But when you start to notice how much it can affect your mind, it can serve as another motivator to keep going strong."

Additional sources:
Systematic review on the Effectiveness of physical activity interventions for improving depression and anxiety: British Journal of Sports Medicine

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