Exercise: A Narrative Review of Mechanism and Dosage As an Antidepressant Publisher



S Ganjeh SOHEILA ; Mm Roostayi Mohammad MOHSEN ; A Daryabor ALIYEH ; K Khademikalantari KHOSRO ; Zs Rezaeian Zahra SADAT
Source: Physical Therapy Reviews Published:2025

Abstract

Background: Depression and anxiety are common aspects of modern life, while relaxation and emotional relief following exercise are universal experiences. However, which type of exercise is most effective in alleviating the adverse effects of depression and anxiety? Objectives: The main questions of this study were, ‘Which exercise regimens significantly improve the symptoms of depression and anxiety, regardless of formal clinical diagnosis?’ and 2) ‘What are the underlying mechanisms for these effects?’ Methods: This review gathered the most recent evidence from international databases, including Scopus, PEDro, ISI Web of Science, Cochrane Library, and PubMed. All systematic reviews published in English since January 1, 2017, were included if the effects of the exercise could be easily extracted. Results: Among the 3,890 articles retrieved using the selected keywords, 78 systematic reviews were included. The physiological effects of exercise on depression on general depression, depression secondary to various health issues, and depression caused by home quarantine were investigated across different ages and stages of life. Despite global consensus supporting regular physical exercise as an anti-anxiety and anti-depressant with no clinically significant side effects, the methodology of most articles in the field scientifically limits the generalizability of the findings and the ability to draw comprehensive conclusion. Conclusion: The positive effects of exercise, particularly aerobic regimens, on depression and anxiety are mediated by several physiological, neurobiological, and behavioral mechanisms. Most systematic reviews strongly recommend further studies with larger sample sizes, improved adherence to standard research methodologies, and longer intervention and follow-up periods. © 2025 Elsevier B.V., All rights reserved.