I’m going to be sharing with everyone some recent research findings on a few exercise-based therapies for depression and anxiety.
Hopefully some of this will be useful.
Mental health, which includes emotional, psychological, and social well-being, affects the way that a person acts, thinks, and feels.
It is now well-established that mental health issues can increase a person’s risk of physical health problems, such as diabetes, heart disease and stroke. Conversely, chronic physical health conditions can increase the risk of mental health concerns.
In the US, it is estimated that more than one and five adults (20%) live with a mental illness (“any mental illness”). This is defined as a mental, behavioral or emotional disorder that can vary in its impact from mild to severe.
Exercise
The strength of recommendation according to research is “conditional”.
Over the years, exercise has become a well-accepted tool for the management of depression and anxiety.
In fact, the American Psychiatric Association’s guideline on the treatment of depression acknowledges exercise as a relevant and beneficial treatment modality for all severities of depression.
For mild depression, the guideline indicates that a patient may elect to try exercise as a sole treatment for their symptoms for the first several weeks.
As for patients with more severe depression and or those who are using other treatments, exercise is considered a reasonable addition to any treatment plan.
A 2023 meta-analysis pooled together more than 90 studies to assess the overarching benefits of exercise for the management of depression, anxiety, and stress.
The analysis found that physical activity had medium benefits for all three conditions when compared with usual care.
Some of the largest benefits were seen in people with depression, certain chronic conditions, and pregnant and postpartum females.
Higher intensity interventions were associated with greater improvements, although the benefits of physical activity appeared to wane over time.
A separate, large meta-analysis pooled data from more than 200 studies in people with depression.
That analysis determined that certain forms of exercise, including walking or jogging, strength training, mixed aerobic exercises, yoga, and tai chi or qi gong, offered the greatest benefits.
Yoga
Let’s look at what research says about doing yoga for mental health benefits.
Yoga is a form of meditative physical activity that originated from a traditional system of medicine in India: Ayurveda.
Yoga generally involves controlled breathing, meditation, and body posturing, although there are many subtypes of yoga which involve differing levels of physical activity.
The evidence to date indicates that practicing yoga for one or two months can improve symptoms of depression in people with mild or new-onset depression.
Additionally, it appears to be beneficial as an adjunct therapy in people who are taking conventional antidepressants.
Importantly, most of these studies evaluated the use of “Western yoga,” which tends to entail a greater focus on physical yoga poses.
Research on the use of yoga for anxiety is limited to smaller clinical studies. However, that research does suggest that practicing differing styles of yoga can modestly improve symptoms of anxiety when compared with a control or other active treatment.
Qi gong and tai chi
“Qi gong is a martial art-like exercise with a focus on meditation and breathing that originated in China. It is intended to regulate the body’s qi (vital energy or life force).
There are several varieties of qi gong, with some that involve slow movements and exercise and others that involve bodywork conducted by a trained professional.
Tai chi is one specific form of qi gong that has become relatively popular in North America. This form of exercise involves controlled breathing and slow, rhythmic body movements which are intended to facilitate the flow of qi.
Small clinical studies suggest that practicing qi gong for 90-530 minutes each week for up to four months can reduce symptoms of depression when compared with various control groups.
Tai chi has also been evaluated in people with depression, although these studies have been relatively small.
While one study suggests that practicing tai chi for two hours weekly for 10 weeks can improve symptoms when compared with simple health education, a follow-up study in this same group of patients did not ultimately identify additional benefits with tai chi.
A meta-analysis of 10 clinical studies in healthy adults, some of which were low-quality and not randomized, shows that practicing tai chi five times weekly for a year can modestly improve anxiety symptoms when compared with a wait-list or control group.
However, it did not seem to improve depressive symptoms or stress.”
All of the alternative therapy research I’ve been sharing is coming from a team of mental health professionals through a continuing education provider.
Our field has been lacking in this area, so it is important to me to get this information out there.
Have you ever tried qi gong or tai chi? I haven’t.
Reference
I received this information while attending a continuing education course on Alternative Therapies for Anxiety and Depression.
American Psychiatric Association. Practice Guideline for the Treatment of
Patients with Major Depressive Disorder, Third Edition. Available
at https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/g
uidelines/mdd-1410197717630.pdf. Last accessed December 13, 2024.
Singh B, Olds T, Curtis R, et al. Effectiveness of physical activity interventions
for improving depression, anxiety and distress: an overview of systematic
reviews. Br J Sports Med. 2023;57(18):1203-1209.
Lin IH, Huang CY, Chou SH, Shih CL. Efficacy of prenatal yoga in the
treatment of depression and anxiety during pregnancy: a systematic review
and meta-analysis. Int J Environ Res Public Health. 2022;19(9):5368.
Jiang X, Li H, Wang D, Shan L, Wang F, Kang Y. Efficacy of nondrug
interventions in perinatal depression: a meta-analysis. Psychiatry Res.
2022;317:114916.
Wang G, Liang C, Sun G. Yoga’s therapeutic effect on perinatal depression: a
systematic review and meta-analysis. Psychiatr Danub. 2022;34(2):195-204.
Liu L, Liu C, Liu X, Yang Y. Summary of the effect of an exercise intervention
on antenatal depression and the optimal program: a systematic review and
meta-analysis. BMC Pregnancy Childbirth. 2023;23(1):293.
Guo L, Kong Z, Zhang Y. Qigong-based therapy for treating adults with major
depressive disorder: a meta-analysis of randomized controlled trials. Int J
Environ Res Public Health. 2019;16(5):826.
Lavretsky H, Alstein LL, Olmstead RE, et al. Complementary use of tai chi
chih augments escitalopram treatment of geriatric depression: a
randomized controlled trial. Am J Geriatr Psychiatry. 2011;19(10):839-850.
Liu X, Li R, Cui J, et al. The effects of tai chi and qigong exercise on
psychological status in adolescents: a systematic review and meta
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