Exercise – It Works For Depression

I’m currently reading with great pleasure Tony Schwartz’s new book, The Way We’re Working Isn’t Working – The Four Forgotten Needs That Energize Great Performance. Schwartz’s main premise is that we need balance — between activity and rest on the physical level, between performance and renewal on the emotional level, between left and right brain on the mental level, and between inner and outer work on the spiritual level. If we don’t have this balance, we tread water — we may look like we’re high performers but compared to what we are capable of when we have balance, we don’t produce much, are not very creative, and don’t have as much fun, or as much impact, as we could have.

One chapter of the book is dedicated to movement. Schwartz cites an important study in it — the SMILE study (Standard Medical Intervention and Long-term Exercise, conducted at Duke University), which found that vigorous exercise three times a week for half an hour or forty-five minutes reduced symptoms of depression as effectively as antidepressants.

Figure from Psychosomatic Medicine 62:633-638 (2000)What Schwartz does not mention is that a follow-up study went even further. In the initial study, participants exercised for 16 weeks and were then given a depression test four months later. When participants were investigated another two months later, those that had kept up with the exercise were doing extremely well. When they were interviewed about depression symptoms, according to the Diagnostic and Statistical Manual (DSM IV) and the Hamilton Rating Scale for Depression, those who had exercised were more likely to be partially or fully recovered or were less likely to have relapsed than the group that had only taken medication (Zoloft) or taken medication and exercised. In fact, an illustration shows that there were approximately 60% more in the exercise group than those in the medication group who had recovered, and there were about six times more in the medication group who had relapsed compared to the exercise group.

Is exercise the solution to depression, then? Of course not. While the findings are truly impressive, there were many who had recovered with medication alone or with a combination of the two. There is always a tendency to take the main finding of a study and proclaim it to be the new truth – but neither life nor science is that simple. However, the study is something that we need to seriously think about, or better yet, try out ourselves. One thing is for certain: the benefits of exercise far outweigh its drawbacks.

The heading under which Schwartz talks about the initial SMILE study is “Move and Thrive”. For someone who is in the depths of a major depression, these two may seem far off, and getting oneself motivated to exercise can seem next to impossible. However, starting an exercise routine — or let’s call it a movement ritual, as Schwartz would (“exercise routine” always sounds so serious, doesn’t it?) — when one is not currently in the grips of depression may just be the thing that forestalls or at least alleviates the next bout.


Babyak M, Blumenthal JA, Herman S, Khatri P, Doraiswamy M, Moore K, Craighead WE, Baldewicz TT, & Krishnan KR (2000). Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months. Psychosomatic medicine, 62 (5), 633-8 PMID: 11020092

Blumenthal JA, Babyak MA, Moore KA, Craighead WE, Herman S, Khatri P, Waugh R, Napolitano MA, Forman LM, Appelbaum M, Doraiswamy PM, & Krishnan KR (1999). Effects of exercise training on older patients with major depression. Archives of internal medicine, 159 (19), 2349-56 PMID: 10547175

Isabella Mori

Isabella Mori is a psychotherapist in private practice in Vancouver. She has been working in the field of mental health, counseling, psychotherapy and movement therapy for 18 years.
See All Posts By The Author