Clinical Inquiries: Does exercise alleviate symptoms of depression?

Yes. Exercise reduces patient-perceived symptoms of depression when used as monotherapy (strength of recommendation [SOR]: B, meta-analysis of randomized controlled trials [RCTs] with significant heterogeneity). It relieves symptoms as effectively as cognitive behavioral therapy (CBT) or pharmacologic anti-depressant therapy (SOR: B, meta-analysis) and more effectively than bright light therapy (SOR: B, meta-analysis). Resistance exercise and mixed exercise (resistance and aerobic) work better than aerobic exercise alone (SOR: B, meta-analysis). High-frequency exercise is more effective than low-frequency exercise (SOR: B, small RCT). "Mindful" exercise, which has a meditative focus, such as tai chi and yoga, also reduces symptoms of depression (SOR: B, systematic review of RCTs).