Depression remains one of the most common and disabling conditions worldwide. Researchers and clinicians increasingly recognize that recovery from Depression is not “one-size-fits-all.” For some, talk therapy and medication provide enough relief. For others, the benefits of exercise for Depression can offer life changing additions to their mental health regimens.
Movement, neuromodulation, and innovative medicines all have roles to play in overcoming the challenges of Major Depressive Disorder (MDD). A groundbreaking review published in The BMJ (2024) analyzed more than 200 clinical trials and over 14,000 participants. Its conclusion was powerful: the benefits of exercise for Depression—especially walking, jogging, yoga, and strength training—provide clinically meaningful relief for patients. Moreover, beyond Depression and movement, these strategies show great potential when amplified in conjunction with other treatment modalities.
What the BMJ Review Proved: The Benefits of Exercise for Depression are Clinically Significant
The BMJ review, a 2024 network meta-analysis of 218 randomized controlled trials, examined multiple forms of exercise in treating Depression. Its findings confirm what patients and clinicians have long suspected: structured physical activity is a powerful antidepressant, and should be seriously considered as a part of the patient recovery process. Many prominent clinicians and experts around the world have publicly supported the BMJ findings on the subject.
Clinical Findings on Depression and Movement Types
The research found that different types and intensities of exercise had varying effects on participants’ Depression, measured using Hedges’ g to account for standardised mean differences in datasets. The following results indicate the varying reduction that each type of exercise had on patients’ Depression across the meta-analysis in descending order:
- Walking and jogging: Showed the strongest impact (Hedges’ g ≈ –0.62), rivaling antidepressants in effect size.
- Yoga: g ≈ –0.55, combining physical movement with mindfulness and breathing practices.
- Strength training: g ≈ –0.49, emphasizing empowerment and resilience.
- Mixed aerobic exercise: g ≈ –0.43, such as cycling or group fitness.
- Tai chi or qigong: g ≈ –0.42, highlighting the benefits of low-impact, meditative exercise.
These effects are clinically significant, translating into noticeable reductions in depressive symptoms across each type of exercise, indicating a strong correlation between Depression and movement.
The Benefits of Exercise for Depression: How it Works
The BMJ review confirms that exercise is far from merely physical. It triggers neurochemical changes, boosting serotonin, dopamine, and endorphins. It enhances neuroplasticity, reduces inflammation, and regulates stress hormones. Just as important, it builds structure, mastery, and social engagement—all essential components in long-term recovery.
Who Benefits Most From Exercise for Depression?
The review found exercise effective across all ages and baseline severities, from mild to severe Depression. Importantly, supervised and structured programs produced better outcomes, reinforcing the need for accountability and support.
Caveats to the Study’s Findings: Exercise Alone May Not Be Enough
Evidence certainty ranged from low to very low, due to study biases and limited long-term follow-up. Still, with consistent results across hundreds of trials, the message is clear: exercise should certainly be part of frontline Depression care.
For many, exercise improves mood and resilience. But others face barriers—lack of energy, severe symptoms, or treatment-resistant Depression. In these cases, exercise may not be sufficient in isolation.
This is where advanced, evidence-based treatments come in. At Mid City TMS, we offer two of the most innovative options available today, Transcranial Magnetic Stimulation (TMS) and Esketamine (Spravato®). Both are FDA-approved, non-traditional approaches that work on brain systems untouched by standard antidepressants.
TMS: Gentle Brain Stimulation, Lasting Change
Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that uses gentle magnetic pulses to stimulate underactive areas of the brain linked to Depression. Sessions are performed in-office, are well-tolerated, and require no anesthesia or recovery time.
TMS activates the prefrontal cortex, the region tied to mood regulation; it enhances neuroplasticity, helping the brain form healthier circuits. It also offers durable benefits after a full treatment course (typically 7-8 weeks).
Large multicenter trials and years of clinical use show that TMS provides significant and lasting relief, even for those who did not respond to medications. When paired with findings on Depression and movement, the evidence supporting TMS helps to create a more comprehensive plan for patients moving forward with their treatment.
Esketamine: A Breakthrough Option
Esketamine (Spravato®) is a nasal spray derived from ketamine, targeting the brain’s glutamate system—a completely different mechanism than SSRIs or SNRIs. This allows for rapid symptom reduction, often noticeable within hours to days.
Studies like the TRANSFORM and SUSTAIN trials show Esketamine helps patients with treatment-resistant Depression and acute suicidal ideation (with rapid onset). Long-term, esketamine has also been found to delay relapse into TRD when paired with oral antidepressants.
It’s important to acknowledge that esketamine can cause temporary dissociation, dizziness, or increased blood pressure, which is why it is administered only in certified clinics under FDA REMS protocols. At Mid City TMS, patients receive Esketamine under close medical supervision in a calming, supportive environment.
The Incredible Synergy of Exercise, TMS, and Esketamine: Better Together
The BMJ review makes it clear: exercise is not a secondary recommendation—Depression and movement should be paired as a frontline treatment. Yet we also know many patients need more than just one line of defense against this challenging condition. At Mid City TMS, we are redefining what comprehensive care looks like: blending exercise, TMS, Esketamine, and psychotherapy to meet patients wherever they are in their journey.
The beauty of modern Depression care is that treatments no longer exist in silos. At Mid City TMS, we often see the greatest success when combining the benefits of exercise for Depression with neuromodulation or Esketamine. Exercise builds long-term resilience, energy, and structure, TMS reshapes neural circuits over the course of a few weeks, and esketamine provides rapid relief, creating the stability needed to re-engage in both life and therapy.
For many patients, esketamine or TMS reduces Depression just enough to make exercise possible again—creating a positive feedback loop that accelerates recovery. At Mid City TMS, we embrace this new evidence, using these options to restore our patients’ hope even when standard treatments have failed.
Creating a Patient-Centered Treatment Pathway
Here’s how a patient journey might look at Mid City TMS (or other practices) when incorporating Depression and movement with the above strategies:
- Comprehensive evaluation: We’ll assess a patient’s medical history, prior treatments, lifestyle, and goals.
- Incorporate exercise: Patients are guided toward feasible, structured routines (like walking programs or yoga classes).
- Add TMS or Esketamine if needed: For those not improving with exercise and standard therapies, advanced treatments are introduced.
- Ongoing support: Dr. Bruno, along with our experienced team will continue to monitor patient progress, adjust treatment as needed, and provide encouragement every step of the way.
This integrated model reflects our belief that Depression requires both science and compassion, and Mid City TMS is ready to offer both to our community.
Building a Comprehensive and Integrated Healing Strategy with Mid City TMS
Depression may feel overwhelming, but science shows there are multiple, effective ways forward, including a clinical gravitation towards making the most of the benefits of exercise for Depression. Exercise provides accessible, empowering relief—along with both TMS and Esketamine—each offering the possibility of new hope when traditional options fall short.
At Mid City TMS, we believe in tailoring care to the individual. Whether it’s through movement, magnetic stimulation, or rapid-acting medicine, we are here to help you reclaim your life. You don’t have to walk this road alone. Contact us today to explore exercise-based programs, Esketamine treatment, or TMS, and take your first step toward lasting recovery.
Sources
- Noetel, M., Sanders, T., Gallardo-Gómez, D., Taylor, P., Del Pozo Cruz, B., van den Hoek, D., Smith, J. J., Mahoney, J., Spathis, J., Moresi, M., Pagano, R., Pagano, L., Vasconcellos, R., Arnott, H., Varley, B., Parker, P., Biddle, S., & Lonsdale, C. Effect of exercise for depression: Systematic review and network meta-analysis of randomised controlled trials. BMJ. 2024;384:e075847. https://www.bmj.com/content/384/bmj-2023-075847
- BMJ Group. Walking, jogging, yoga, and strength training ease depression. BMJ Group. 2024. https://bmjgroup.com/walking-jogging-yoga-and-strength-training-ease-depression/
- Science Media Centre. Expert reaction to systematic review on exercise and depression. Science Media Centre. 2024. https://www.sciencemediacentre.org/expert-reaction-to-systematic-review-and-network-meta-analysis-on-the-effect-of-exercise-on-depression/
- Popova, V., Daly, E. J., Trivedi, M., Thase, M. E., Cooper, K., Lane, R., Lim, P., Jacobs, R., Zhang, Y., & Drevets, W. C. Efficacy and safety of flexibly dosed esketamine nasal spray combined with a newly initiated oral antidepressant in treatment-resistant depression: A randomized double-blind active-controlled study. The American Journal of Psychiatry. https://pubmed.ncbi.nlm.nih.gov/31109201/
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