HIGH-INTENSITY exercise has increasingly been explored as a potential therapeutic intervention for depression, offering a non-pharmacological alternative or adjunct to traditional treatments. With growing interest in the mental health benefits of physical activity, this study sought to evaluate the effectiveness of high-intensity exercise in reducing depressive symptoms through a systematic review and meta-analysis of current evidence. A key finding is that high-intensity exercise was associated with a modest but statistically significant improvement in depression severity.
To conduct this review, the authors systematically searched PubMed, Embase, Cochrane, and Web of Science up to 30 June 2025. They included nine randomised controlled trials comprising a total of 514 participants: 193 assigned to high-intensity exercise interventions, and 321 to control conditions. Depression outcomes were assessed using standardised measures including the Hamilton Rating Scale for Depression (HRSD), Hamilton Depression Rating Scale (HAMD), Beck Depression Inventory (BDI-II), and others. Effect sizes were calculated using standardised mean differences (SMDs) with 95% confidence intervals. Subgroup and sensitivity analyses were performed to assess the robustness of findings and identify sources of heterogeneity.
The meta-analysis showed that high-intensity exercise significantly improved depression severity on the HRSD (SMD: -0.44; 95% CI: -0.69–-0.18; p=0.0008) and across overall depression scores (SMD: -0.23; 95% CI: -0.39–-0.07; p=0.006). However, other measures such as HAMD (p=0.14), BDI-II (p=0.28), and PHQ-9/MADRS/GDS (p=0.06) did not reach statistical significance. Maximal oxygen uptake (VO2max) also showed no significant difference (SMD: 0.29; p=0.27). Subgroup analysis revealed that long-term interventions were more effective than short-term ones, with older adults (60+) experiencing greater benefits than younger adults. High-intensity aerobic exercise was the most effective modality, followed by resistance training, while interval training was less impactful.
These findings support the potential role of high-intensity exercise as a supplementary approach to managing depression, particularly in older populations and when applied over longer durations. However, limitations such as small sample sizes, heterogeneity between studies, and lack of long-term follow-up reduce the certainty of the evidence. For clinical practice, high-intensity exercise could be considered as part of a personalised treatment plan, but further large-scale, multi-centre trials are needed to confirm these benefits and clarify optimal protocols.
Reference
Zeng J, Wang H. The impact of high-intensity exercise on patients with depression: a systematic review and meta-analysis of randomized controlled trials. Front Public Health. 2025;13:1616925.
