PHYSICAL ACTIVITY IN PSYCHIATRY: MECHANISMS AND EFFICACY IN THE INTEGRATED TREATMENT OF DEPRESSION
Abstract
Depression is a serious mental disorder that manifests itself primarily as sadness, lack of energy, and reduced activity, which often hinders normal functioning. People who struggle with depression often feel overwhelmed by their lives. This mental disorder can take a variety of forms, ranging from temporary mood swings in everyday life to a serious clinical condition with significant symptoms and additional signs that clearly differ from what is considered normal. Treatment includes both pharmacotherapy and psychological therapy. Evidence for the effectiveness of this approach is solid and supported by numerous studies. However, it is worth noting that each patient is unique in terms of mental health and should be treated individually. Therefore, alternative methods may be considered and their effectiveness in the prevention and treatment of mental illnesses of civilization, especially in the context of depression, may be tested. An analysis of the available literature indicates that high levels of physical activity and regular exercise have a protective effect against depression. In combination with other forms of treatment, exercise and physical activity can contribute to a faster improvement in patients' health. This publication is a review and focuses on standardizing the definition of depression in relation to its significance in combination therapy. Physiological mechanisms that show how physical activity affects well-being were examined. The work is based on scientific research in the context of clinical trials. Practical tips on physical activity in cases of depression are also included, and obstacles and limitations are discussed.
References
Bendau, A., Petzold, M. B., Kaminski, J., Plag, J., & Ströhle, A. (2024). Exercise as Treatment for “Stress-Related” Mental Disorders. Current Neuropharmacology, 22(3), 420–436. https://doi.org/10.2174/1570159X22666230927103308
Borsoi, M., Antonio, C. B., Viana, A. F., Nardin, P., Gonçalves, C.-A., & Rates, S. M. K. (2015). Immobility behavior during the forced swim test correlates with BNDF levels in the frontal cortex, but not with cognitive impairments. Physiology & Behavior, 140, 79–88. https://doi.org/10.1016/j.physbeh.2014.12.024
Chen, C., Beaunoyer, E., Guitton, M. J., & Wang, J. (2022). Physical Activity as a Clinical Tool against Depression: Opportunities and Challenges. Journal of Integrative Neuroscience, 21(5). https://doi.org/10.31083/j.jin2105132
Chen, J., Fang, X., Zhang, F., Shen, J., Liu, Y., Xu, P., Ye, R., Zhong, Q., Chen, G., Wang, Z., Chen, S., Li, L., Lin, Z., & Gao, Y. (2024). The associations of chronic pain and 24-h movement behaviors with incident mental disorders: evidence from a large-scale cohort study. BMC Medicine, 22(1), 313. https://doi.org/10.1186/s12916-024-03534-5
Choi, K. W., Chen, C.-Y., Stein, M. B., Klimentidis, Y. C., Wang, M.-J., Koenen, K. C., & Smoller, J. W. (2019). Assessment of Bidirectional Relationships Between Physical Activity and Depression Among Adults. JAMA Psychiatry, 76(4), 399. https://doi.org/10.1001/jamapsychiatry.2018.4175
Craft, L. L., & Perna, F. M. (2004). The Benefits of Exercise for the Clinically Depressed. The Primary Care Companion For CNS Disorders, 6(3). https://doi.org/10.4088/PCC.v06n0301
Dean, J., & Keshavan, M. (2017). The neurobiology of depression: An integrated view. Asian Journal of Psychiatry, 27, 101–111. https://doi.org/10.1016/j.ajp.2017.01.025
Depression in adults: treatment and management NICE guideline. (2022). www.nice.org.uk/guidance/ng222 (Access 11.08.2025)
Ghalandari-Shamami, M., Nourizade, S., Yousefi, B., Vafaei, A. A., Pakdel, R., & Rashidy-Pour, A. (2019). Beneficial Effects of Physical Activity and Crocin Against Adolescent Stress Induced Anxiety or Depressive-Like Symptoms and Dendritic Morphology Remodeling in Prefrontal Cortex in Adult Male Rats. Neurochemical Research, 44(4), 917–929. https://doi.org/10.1007/s11064-019-02727-2
Greenberg, P. E., Fournier, A.-A., Sisitsky, T., Simes, M., Berman, R., Koenigsberg, S. H., & Kessler, R. C. (2021). The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018). PharmacoEconomics, 39(6), 653–665. https://doi.org/10.1007/s40273-021-01019-4
Heissel, A., Heinen, D., Brokmeier, L. L., Skarabis, N., Kangas, M., Vancampfort, D., Stubbs, B., Firth, J., Ward, P. B., Rosenbaum, S., Hallgren, M., & Schuch, F. (2023). Exercise as medicine for depressive symptoms? A systematic review and meta-analysis with meta-regression. British Journal of Sports Medicine, 57(16), 1049–1057. https://doi.org/10.1136/bjsports-2022-106282
Hohls, J. K., König, H.-H., Quirke, E., & Hajek, A. (2021). Anxiety, Depression and Quality of Life—A Systematic Review of Evidence from Longitudinal Observational Studies. International Journal of Environmental Research and Public Health, 18(22), 12022. https://doi.org/10.3390/ijerph182212022
Huang, W., Ji, Y., Duan, N., Zheng, H., Qian, R., Wang, K., Li, J., & Tian, Y. (2025). Age‐Dependent Efficacy of Electroconvulsive Therapy in Depression: A Longitudinal Study of Symptom Trajectories and Treatment Predictions. Brain and Behavior, 15(4). https://doi.org/10.1002/brb3.70487
Jain, S., Gupta, S., Li, V. W., Suthoff, E., & Arnaud, A. (2022). Humanistic and economic burden associated with depression in the United States: a cross-sectional survey analysis. BMC Psychiatry, 22(1), 542. https://doi.org/10.1186/s12888-022-04165-x
Jin, Y., Sun, L. H., Yang, W., Cui, R. J., & Xu, S. B. (2019). The Role of BDNF in the Neuroimmune Axis Regulation of Mood Disorders. Frontiers in Neurology, 10. https://doi.org/10.3389/fneur.2019.00515
Kim, H., Lee, K., Lee, Y. H., Park, Y., Park, Y., Yu, Y., Park, J., & Noh, S. (2023). The Effectiveness of a Mobile Phone–Based Physical Activity Program for Treating Depression, Stress, Psychological Well-Being, and Quality of Life Among Adults: Quantitative Study. JMIR MHealth and UHealth, 11, e46286. https://doi.org/10.2196/46286
Kouba, B. R., de Araujo Borba, L., Borges de Souza, P., Gil-Mohapel, J., & Rodrigues, A. L. S. (2024). Role of Inflammatory Mechanisms in Major Depressive Disorder: From Etiology to Potential Pharmacological Targets. Cells, 13(5), 423. https://doi.org/10.3390/cells13050423
Kupferberg, A., & Hasler, G. (2023). The social cost of depression: Investigating the impact of impaired social emotion regulation, social cognition, and interpersonal behavior on social functioning. Journal of Affective Disorders Reports, 14, 100631. https://doi.org/10.1016/j.jadr.2023.100631
Lee, J., Kim, J., & Ory, M. G. (2024). The impact of immersive virtual reality meditation for depression and anxiety among inpatients with major depressive and generalized anxiety disorders. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1471269
Loomes, M. W., & Rosenbaum, S. (2023). Exercise and Psychotherapy in the Treatment of Anxiety Disorders (pp. 1–21). https://doi.org/10.4018/978-1-6684-6040-5.ch001
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. (2024). Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ, e075847. https://doi.org/10.1136/bmj-2023-075847
Pearce, M., Garcia, L., Abbas, A., Strain, T., Schuch, F. B., Golubic, R., Kelly, P., Khan, S., Utukuri, M., Laird, Y., Mok, A., Smith, A., Tainio, M., Brage, S., & Woodcock, J. (2022). Association Between Physical Activity and Risk of Depression. JAMA Psychiatry, 79(6), 550. https://doi.org/10.1001/jamapsychiatry.2022.0609
Pompili, M., Trocchia, M. A., Longhini, L., Dispenza, E., Di Legge, C., Sarubbi, S., Erbuto, D., & Berardelli, I. (2025). Efficacy of Intranasal Esketamine in Treatment‐Resistant Depression: A Six‐Month Real‐World Follow‐Up Study of Depressive Symptoms, Hopelessness, and Suicide Risk. Human Psychopharmacology: Clinical and Experimental, 40(4). https://doi.org/10.1002/hup.70008
Recchia, F., Bernal, J. D. K., Fong, D. Y., Wong, S. H. S., Chung, P.-K., Chan, D. K. C., Capio, C. M., Yu, C. C. W., Wong, S. W. S., Sit, C. H. P., Chen, Y.-J., Thompson, W. R., & Siu, P. M. (2023). Physical Activity Interventions to Alleviate Depressive Symptoms in Children and Adolescents. JAMA Pediatrics, 177(2), 132. https://doi.org/10.1001/jamapediatrics.2022.5090
Ross, R. E., VanDerwerker, C. J., Saladin, M. E., & Gregory, C. M. (2023). The role of exercise in the treatment of depression: biological underpinnings and clinical outcomes. Molecular Psychiatry, 28(1), 298–328. https://doi.org/10.1038/s41380-022-01819-w
Sampasa-Kanyinga, H., Colman, I., Goldfield, G. S., Janssen, I., Wang, J., Podinic, I., Tremblay, M. S., Saunders, T. J., Sampson, M., & Chaput, J.-P. (2020). Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: a systematic review. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 72. https://doi.org/10.1186/s12966-020-00976-x
Sampogna, G., Toni, C., Catapano, P., Rocca, B. Della, Di Vincenzo, M., Luciano, M., & Fiorillo, A. (2024). New trends in personalized treatment of depression. Current Opinion in Psychiatry, 37(1), 3–8. https://doi.org/10.1097/YCO.0000000000000903
Saran, T., Mazur, A., & Łukasiewicz, J. (2021). The significance of physical activity in the prevention of depressive disorders. Psychiatria Polska, 55(5), 1025–1046. https://doi.org/10.12740/PP/OnlineFirst/118054
Schuch, F. B., Vancampfort, D., Richards, J., Rosenbaum, S., Ward, P. B., & Stubbs, B. (2016). Exercise as a treatment for depression: A meta-analysis adjusting for publication bias. Journal of Psychiatric Research, 77, 42–51. https://doi.org/10.1016/j.jpsychires.2016.02.023
Schwefel, M. K., Kaufmann, C., Gutmann, G., Henze, R., Fydrich, T., Rapp, M. A., Ströhle, A., Heissel, A., & Heinzel, S. (2025). Effect of physical exercise training on neural activity during working memory in major depressive disorder. Journal of Affective Disorders, 372, 269–278. https://doi.org/10.1016/j.jad.2024.12.016
Singh, B., Olds, T., Curtis, R., Dumuid, D., Virgara, R., Watson, A., Szeto, K., O’Connor, E., Ferguson, T., Eglitis, E., Miatke, A., Simpson, C. E., & Maher, C. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. British Journal of Sports Medicine, 57(18), 1203–1209. https://doi.org/10.1136/bjsports-2022-106195
Sumińska, S. (2021). The impact of physical activity on cognitive functions. Medycyna Pracy. https://doi.org/10.13075/mp.5893.01103
Sun, C., Wang, Y., Fang, Y., He, Y., Wang, X., So, B. C. L., Shum, D. H. K., & Yan, C. (2022). The effect of physical activity on anhedonia in individuals with depressive symptoms. PsyCh Journal, 11(2), 214–226. https://doi.org/10.1002/pchj.485
Tang, A. L., & Thomas, S. J. (2020). Relationships Between Depressive Symptoms, Other Psychological Symptoms, and Quality of Life. Psychiatry Research, 289, 113049. https://doi.org/10.1016/j.psychres.2020.113049
TSYHANOVSKA, N., SKALSKI, D. W., FILIPKOWSKA, D., & KREFT, P. (2025). WPŁYW AKTYWNOŚCI FIZYCZNEJ NA REDUKCJĘ STRESU I REGULACJĘ EMOCJI. PHYSICAL CULTURE AND SPORT: SCIENTIFIC PERSPECTIVE, 2(1), 213–320. https://doi.org/10.31891/pcs.2025.1(1).106
Tustin, J. L., Crowcroft, N. S., Gesink, D., Johnson, I., Keelan, J., & Lachapelle, B. (2018). User-Driven Comments on a Facebook Advertisement Recruiting Canadian Parents in a Study on Immunization: Content Analysis. JMIR Public Health and Surveillance, 4(3), e10090. https://doi.org/10.2196/10090
White, R. L., Vella, S., Biddle, S., Sutcliffe, J., Guagliano, J. M., Uddin, R., Burgin, A., Apostolopoulos, M., Nguyen, T., Young, C., Taylor, N., Lilley, S., & Teychenne, M. (2024). Physical activity and mental health: a systematic review and best-evidence synthesis of mediation and moderation studies. International Journal of Behavioral Nutrition and Physical Activity, 21(1), 134. https://doi.org/10.1186/s12966-024-01676-6
Wu, J., Shao, Y., Zang, W., & Hu, J. (2025). Is physical exercise associated with reduced adolescent social anxiety mediated by psychological resilience?: evidence from a longitudinal multi-wave study in China. Child and Adolescent Psychiatry and Mental Health, 19(1), 17. https://doi.org/10.1186/s13034-025-00867-8
Wu, S., Yin, Y., & Du, L. (2022). Blood–Brain Barrier Dysfunction in the Pathogenesis of Major Depressive Disorder. Cellular and Molecular Neurobiology, 42(8), 2571–2591. https://doi.org/10.1007/s10571-021-01153-9
Zhao, X.-D., Oh, S.-S., Zhang, Z., & Wang, C. (2025). Move your body, stay away from depression: a systematic review and meta-analysis of exercise-based prevention of depression in middle-aged and older adults. Frontiers in Public Health, 13. https://doi.org/10.3389/fpubh.2025.1554195
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