Exercise and mental health: how movement helps depression and anxiety

Regular exercise reduces symptoms of depressionDepressionA medical condition in which low mood or loss of interest lasts most of the day, nearly every day, for at least two weeks, and affects sleep, energy and daily life.Read the full definition and anxietyAnxiety disorderWorry or fear that is stronger than the situation calls for, lasts for weeks or months, and gets in the way of daily life. Anxiety disorders are common and treatable.Read the full definition, and the evidence is strong enough that guidelines now include it as a treatment. Walking, jogging, yoga and strength training all help. You do not need a gym: a brisk daily walk counts, and even short bouts are better than none. For mild to moderate symptoms exercise can be a main part of treatment; for severe illness it works alongside, not instead of, medical care.

That is not the same as telling a depressed person to "just go for a walk". Low mood drains energy and motivation, so the hard part is starting. This page covers what the evidence shows, how much is enough, and how to make it realistic — including for women who cannot easily exercise outside the home.

What the evidence shows

The largest recent analysis, published in the BMJ in 2024 by Michael Noetel and colleagues, combined 218 randomised trials with more than 14,000 people who had depression. Compared with control treatments, walking or jogging, yoga, strength training, mixed aerobic exercise, and tai chi or qigong all produced moderate reductions in depression. The effects were larger when exercise was more vigorous, when it was done in groups, and when it followed a clear programme. Strength training and yoga had the fewest drop-outs.

The authors concluded that exercise could be considered alongside talking therapy and antidepressants as a core treatment for depression. They were also frank about the limits: only one study met the strictest standard for low risk of bias, and confidence in the findings was rated low for walking or jogging and very low for the other types, partly because people always know whether they are exercising. Independent experts made the same points, and stressed that for someone who can barely get out of bed, exercise alone is not enough.

For anxiety, a 2023 overview in the British Journal of Sports Medicine pulled together 97 systematic reviews covering more than 1,000 trials. It found medium-sized benefits of physical activity for depression, and similar benefits for anxiety and psychological distress, across healthy adults and people with long-term illnesses, and during and after pregnancy. Higher-intensity activity was linked to greater improvement.

Why it might help

The mechanisms are not fully understood, and it is better to say so than to repeat claims about "endorphin rushes". Likely contributors include better sleep, a sense of achievement and control, a break from ruminationRuminationGoing over the same upsetting thoughts again and again — why something happened, what it means, what is wrong with you — without reaching a solution. It deepens low mood.Read the full definition, time outdoors and with other people, and physical changes in the body's stress systems. Exercise also works through the same route as behavioural activationBehavioural activationA structured therapy for depression that gets you back into rewarding and meaningful activities in small, planned steps, rather than waiting until you feel like it.Read the full definition, a proven therapy for depression: doing planned, rewarding activity even before the mood improves, rather than waiting to feel like it.

How much is enough

The World Health Organization recommends that adults do 150–300 minutes of moderate-intensity activity a week (for example 30 minutes on five days), or 75–150 minutes of vigorous activity, plus muscle-strengthening exercises on two or more days. Moderate means you are breathing faster and can talk but not sing; vigorous means you can only say a few words at a time.

Those are targets, not entry requirements. The NHS puts it plainly: any exercise is better than none, and even a brisk 10-minute walk can clear your mind. For someone who is depressed and currently does nothing, a daily 10-minute walk is a genuine start.

Options for women who exercise at home

Many women in Pakistan face real barriers to exercising outside: safety, family expectations, heat, lack of women-only spaces, and the demands of housework and children. None of these makes exercise impossible, and home-based activity is effective.

• Walk where you can: on the roof in the early morning or evening, around the courtyard, or up and down the stairs.
• Follow a video: free home workout, yoga and stretching videos need no equipment. Ten to twenty minutes is enough to start.
• Walk with company: a sister-in-law, neighbour or daughter makes it more acceptable, safer and more enjoyable, and a group helps motivation.
• Use strength at home: squats while the kettle boils, wall push-ups, step-ups on a low stair, lifting filled water bottles.
• Use the cool hours: after Fajr or after Maghrib in summer; in Ramadan, a gentle walk after iftar.
• Ask for time, not permission to be unwell: a 20-minute walk framed as doctor-advised treatment is often easier for a family to support.

Safety and when to be careful

• If you have diabetes and take insulin or a sulfonylurea (such as gliclazide or glimepiride), exercise can cause low blood sugarHypoglycaemiaBlood sugar that has fallen too low, usually below 70 mg/dL. It comes on within minutes and needs sugar immediately.Read the full definition. Check your sugar and carry something sweet — see our page on exercise and diabetes.
• Chest pain, unusual breathlessness, fainting or palpitations during exercise mean stop and see a doctor before continuing.
• If you have heart disease, uncontrolled high blood pressureHypertensionHypertension is blood pressure that stays high enough, over repeated proper measurements, to damage the arteries over time. It almost never causes symptoms, which is why it is found by measuring rather than by feeling unwell.Read the full definition, a recent operation or are pregnant with complications, ask your doctor what is safe first.
• In an eating disorderEating disorderA mental health condition in which a person uses control of food, eating or weight to cope with feelings. Eating disorders can seriously harm the body and are treatable.Read the full definition, exercise can become compulsive and harmful. Exercise plans should be made with the treating team.
• During maniaManiaA period of abnormally high or irritable mood with greatly increased energy, little need for sleep, racing thoughts and risky behaviour, lasting a week or more. It defines bipolar I disorder.Read the full definition or hypomaniaHypomaniaA milder form of mania: several days of raised or irritable mood, more energy and less need for sleep, noticeable to others but without psychosis or the need for hospital.Read the full definition, a sudden burst of intense exercise can be part of the illness rather than a sign of recovery.
• In heat above the high 30s °C, exercise indoors or in the coolest part of the day, and drink water.

Getting started when you feel low

1. Start smaller than you think you need to. Five to ten minutes of walking is a success.
2. Pick a fixed cue. After lunch, after Asr, or when the children leave for school.
3. Plan it with someone. A walking partner turns an intention into an appointment.
4. Do it before you feel like it. Motivation tends to follow action, not the other way round.
5. Track days, not results. Tick the calendar. Mood improvements usually take a few weeks.
6. Build up gradually towards 30 minutes on most days, adding strength exercises twice a week.
7. Tell your doctor you have started. Exercise can be part of your treatment plan, and your doctor can adjust other treatment accordingly.