Physical Activity as a Clinical Tool against Depression: Opportunities and Challenges

Depression is a major public health issue in numerous countries, with around 300 million people worldwide suffering from it. Typically, depressed patients are treated with antidepressants or psychological therapy or a combination of both. However, there are some limitations associated with these therapies and as a result, over the past decades a number of alternative or complementary therapies have been developed. Exercise is one such option that is supported by published extensive basic and clinical research data. The aim of this review was to examine the beneficial effects of exercise in depression. Physical activity and exercise have been shown to be effective in treating mild-to-moderate depression and in reducing mortality and symptoms of major depression. However, physical activity and exercise are still underused in clinical practice. This review attempts to propose a framework to help clinicians in their decision-making process, how to incorporate physical activity in their toolkit of potential therapeutic responses for depressed patients. We first summarize the interactions between depression and physical activities, with a particular focus on the potential antidepressant physiological effects of physical activity. We then identify some of the barriers blocking physical activity from being used to fight depression. Finally, we present several perspectives and ideas that can help in optimizing mitigation strategies to challenge these barriers, including actions on physical activity representations, ways to increase the accessibility of physical activity, and the potential of technology to help both clinicians and patients.