Exercise as first‑line depression therapy

A high‑quality Cochrane meta‑analysis of 73 randomized trials (~5,000 people) finds exercise—especially combined aerobic plus resistance training, 13–36 sessions, light‑to‑moderate intensity—produces depressive‑symptom improvements comparable to antidepressants and psychotherapies. The review cites overlapping biological mechanisms (serotonin/dopamine, BDNF) and suggests underuse in practice despite guideline recognition. — If exercise is equivalently effective, health systems and guideline bodies should reallocate resources toward scalable exercise programs, clinical referral pathways, and reimbursement models that make physical‑activity treatment accessible as a bona fide first‑line option.