A New Study Asks, “Can Running Really Replace Antidepressants?”

There’s no doubt running – or any exercise, for that matter – is good for mental health. From elevating your mood (the “runner’s high” is real!) to reducing stress, study after study shows the benefits of training are not just physical. “Running is my therapy” is a common refrain, implying that some endurance athletes can use training to manage their mental health. That’s a great thing! But can running flat-out replace certain mental health treatments, like antidepressant medication? A new study is getting a lot of attention for asking just that.

Titled “Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders,” the researchers behind the study investigated the impact of running on two of the most common mental health issues: depression, which affects more than 21 million American adults each year; and anxiety, which affects 42.5 million American adults, according to Mental Health America. Of those, an estimated 56% do not receive treatment, and we know from additional research that mental health issues are more prevalent in the endurance athlete community.

Here, I summarize the findings of the current study on running vs. antidepressants and suggest some other ways to help those dealing with depression and anxiety.

Summary of the study

The study was set up to compare the impact of antidepressants and running therapy on mental and physical health over 16 weeks. Participants were ages 18-70 with a diagnosed depressive disorder or anxiety disorder. Prior to the study, participants did not exercise more than once per week and weren’t currently taking antidepressants. They were divided into two groups:

1. An antidepressant group
2. A running therapy group

For the antidepressant group, medications were prescribed and monitored by a psychiatrist. The running therapy group involved at least two 45-minute running sessions per week, and education on injury, sleep, and nutrition.

Findings

Mental health

The study found both running therapy and antidepressants were equally effective in decreasing depression and anxiety symptoms.  At week 16, 45% of the antidepressant group and 43% of the running group no longer had a  diagnosable depression or anxiety disorder.

Interestingly enough, antidepressants worked faster in reducing symptoms at the beginning (particularly for anxiety), but running therapy caught up in symptom reduction, with no measurable difference by the end.

However, treatment compliance was significantly higher in the medication group. It was easier for people to take medications as prescribed than to complete the running therapy. Only 52% of the running therapy group completed the study in compliance, whereas 82.2% completed the antidepressant medication group.

Physical health

Unsurprisingly, the running therapy group improved their physical health much more than the antidepressant group. They found more improvement in weight, blood pressure, heart rate, lung capacity and other measures.  The study found deterioration in the physical health outcomes of the antidepressant group. Some of these negative physical health effects are often reported as side effects of selective serotonin reuptake inhibitors (SSRIs), the most commonly-prescribed class of drugs for depression treatment.

The authors concluded that exercise therapy should be considered a standard practice for those with depression and anxiety, and caution should be used when prescribing antidepressants with physically unhealthy patients.

Does this mean I can go off my medications?

If you are dealing with depression or anxiety, the first step is to see a licensed provider for an assessment. Mental health providers will work with you to figure out what is best for you. The study authors mentioned that for many severe conditions, exercise therapy may be used as a complementary treatment along with medication.

If you are on antidepressants, do not change your use of medication without consultation with your provider. If you want to try running therapy, work with your doctor to monitor its effectiveness. The study showed improvement for those who were not already physically active. Your results might be different.

It’s important to recognize that a larger percentage of people in the study still reported symptoms post-participation. This is a reminder that alleviating depression and anxiety can be complex. Don’t make any rash decisions or be judgmental of your own process as you figure out what works best.

Building your mental health toolbox

As we can see from this study, it’s not so simple as saying “running is my therapy” and leaving it at that. When it comes to mental health, there is no one silver bullet or cure-all—medication, exercise, or otherwise. Instead, it’s best to take a holistic approach, evaluating all aspects of your life to discover opportunities to prioritize and care for yourself. In addition to exercise and working with a mental health professional, consider equipping yourself with as many tools as you can in your mental health toolbox. These include:

1. Sleep and rest: Sleep has many important mental and physical functions. It’s hard to have good mental or physical health without good quality sleep.
2. Balanced nutrition: Your nutrition significantly impacts your ability to overcome mental health challenges. Getting away from diet culture, fasting, and restrictions is helpful. If you struggle with food, it may be helpful to meet with a Registered Dietitian who has experience working with athletes.
3. Strong social connection and relationships: Our current lives can keep us isolated and struggling with our own problems. Make sure you are talking to friends, family, neighbors and people in your community. If you struggle with this, please reach out to a therapist.
4. Purpose and meaning: Connect beyond yourself and your current concerns. Some examples could be caring for others, doing work that feels purposeful, exploring and being connected to the environment, spending time with loved ones, or involvement in spirituality.
5. Self-awareness: Do you deeply understand your needs, thoughts, feelings and behaviors? How do you relax and take care of yourself? When do you need extra help? Taking time to reflect and answer these questions will help you find solutions to some challenges.
6. Enjoyment and fun: Incorporate happiness, fun, and joy to help you get through many of the difficulties that impact mental health.

For more consider reading Mental Health Resources for Triathletes. Coaches might also find value in this primer: What Coaches Need to Know About Mental Health.

It is a lifelong journey to build and use your mental skills toolbox, and the details of what’s in those boxes can change based on life stage and circumstances. So keep paying attention to what your mind and body are telling you, and remember – you’re not in this alone. Though a run can be a great way to boost mental health, it’s not a panacea – it’s just one of many tools available as you build a better, healthier you.