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defined dosages. A major review published in the British Journal of Sports Medicine in 2023 looked at data from a wide range of populations and found that exercise clearly reduces symptoms of both depression and anxiety. The effects were especially strong in people with other health conditions, like HIV or kidney disease, and in groups like pregnant and postpartum women. In many cases, the improvements seen were as good as, or even better than, those achieved with antidepressants or talk therapy. Another earlier study comprised of 111 prospective cohort studies found that regular physical activity lowers the risk of developing depression by about 31%, even for people who hadn’t previously struggled with their mental health. In addition, research shows that exercise helps not just with mood but also supports brain health and may lower the risk of dementia. Recent reviews have found that staying active is linked to a reduced chance of developing all types of dementia, including Alzheimer’s. This strengthens the idea that exercise is a powerful, changeable lifestyle factor that benefits mental health in many ways. So, how does exercise actually help? It’s not just about “blowing off steam” or distracting yourself. There are real biological changes that happen when we move our bodies. Exercise increases the levels of important brain chemicals like serotonin and dopamine, which help regulate mood. It also reduces inflammation, which is increasingly recognised as a factor in depression. Furthermore, exercise boosts brain-derived neurotrophic factor (BDNF). This molecule helps brain cells grow and survive, especially in the hippocampus, (the part of the brain that plays a key role in emotion and memory). People with depression often have a smaller hippocampus, but regular physical activity can help rebuild it over time. Interestingly, even a single workout can start to make a difference in how this part of the brain functions. The benefits of exercise also extend beyond the physical realm. Exercise gives people structure, helps them feel a sense of progress, and can help reconnect them with others which are things that are often missing when someone is struggling with their mental health. Whether it’s a morning walk, dancing in the kitchen, or a yoga class, moving your body helps you feel more in control, more present and more hopeful. And that, sometimes, is just what’s needed to shift things in the right direction. What should we prescribe? Practical guidance for clinicians Current guidelines recommend engaging in moderate physical activity three to five days a week, with each session lasting between 30 and 60 minutes (for adults). Moderate intensity is generally effective, where patients should aim for a pace at which they can talk but not sing. For those aged 5 to 17 (children and adolescents) guidelines recommend aiming for about 60 minutes of moderate to vigorous aerobic activity each day, as well as including activities that build muscle and bone strength at least three times a week to support overall health and development. Most importantly, consistency matters more than intensity. The primary goal is to help patients develop a sustainable habit of MHM | 2025 | Volume 12 | Issue 3 | Movement as Medicine: How Exercise Can Support Patients with Depression and Anxiety MHM Issue 3 | 2025 | MENTAL HEALTH MATTERS | 19 MHM