New research shows how effective resistance training can be in managing mental health symptoms.
There’s no doubt that working out makes you feel good. But could exercise be a stand-in for traditional mental health care? When it comes to managing symptoms, the short answer is yes.
One 2023 meta-analysis — which looked at nearly 100 meta-reviews of randomized controlled trials — published in the British Journal of Sports Medicine declared that exercise should be a “mainstay approach” in the management of depression, anxiety, and other forms of psychological distress.
Researchers have also honed in on how specific types of exercise can help. In young people, 30 to 60 minutes of resistance exercise done three to four times a week was found to be the most effective type of exercise to improve depression and anxiety, a June 2023 meta-analysis published in the journal Frontiers in Psychiatry reported. Strength training outranked aerobic exercise, mixed exercise, and mind-body exercise (although all had mental health benefits).
Resistance training was also determined to be an effective intervention for reducing depression symptoms in older adults, according to a September 2023 study in Geriatric Nursing. It improved anxiety symptoms in adults, as well, a 2017 meta-analysis published in Sports Medicine found.
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So how do muscle-strengthening activities specifically boost mood? That 2023 meta-analysis hypothesized that exercise interventions may mitigate anxiety by influencing the hypothalamic-pituitary-adrenal axis and reducing the glucocorticoid (aka “fight-or-flight”) response to stressful stimuli. “The hypothalamic-pituitary-adrenal axis plays a huge role in regulating our response to stress, our perceived stress, and our physiological responses to stress,” explains Toby Pasman, a board-certified neurophysiologist.
The second study pointed to improved circulating levels of brain-derived neurotrophic factor (BDNF), a molecule involved in memory and learning. “There’s a very strong correlation between diminished BDNF levels and a variety of different mental health issues, including depression and anxiety,” says Pasman. BDNF plays a major role in neuroplasticity (strengthening existing connections between neurons) and neurogenesis (forming new neurons), both of which can have big effects on overall mental health.
Resistance training, like all exercise, also triggers the production of neurotransmitters such as endorphins, dopamine, serotonin, and norepinephrine, which can improve mood and increase motivation, drive, and alertness, says Pasman. Strength training has been shown to reduce C-reactive protein, an inflammatory marker specifically linked to depression, as well, he adds; in a 2012 study published in the Journal of Research in Medical Sciences, strength training reduced C-reactive proteins by 20 percent, anxiety by 27 percent, and depression by 30 percent.
“Another huge factor is increases in brain blood flow and oxygenation as the result of doing resistance training,” says Pasman. “Better blood flow and oxygen to the brain is going to correlate to better mood, better focus, less anxiety, and better sleep.”
Better blood flow and oxygen to the brain is going to correlate to better mood, better focus, less anxiety, and better sleep.
What’s more, strength training can improve mitochondrial function, he adds. The mitochondria are the powerhouses of your cells, and “the brain — specifically the prefrontal cortex, which plays a big role in mood regulation — is chock-full of them,” Pasman explains. Increased mitochondrial function benefits your workouts by driving more energy to your muscles, but it also supports your mental health; several studies have found a relationship between mitochondrial dysfunction and mood disorders.
And then, of course, there’s the psychological aspect, which you’ve probably experienced yourself. “I think strength training builds a lot of confidence in people,” says Pasman. “It develops mental fortitude, in that you’re consciously choosing to put yourself through something that you know is beneficial long-term even if it’s unpleasant in the short-term.” That kind of life lesson may be harder to study in a lab, but it certainly isn’t limited to the gym.
No matter the exact mechanism, it doesn’t take much to tap into the mental health benefits of resistance training. The Physical Activity Guidelines for Americans, which were updated in 2018, recommend muscle-strengthening activities on two or more days a week. From a mental health perspective, that number was backed up by a 2018 meta-analysis published in the journal JAMA Psychiatry. In looking at 33 randomized clinical trials involving 1,877 participants, researchers determined that performing resistance training two or more days a week led to "significant" reductions in symptoms for people with mild to moderate depression. It didn’t matter how many reps or sets they did, or whether they even gained muscle strength; just doing the workout made all the difference.
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Pasman suggests prioritizing shorter, more intense workouts, where high intensity means maximal weight. “The heavier the weight you lift — within the constraints of your physical capabilities — the more significant elevations you’ll get in those neurotransmitters and BDNF,” he explains. “There’s just going to be a greater physiological response.”
While hitting the weight room isn’t a "cure" for mental health disorders — most studies suggest it as an add-on to traditional treatment — resistance training has been consistently shown to reduce the symptoms of issues like depression and anxiety. It might not always be easy to motivate yourself for a workout, but the physical and mental benefits will make it worthwhile.