At least 25% of individuals living with multiple sclerosis (MS) experience depression, with even more facing depressive episodes during their disease course. Experts attribute this to both neurological and immune changes, as well as the psychological strain of coping with a chronic illness.
Anxiety frequently co-occurs, affecting roughly one-third of MS patients, often triggered by disease-related uncertainties. While pharmacological treatments exist, they often bring undesirable side effects, and a substantial number of MS patients with depression receive no treatment.
Recent research highlights exercise as a potent, drug-free depression treatment for people with MS, showing effectiveness comparable to antidepressants and psychotherapy. A new review, published in Physiotherapy Theory and Practice, confirms that regular physical activity significantly improves mental health in MS patients and offers additional benefits.
The study focused on exercise adherence to the Physical Activity Guidelines for MS (PAG-MS), which recommend at least 150 minutes weekly of moderate-intensity aerobic activity combined with strength training twice per week.
Reviewing 12 randomized controlled trials involving 458 predominantly female MS patients aged 28 to 48, researchers found diverse exercise modalities—including yoga, aquatic exercise, aerobic and resistance training—performed two to five times weekly for 15 to 105 minutes per session.
Using the Beck Depression Inventory to assess outcomes, the study’s lead author, Sodiq Fakorede, noted that exercise following PAG-MS guidelines reduced depression scores by an average of 4.46 points, surpassing the minimal clinically important difference of 3.0 points. This signifies a meaningful improvement in depressive symptoms for MS patients engaging in this level of physical activity.
Yoga and aquatic exercises, specifically when practiced thrice weekly over at least eight weeks, appeared particularly effective in alleviating depression symptoms. However, limited data on anxiety outcomes showed no clear benefits, underscoring the need for further targeted research.
Researchers explain that exercise may combat depression by releasing endorphins—natural mood elevators—and promoting neural growth in brain regions impaired by depression, such as the hippocampus. Additionally, increased physical strength enhances self-esteem and coping skills, empowering patients to engage more fully in daily life.
Beyond mental health, exercise also combats fatigue, improves physical function, and enhances overall quality of life for people with MS. According to experts, consistent physical activity, regardless of type, is key to maintaining wellness and managing aging effects in MS patients.
This growing evidence positions exercise as a vital, non-pharmacological depression treatment that empowers individuals with MS to take an active role in their mental and physical health.
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