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New research has found that moderate-intensity exercise may be beneficial for treating and preventing postpartum depression. Kerkez/GC Images
  • A large study spanning 11 countries suggests that regular bouts of moderate-intensity exercise may help treat and prevent postpartum depression.
  • The study authors say aerobic exercise like swimming, cycling, jogging, and dance were more effective for reducing postpartum depression than standard care.
  • Experts caution that exercise should not replace first-line treatment for severe postpartum depression, such as psychotherapy and antidepressants.

Postpartum depression is a debilitating condition affecting 1 in 8 pregnancies.

Diagnoses are often overlooked, meaning the prevalence of postpartum depression (PPD) may be higher than current estimates.

Treatment for postpartum depression may range from antidepressants to psychotherapy and social support.

Now, a new meta-analysis found that moderate-intensity exercise was significantly effective in reducing postpartum depression compared to standard care. The findings were published November 29 in the journal PLOS ONE.

Also of note, the study authors say that exercise is also associated with preventing postpartum depression onset.

“The results of our study are intriguing,” study co-author Renyi Liu, a PhD student and associate professor at the China University of Geosciences in Wuhan, told Healthline.

“While we anticipated positive outcomes associated with exercise, the remarkable degree of effectiveness, especially with moderate intensity and frequency, was surprising. This reinforces the potential role of exercise in managing and preventing postpartum depression.”

While there are countless benefits to exercise, experts caution it should not be considered a substitute for first-line postpartum depression treatments, particularly in severe cases.

The new research builds on prior evidence suggesting the benefits of exercise for postpartum depression. The meta-analysis includes 26 studies comprising 2,867 subjects across 11 countries and regions, including China, where the study was conducted.

Researchers compared subjects who participated in various forms of aerobic exercise to a control group receiving standard care. The types of exercise studied included:

The analysis shows the effectiveness of aerobic exercise in both prevention and treatment for postpartum depression is significant compared to standard care, with a stronger emphasis on prevention.

The authors found the optimal prescribed exercise regimen is 3–4 times per week at moderate intensity for 35–45 minutes.

All forms of exercise studied were effective in treating and preventing postpartum depression with the exception of the yoga group.

“Based on our research findings, initiating an exercise program during pregnancy and continuing postpartum appears to be beneficial,” Liu said.

“However, individual circumstances may vary, and it is advisable to consult healthcare providers to tailor exercise recommendations based on specific needs and conditions.”

The researchers noted limitations in their findings, such as potential selection bias and variations in participant exercise regimens.

The risk of bias was evident in the yoga group, Liu said, which did not show a significant improvement in postpartum depression symptoms or onset compared to the control group. Still, Liu noted that yoga is still considered a viable option for exercise.

“The aim was to identify a more optimal aerobic exercise based on its effectiveness. After grouping, the variability in the intervention effects within the yoga group is most likely attributed to a risk of bias in the results of studies that employed yoga as an intervention,” Liu said.

“This bias may arise due to various factors, such as study design, intervention type, and participant characteristics.”

Other factors, such as mood enhancement from team-based and supervised exercise, may have also affected the study’s outcomes.

The authors wrote it’s important to “exercise caution” when interpreting the findings. They say further research is needed to fully understand the effects of various forms of exercise, including yoga, on postpartum depression.

Liu explained that the standard care group in the meta-analysis involved education, psychological support, and recommendations for physical activity without prescribing structured exercise.

The standard treatment group did not, however, closely examine antidepressant use.

“Medication was not included in the preventive process for PPD,” Liu said. “In the treatment of PPD, medication usage is generally considered based on the severity of the condition and patient preference. In this study, which primarily focuses on treatment, the reported interventions almost entirely exclude the use of antidepressant medications.”

Clinical psychologist Dr. Eynav Accortt, PhD, director of the Reproductive Psychology Program and assistant professor in the Department of Obstetrics and Gynecology at Cedars-Sinai in Los Angeles, emphasized the value of psychotherapy and antidepressants for treating postpartum depression.

Accortt was not involved in the study.

Severe cases of postpartum depression may interfere with an individual’s ability to function and may require fast-acting antidepressants like the recently approved postpartum depression pill, Zuranolone.

According to Accortt, while research continues to show the benefits of exercise for postpartum depression, there’s typically only a slight reduction in symptoms.

“Exercise is not a treatment for moderate to severe postpartum depression or anxiety,” she told Healthline.

“When people tout this claim as if you don’t even need your antidepressants, you don’t need to go to psychotherapy, all you got to do is exercise, that’s really a simplified and actually dangerous approach.”

Accortt noted that exercise may be a helpful adjunctive therapy for postpartum depression, but, in many cases, it is usually in combination with psychological or medical treatments.

Physical activity is often recommended during pregnancy and postpartum once your physician has cleared you for exercise.

However, a pregnant and postpartum person may experience significant physical changes that prevent them from safely engaging in certain forms of exercise.

Accortt explained that many people might feel societal pressure to “bounce back” after giving birth.

“It took 9 to 10 months to create a life, and your body has changed drastically to support that life, and now it will take a minimum of 9 to 10 months to get back to feeling like you did before you were pregnant,” she said.

“So exercise in the pregnancy and immediate postpartum should only be done if you have gotten the go-ahead from your physician to do so.”

Accortt noted that regardless of what exercise you might try, it should be something you enjoy.

“The point of this is not for weight loss — there should be no pressure. If we try to meet those expectations of bouncing back to get back to routines that we used to enjoy, we are just going to be disappointed, our depression and anxiety are certainly going to go back up, and our stress is going to go back up. So the idea is to take it really slow,” she said.

As a proponent of yoga, Accortt said the benefits will inevitably vary depending on what style of yoga you practice.

For instance, you can’t really compare a slower form of yoga like Hatha to a faster, more aerobic style of yoga like Vinyasa. This may have distorted the results of the new meta-analysis, where researchers noted the potential for bias.

Liu agreed that lighter forms of exercise may also be helpful in reducing postpartum depression compared to moderate aerboic exercise.

“The key is engaging in activities that are safe and suitable for the individual,” Liu said.

“I think we have to mix it up so we get the most benefit physically, mentally, and emotionally, because you may enjoy a yoga class but feel you get a good workout with a hike or a jog,” Accortt noted.

“It has to be realistic, it has to be joyful, and in pregnancy and postpartum, it needs to be in small doses and supported by a physician.”

A new meta-analysis suggests that moderate-intensity aerobic exercise like swimming, cycling, jogging, and dancing may be more effective for reducing postpartum depression compared to standard care.

While the research builds on evidence supporting the benefits of exercise for postpartum depression, more studies are needed before exercise should be considered a replacement for first-line treatments like antidepressants and psychotherapy.

If you’re pregnant or postpartum, be sure your physician clears you before starting a new exercise regimen. Remember to take it slow and engage in activities that bring you joy.