Document Type : Review Article


1 Department of Physical Education, Zarand Branch, Islamic Azad University, Kerman, Iran

2 Department of Educational Sciences, Kerman Branch, Islamic Azad University, Kerman, Iran


Anxiety and depression are the most frequently diagnosed psychological diseases showing a high co-morbidity. They have a severe impact on the lives of the persons concerned. The physical, mental and social benefits of exercise have been well-documented. In Iran, mental disorders are one of the largest sources of disease burden. The aim of this paper is to critically review the currently available literature with respect to the association of physical activity, exercise and the prevalence and incidence of depression and anxiety disorders


Rhodes RE, Temple VA, Tuokko HA. Evidence-based risk assessment and recommendations for physical activity clearance: Cognitive and psychological conditions. Appl Physiol Nutr Metab. 2011;36:S113-S153.
DiLorenzo TM, Bargman EP, Stucky-Ropp R et al (1999) Long-term effects of aerobic exercise on psychological outcomes. Prev Med 28:75–85
Blumenthal JA, Babyak MA, Moore KA et al (1999) Effects of exercise training on patients with major depression. Arch Int Med 159:2349–2356
Craft LL, Landers DM (1998) The effects of exercise on clinical depression resulting from mental illness: a metaanalysis. J Sport Exerc Psychol 20:339-357
North TC, McCullagh P, Tran ZV (1990) Effects of exercise on depression. Exerc Sport Sci Rev 18:379–415 
Dimeo F, Bauer M, Vahram I, Proest G, Halter U (2001) Benefits from aerobic exercise in patients with major depression: a pilot study. Br J Sports Med 35:114–117
Knubben K, Reischies FM, Adli M et al (2007) A randomised, controlled study on the effects of a shortterm endurance training programme in patients with
major depression. Br J Sports Med 41(1):29–33.
Wittchen HU, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jönsson B, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsycho pharmacol 2011;21(9):655-679. 
Seifert T, Brassard P, Wissenberg M, Rasmussen P, Nordby P, Stallknecht B, et al. Endurance training enhances BDNF release from the human brain. Am J
Physiol Regul Integr Comp Physiol 2010;298(2):R372-R377.
Ströhle A, Stoy M, Graetz B, Scheel M, Wittmann A, Gallinat J, et al. Acute exercise ameliorates reduced brainderived neurotrophic factor in patients with panic disorder. Psychoneuroendocrinology 2010;35(3):364-368.
Sylvia LG, Ametrano RM, Nierenberg AA. Exercise treatment for bipolar disorder: potential mechanisms of action mediated through increased neurogenesis and decreased allostatic load. Psychother Psychosom
Meeusen R, Piacentini MF, De Meirleir K. Brain microdialysis in exercise research. Sports Med 2001;31(14):965-983.
Read JP, Brown RA. The role of physical exercise in alcoholism treatment and recovery. Prof Psychol Res Pract 2003; 34(1):49- 56.
Modie, J. (2003). "'Good' Chemical, Neurons in Brain Elevated Among Exercise Addicts." OHSU, online.
Mattson, Mark P., Wenzhen Duan, Ruqian Wan, and Zhihong Guo. (2004). "Prophylactic Activation of Neuroprotective Stress Response Pathways by Dietary and Behavioral Manipulations." NeuroRx, 111-116.
Pierce EF, Eastman NW, Tripathi HL, Olson KG, Dewey WL (1993) _-endorphin response to endurance exercise: relationship to exercise dependence. Percept Mot Skills 77:767-770.
McKim WA (2003) Drugs and behavior: an introduction to behavioral pharmacology (5th ed.). New Jersey: Prentice Hall.
Nuller YL, Morozova MG, Kushnir ON, Hamper N (June 2001). "Effect of naloxone therapy on depersonalization: a pilot study". J. Psychopharmacol. (Oxford) 15 (2): 93–5.
Fazio E, Medica P, Aronica V, Grasso L, Ferlazzo A (2008): Circulating β-endorphin, adrenocorticotrophic hormone and cortisol levels of stallions before and after short road transport: stress effect of different distances. Acta
Veterinaria Scandinavica 50, 6.
Oswald LM, Wand GS (2004) Opioids and alcoholism. Physiol Behav 81:339-358.
Goldfarb AH, Jamurtas AZ, Kamimori GH, Hegde S, Otterstetter R, Brown DA (1998) Gender effect on betaendorphin response to exercise. Med Sci Sports Exerc 30:1672- 1676.
Lin WC, Zhang J, Leung GY, Clark RE. Chronic physical conditions in older adults with mental illness and/or substance use disorders. J Am Geriatr Soc
Scott K, McGee MA, Schaaf D, Baxter J. Mental-physical comorbidity in an ethnically diverse population. Soc Sci Med 2008;66(5):1165-1173.
Scott D, Happell B. The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs 2011;32(9): 589-597.
Chacón F, Mora F, Gervás-Ríos A, Gilaberte I. Efficacy of lifestyle interventions in physical health management of patients with severe mental illness. Ann Gen Psychiatry 2011;10:22.
Ellis Ross, Ryan J. A. (2005). "Emotional Intelligence and Positive Psychology: Therapist Tools for Training/Coaching Clients to Move Beyond Emotional
Relief". Annals of the American Psychotherapy Assn 8 (3): 42–43.
Last CG, Strauss CC; Strauss (1989). "Panic disorder in children and adolescents". J Anxiety Disord 3 (2): 87–95.
Lydiard RB (2003). "The role of GABA in anxiety disorders". J Clin Psychiatry 64 (Suppl 3): 21–27.
Dunlop BW, Davis PG (2008). "Combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression: a review
Muller B, Armstrong HE (1975) A further note on the running treatment for anxiety. Psychother Theory Res Pract 12:385–387
Orwin A (1974) Treatment of situational phobia—a case for running. Br J Psychiatry 125:95–98
Broocks A, Bandelow B, Pekrun G et al (1998) Comparison of aerobic exercise, clomipramine, and placebo in the treatment if panic disorder. Am J
Psychiatry 155:603–609.
Barlow DH, Craske MG (1994) Mastery of your anxiety and panic.Graywind Publications, Albany, NY McEntee DJ, Halgin RP (1999) Cognitive group therapy and aerobic exercise in the treatment of anxiety. J Coll
Stud Psychother 13(3):39–58
Steptoe A, Edwards S, Moses J, Mathews A (1989) The effects of exercise training on mood and perceived coping ability in anxious adults from the general population. J Psychosom Res 33:537–547
Sexton H, Maere A, Dahl NH (1989) Exercise intensity and reduction in neurotic symptoms. Acta Psychiatr Scand 80:231–235
Manger TA (2000) The effects of a community-based aerobic exercise program on posttraumatic stress disorder-related symptoms and concomitant anxiety and depression (dissertation). Hofstra University,
Hempstead, NY Dractu L (2001) Physical exercise: an adjunctive treatment for panic disorder? Eur Psychiatry 16:372–374
Barbany G, Persson H. Regulation of Neurotrophin mRNA Expression in the Rat Brain by Glucocorticoids. Eur J Neurosci 1992; 4(5): 396-403.
Duman RS, Monteggia LM. A neurotrophic model for stressrelated mood disorders. Biol Psychiatry 2006; 59(12): 1116-27.
Neves-Pereira M, Mundo E, Muglia, P, et al. The brainderived neurotrophic factor gene confers susceptibility to bipolar disorder: evidence from a family-based association study. Am J Hum Genet 2002; 71(3): 651-5
Hölzel BK, Carmody J, Evans KC, et al. Stress reduction correlates with structural changes in the amygdala. SCAN 2010; 5(1): 11-17
Castren E, Voikar V, Rantamaki T. Role of neurotrophic factors in depression. Curr Opin Pharmacol 2007; 7(1):18-21.
Ströhle A, Stoy M, Graetz B, et al. Acute exercise ameliorates reduced brain-derived neurotrophic factor in patients with panic disorder. Psychoneuroendocrinology 2012; 35(3): 364-8.
Carro E, Nuñez A, Busiguina S, et al. Circulating insulinlike growth factor I mediates effects of exercise on the brain. J Neurosci 2000; 20(8): 2926-33
Bhui K, Fletcher A. Common mood and anxiety states: Gender differences in the protective effect of physical activity. Soc Psychiatry Psychiatr Epidemiol 2000; 35(1):28-35
Blumenthal JA, Babyak MA, Moore KA et al (1999) Effects of exercise training on patients with major depression. Arch Int Med 159:2349–2356
Singh NA, Clements KM, Fiattarone MA (1997) A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol 52:M27–M35
Fremont J, Craighead LW (1987) Aerobic exercise and cognitive therapy in the treatment of dysphoric moods. Cognit Ther Res 11:241–251
Greist JH, Klein MH, Eischens RR et al (1979) Running as treatment for depression. Compr Psychiatry 20:41–54
Conn, V. S. (2010). Depressive Symptom Outcomes of Physical Activity Interventions: Metaanalysis Findings. Annals of Behavioral Medicine, 39(2): 128-138.
Dang, M. T. (2010). Walking Away the Blues: Exercise for Depression in Older Adults. Nursing, 40(11): 33-36.
Herring, M. P., O'Connor, P. J., and Dishman, R. K. (2010). The Effect of Exercise Training on Anxiety Symptoms Among Patients. Archives of Internal Medicine, 170(4):321-331.
Eysenck, H.J., Nias, D.K.B., and Cox, D.N. (1982). Sport and Personality. Advances in Behaviour Research and Therapy, 4: 1-56.
Powell, K.E., Thompson, P.D., Caspersen, C.J., and Kendrick, J.S. (1987). Physical Activity and the Incidence of Coronary Heart Disease. Annual Review of Public Health, 8: 253-287.