Psychiatrists and mental health professionals have always relied on medication and talk therapy to treat depression, but Dr. Nicholas Fabiano, a psychiatry resident at the University of Ottawa, thinks it's time for a shift. In an editorial for the British Journal of Sports Medicine, he argues that exercise shouldn't be an afterthought, it should be a standard part of every treatment plan for patients with depression.
"Ignoring exercise as a treatment for depression isn't just a missed opportunity. It might even cross the line into negligence," says Dr. Fabiano. "The research is clear: physical activity really does help with depressive symptoms. So why is it still so rare for psychiatrists to prescribe it right alongside medication or therapy?"
Dr. Fabiano advocates that prescribing exercise should become as routine as writing a prescription for antidepressants. However, he's not suggesting a generic "go for a walk" approach. Instead, he proposes structured, individualized exercise plans that follow the FITT principle—Frequency, Intensity, Time, and Type—to ensure they genuinely meet each patient's specific needs and lifestyle constraints.
Dr. Fabiano is calling on the medical field to take exercise seriously. That means teaching it in medical school, including it in clinical guidelines, and making sure insurance covers it. He also wants it to be easier for doctors to refer patients to exercise professionals, and for tech like fitness trackers to be part of the follow-up.
"If we don't hesitate to prescribe a pill, why do we hesitate with exercise?" Dr. Fabiano concludes. For him, it's simple: exercise should be treated as a core part of mental health care, not just something extra for patients to try if they feel like it.
To read the full editorial, click here: Could not prescribing exercise for depression be psychiatric malpractice? https://doi.org/10.1136/bjsports-2025-110405
