When people think about treating mental health conditions like depression or anxiety, they usually think of psychotherapy or medication. Exercise, if mentioned at all, is often framed as a helpful lifestyle add-on. But a growing body of scientific evidence suggests that strength training—including resistance training and powerlifting—deserves recognition as a legitimate mental health intervention with real, measurable effects on the brain and emotional wellbeing.

Strength training does more than build muscle. It alters brain chemistry, supports neural growth, regulates stress systems, and strengthens psychological resilience. Researchers evaluate these changes using a concept called effect size, which is a scientific way of describing how much a treatment helps, not just whether it helps. In simple terms, a small effect size means a modest improvement, a moderate effect size means a meaningful change that improves daily functioning, and a large effect size reflects a substantial and noticeable benefit. Effect sizes allow researchers to compare very different treatments—such as exercise, medication, and psychotherapy—on a common scale.

How Strength Training Affects the Brain

Mental health conditions like depression and anxiety are associated with changes in brain function, including reduced neuroplasticity (the brain’s ability to adapt and change), altered neurotransmitter activity, and dysregulated stress responses. Strength training directly influences these systems.

Regular resistance exercise increases levels of brain-derived neurotrophic factor (BDNF), a protein that supports neuron growth and connectivity (Duman & Aghajanian, 2012). It also reduces chronic cortisol exposure, improves sleep quality, enhances energy regulation, and increases dopamine signaling (Erickson et al., 2015). These are many of the same biological targets addressed by antidepressant medications and psychotherapy, which helps explain why exercise can have such meaningful mental health effects.

Depression: Comparable Effects to Standard Treatments

Depression is the most extensively studied mental health condition in strength-training research. Large meta-analyses of randomized controlled trials consistently show that resistance training produces moderate reductions in depressive symptoms across diverse populations, including people with clinically diagnosed depression (Gordon et al., 2018).

In these studies, effect sizes for strength training typically fall in the moderate range, meaning the improvement is large enough to matter in everyday life—not just statistically significant. For context, meta-analyses of psychotherapy for depression generally report small to moderate effect sizes when compared to control conditions (Cuijpers et al., 2018). Antidepressant medications also show small to moderate effects on average, with larger benefits seen in more severe cases (Kirsch et al., 2008).

This does not mean strength training should replace therapy or medication, particularly for people with severe or complex depression. Rather, it highlights that resistance training produces brain and mood changes of a similar magnitude to many standard treatments and should be taken seriously as part of mental health care.

Anxiety: Training the Nervous System to Recover from Stress

Although anxiety has been studied less than depression in resistance-training research, the findings are encouraging. Meta-analyses show that strength training significantly reduces anxiety symptoms, with effect sizes that are often moderate and sometimes large when compared to inactive control groups (Gordon et al., 2020).

Strength training helps regulate the nervous system by repeatedly exposing the body to manageable physical stress followed by recovery. Over time, this process teaches the brain that stress is tolerable and temporary. This improved stress tolerance translates into lower baseline anxiety and better emotional regulation—key goals of many anxiety treatments.

Powerlifting and Structured Strength Programs

Powerlifting and structured resistance programs emphasize progressive overload, consistency, and measurable progress. From a mental health perspective, this structure is particularly powerful.

Depression and anxiety often erode self-efficacy—the belief that one’s actions can lead to positive change. Strength training directly counters this by providing concrete evidence of progress. The routines, focus, and mastery involved in lifting also support emotional regulation and cognitive stability. While fewer studies isolate powerlifting specifically, its mechanisms closely align with those shown to drive mental health benefits in resistance-training research.

How Does This Compare to Psychotherapy and Medication?

Psychotherapy and antidepressant medications remain first-line treatments for many mental health conditions, and they are essential for many people. However, when researchers compare effect sizes across treatments, the differences are often smaller than expected.

Psychotherapy for depression typically shows small to moderate effect sizes (Cuijpers et al., 2018). Antidepressant medications show similar ranges of benefit when compared to placebo, particularly in mild to moderate depression (Kirsch et al., 2008). Strength training’s effect sizes for depressive symptoms consistently fall within this same range (Gordon et al., 2018; Schuch et al., 2016).

This comparison does not suggest an “either-or” approach. Instead, it shows that strength training is a biologically active intervention capable of producing meaningful mental health improvements—especially when combined with therapy or medication.

Strength Training as Part of Integrated Care

Beyond symptom reduction, strength training offers additional benefits: improved physical health, reduced inflammation, enhanced cognitive function, and lower risk of chronic disease (Erickson et al., 2015). It also empowers people to actively participate in their own recovery, which can be especially valuable for conditions marked by helplessness or low motivation.

The Bottom Line

Strength training is not just about physical strength—it is about brain health, emotional regulation, and resilience. Scientific evidence shows that resistance training produces mental health benefits comparable in size to many established treatments for depression and anxiety. While it should not replace professional care when that care is needed, strength training deserves recognition as a powerful, evidence-based tool for mental health healing.

*This article was co-created with the help of AI.