A groundbreaking study from South Korea has provided robust new evidence that maintaining or boosting exercise levels over time can significantly reduce the risk and severity of depression—a finding with powerful implications for mental health policies across Thailand. Published in the Journal of Affective Disorders, the research followed nearly four million adults over several years, revealing that people who stayed active or increased their activity reported fewer depressive symptoms and lower rates of clinical depression. This comprehensive investigation sheds new light on how consistent physical movement is not just a physical health booster but also a crucial pillar for mental well-being (PsyPost).
Depression remains one of the most pressing public health challenges globally and is similarly acute in Thailand, where social and economic changes, especially in the wake of the COVID-19 pandemic, have been linked to rising rates of anxiety and depressive disorders. Many Thais, including students and working-age adults, have reported heightened stress, reduced motivation, and increased social withdrawal. Traditional approaches have focused heavily on pharmacological and talk therapy solutions, but lifestyle interventions—especially exercise—are quickly gaining attention due to their low cost, accessibility, and broad health benefits.
The South Korean study, led by a medical school professor at CHA University, tracked participants through that country’s exhaustive National Health Insurance Service, which—like Thailand’s Universal Coverage Scheme—offers routine health screenings and extensive health records. Researchers followed a cohort of 3.99 million adults who had consistent data on physical activity, overall health, and depression status between the 2014-2017 period, with subsequent follow-up data until at least 2018. About 209,000 participants had a history of depression, but the vast majority (3.78 million) did not.
Physical activity levels were measured through standardized questionnaires. Activities ranged from brisk walking and cycling (moderate) to running or intense aerobic exercise (vigorous). Respondents were categorized as inactive, low activity (1–2 days/week), moderate (3–4 days), or high (5+ days) and tracked for changes between two key screening periods. Some had an additional baseline assessment to monitor activity before and after a depression diagnosis, allowing researchers to assess if becoming more active post-diagnosis offered any protective effect.
Key findings were both encouraging and nuanced. Among those with a history of depression, those who ramped up their physical activity or maintained a high frequency of exercise were between 8% and 26% less likely to be diagnosed with depression again. This trend extended to depressive symptoms, with more active participants scoring lower on the PHQ-9, a widely used depression screening tool. For individuals without prior depression, the results were even more striking: exercising five days a week dropped the risk of developing depression by up to 40% compared with being inactive.
One particularly intriguing aspect was the importance of maintaining or increasing activity over time. For people who became more active after an initial depression diagnosis, the benefits were still tangible, supporting the view that it is “never too late to benefit from adopting a more active lifestyle,” as the study’s lead author told PsyPost. Conversely, those who were inactive before diagnosis and remained inactive showed a stubbornly higher risk, reinforcing the idea that prevention, not just treatment, requires a sustained behavioral shift.
Why does exercise confer this mental health boost? The study pointed to several possible mechanisms. Physical activity helps regulate the body’s stress response, improves sleep quality, and encourages social engagement—all critical factors in mental well-being. On a biological level, exercise enhances mood by stimulating brain regions involved in emotional regulation and by increasing important growth factors like brain-derived neurotrophic factor. As a result, regular movement is increasingly seen by mental health professionals worldwide as a core preventive and therapeutic strategy (British Journal of Sports Medicine, Psychology Today).
The study design also highlights the importance of large, representative national databases—something Thailand’s Ministry of Public Health is working to strengthen, especially since the country faces well-documented barriers to mental healthcare access. Limitations nonetheless remain: activity was self-reported, clinical diagnoses may undercount some cases, and depression was only measured at specific ages. Yet, by following four million adults over several years—and tying outcomes to specific patterns of activity—this research represents one of the world’s most comprehensive analyses to date on exercise and depression.
Thai health professionals and educators can draw significant lessons. Despite widespread agreement on the value of exercise, many Thais struggle with sedentary lifestyles, particularly in urban settings like Bangkok where traffic congestion, air quality, and long working hours pose constant obstacles. The Thai National Health Examination Survey has found that less than half of working-age adults meet the World Health Organization’s recommendation of at least 150 minutes of moderate-intensity exercise per week. Physical education classes in schools often fall below international guidelines for both frequency and variety, and many community recreation spaces are limited in poorer districts.
According to a mental health official at the Thai Ministry of Public Health, integrating more structured group exercise programs into the workplace, schools, and community organizations could serve both physical and mental health goals at once. “Our data consistently show the positive impact of even modest increases in physical activity, especially for those with a history of depression,” reported one senior researcher at a leading Bangkok medical university. “Public health messaging and local government policy should make active living the easy and accessible choice, particularly for vulnerable populations.”
A Thai mental health social worker added, “Cultural beliefs about exercise in Thailand sometimes emphasize body appearance or weight loss rather than holistic well-being. We need to adjust our messaging to show that movement of any kind—dancing at a temple festival, walking to the wet market, even simple yoga at home—can all contribute to better mood and stress management.”
There is also growing recognition within the Thai education system that student well-being cannot be separated from physical health. Pilot programs in Chiang Mai and Khon Kaen have successfully introduced short aerobic sessions and mindfulness walks during the school day, with participating students reporting higher energy, improved concentration, and lower anxiety. Lessons learned from the South Korean study could inform the development of more sustained and inclusive programs, particularly in areas where students face high academic pressure or where access to sports facilities is limited.
Looking ahead, Thailand could adopt further innovations, such as leveraging fitness tracking devices or smartphone apps already popular among young Thais, to monitor real-time movement patterns and deliver personalized health nudges. The study author at CHA University notes that their next phase of research seeks to use wearables to provide more objective, real-world data—a strategy that could easily be piloted in Thai corporate or school settings.
As mental health issues in Thailand are projected to rise, especially among youth and aging populations, this new research sends a clear message: moving more, and moving consistently, should be a national health priority. For individuals, the call to action is simple but powerful. If you are currently inactive, start with small, manageable steps—such as short daily walks or joining group exercise activities at your wat (temple) or community center. If you are already active, aim to maintain or gently increase your level, knowing that every bit of movement contributes not only to your physical health but also your emotional resilience.
Ultimately, the evidence is stronger than ever: regular exercise is a potent, accessible tool for both preventing and managing depression. As the lead author summarized, “Given the global mental health crisis, our findings reinforce a simple yet powerful message: staying active can serve as an accessible and effective strategy to support mental well-being, both for individuals currently struggling with depression and for those aiming to prevent it.”
For Thais, adopting this approach—individually and through public health initiatives—could bring about dramatic reductions in mental health burden across society. By reframing physical activity as a form of self-care as important as nutrition and sleep, all sectors from schools to workplaces to local government can help turn this research insight into widespread, lasting change.
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