Pilates for depression: what it can do for low mood, how to start, and where to get help
Pilates may ease low mood. In small trials, mostly in women, people who did Pilates two or three times a week had lower depression scores than people who did nothing. It hasn't been tested as a treatment for clinical depression, and walking, yoga and strength training have more evidence, so it works best as one part of the help you get, never instead of talking therapy or medicines.
If you are thinking about suicide or can't keep yourself safe, call 999 or go to A&E. For urgent help, call Samaritans free on 116 123, any time, or in England call 111 and select the mental health option. In the US, call or text 988.
This guide covers what exercise and the Pilates trials show, how Pilates compares with walking, yoga and tai chi, why some effort helps, how to start when you have no motivation, medicines, and where to get help.
The NHS says a mental health emergency should be taken as seriously as a physical one, and that you will not be wasting anyone's time.
Call 999 or go to A&E if your life is at risk: for example, you have seriously harmed yourself or taken an overdose, or you feel you can't keep yourself safe.
For urgent help in England, call 111 and select the mental health option, or use 111 online.
Call Samaritans on 116 123. It is free, any time, day or night.
In the US, call or text 988, the 988 Suicide and Crisis Lifeline, any time.
In the 2026 Cochrane review, exercise eased depression symptoms by a moderate amount, less in the best-run trials, and about as much as talking therapy. NICE (the National Institute for Health and Care Excellence) lists group exercise among the first treatments for less severe depression.
Across 18 small trials (827 people, mostly women), depression scores fell with Pilates, mostly against doing no exercise. No trial has tested Pilates in people diagnosed with clinical depression, so treat it as an addition, not a treatment on its own.
Walking or jogging, yoga and strength training have the most trials for depression. In older adults, tai chi ranked above Pilates. Where Pilates was compared with walking or aerobic exercise, it helped mood about as much.
Set small targets you can easily achieve: even a brisk 10-minute walk or a 10-minute session counts. Plan it at a set time rather than waiting to feel like it.
A low mood can make you feel sad, anxious, angry, tired or low in confidence, and often gets better after a few days or weeks. "If you have a low mood that lasts 2 weeks or more, it could be a sign of depression." Depression ranges from feeling persistently low in spirit to feeling that life is no longer worth living.
For mild depression, a GP may suggest waiting to see if it improves, exercise, guided self-help or talking therapy. For moderate or severe depression, talking therapy and antidepressants together are often recommended. NICE says antidepressants shouldn't routinely be the first treatment for less severe depression.
A programme designed for people with depression, led by a trained practitioner, usually more than once a week for 10 weeks, in groups of about 8, that includes moderate intensity aerobic exercise. A general Pilates class is light to moderate and mostly not aerobic, so it isn't the same thing; a Pilates class plus brisk walking gets closer (our reading).
Physical effort, which eases depression across hundreds of trials; a group and a teacher, and group and supervised exercise did better in a 2026 review; and small, achievable goals. The trials can't tell which part matters most.
Lower depression scores, mostly against doing nothingEmerging evidence
A review of 18 randomised trials (827 people, nearly all women; read in full) found depression scores fell by a moderate to large amount with Pilates (a standardised mean difference of 0.71), and anxiety by a little less. Most comparison groups did no exercise. Programmes ran 6 to 16 weeks, 40 to 70 minutes, 2 or 3 times a week. No trial reported side effects, so safety couldn't be judged. An earlier review of 8 trials found larger effects, from small, very varied trials.
An overview of 12 studies (read in full) found Pilates helped depressive symptoms against inactivity and was at least comparable to aerobic exercise, but its studies were in students, older women, caregivers and people with obesity, not people diagnosed with major depression. We found no Pilates trial in diagnosed depression.
The largest review measured something narrowerMixed evidence
A 2026 review of 32 trials (1,264 people) found clear gains in quality of life and self-esteem, but said the evidence for depression and anxiety "remains limited or non-significant". Online classes did about as well as in-person ones in adults.
In 110 women aged about 69, 12 weeks of Pilates lowered depression scores against no exercise. In 60 older women, 8 weeks lowered depression and raised happiness. In 43 people in drug rehabilitation, 24 weeks eased depression and anxiety more than usual rehabilitation. In 28 women with high blood pressure, 13 weeks improved depression, anxiety, stress, mood and sleep. All were small.
A study of 148 older women had no comparison group, and a study often quoted by Pilates teaching bodies compared 25 people who chose Pilates with 24 inactive people, so neither can show that Pilates caused the change.
The 2026 Cochrane review pooled 57 trials (2,189 people): exercise eased depression symptoms by a moderate amount against no treatment or a control, at low certainty, and by less in the 7 best-run trials. It was probably about as effective as psychological therapy, and may be about as effective as antidepressants, though those comparisons rest on a few small trials.
In 218 trials (14,170 people with major depression), walking or jogging, yoga and strength training were among the most effective, and benefits rose with intensity. Pilates isn't among the types its summary reports. Confidence was low to very low.
A 2026 review of 81 analyses found larger falls in depression with group and supervised exercise, and an overview of 97 reviews found bigger benefits with harder exercise.
Exercise "can boost your mood if you have depression, and it's especially useful for people with less severe depression", and "Any type of exercise is useful, as long as it suits you and you do enough of it." A GP may be able to refer you to exercise on prescription.
In 63 adults with overweight, an hour 3 times a week for 8 weeks of either Pilates or walking improved depression and quality of life; only walking eased anxiety in the moment.
In 75 inactive older women, Pilates improved depression more than aerobic exercise; in 30 women after the menopause, Pilates and aerobic exercise helped depressive symptoms equally; in 105 students, Pilates and therapeutic exercise both helped, with no clear difference.
In 23 stressed adults, Pilates and yoga improved mental health about equally. In older adults, network analyses ranked tai chi above Pilates, which had only 2 trials, and one analysis of 8 exercise types had a single Pilates study.
The NHS says "set small targets that you can easily achieve", start gradually if you haven't exercised for a while, and that "even a brisk 10-minute walk can clear your mind and help you relax".
Plan it, don't wait to feel like itEmerging evidence
Behavioural activation, a talking therapy NICE lists, schedules activities and notices their effect on mood; it worked across 26 trials. Borrow the idea: book a class or a 10-minute home session at a set time and count it as done.
Group and supervised exercise did better, and NICE's programme is a group. A class, an online group or a friend gives you company and a reason to turn up.
Benefits rose with intensity in the trials. Pilates averages about 3 METs (a measure of effort: sitting still is 1), which is light to moderate, so let some sessions warm you up with the hundred, swimming or standing work, and add brisk walking where you can talk but not sing.
Pilates trials used 2 or 3 sessions a week of 40 to 70 minutes for 6 to 16 weeks. NICE's group exercise runs more than once a week for 10 weeks. The NHS suggests building towards 150 minutes of moderate activity a week.
Medicines, therapy and claims about brain chemistry
Alongside treatment, never insteadStrong evidence
"Do not stop taking an antidepressant suddenly or without talking to your doctor first." Exercise can be added to talking therapy or medicines; it hasn't been shown to replace them.
Claims that Pilates works by releasing endorphins or serotonin go beyond the evidence. Serotonin rose in one pilot of 16 pregnant women, BDNF (a brain growth protein) didn't rise significantly with Pilates in women with fibromyalgia, cortisol rose in a small trial while mood improved, and one session of core exercise on a Pilates machine raised β-endorphin in people with back pain. No Pilates trial of low mood has measured endorphins.
1 minute of marching is from our standing Pilates for balance class, 6 to 8 bridges from our clinical Pilates class, and 5 to 8 lateral breaths, 5 leg circles each way and 8 to 10 side kicks each side, then 3 mermaid stretches each way, are the move pages' doses.
50 beats of the hundred building to 100, 6 to 10 single-leg stretches each side, 2 or 3 sets of 20 to 30 seconds of swimming and 3 knee hovers of 15 to 30 seconds are the move pages' doses; 2 sets of 8 to 12 sit-to-stands and wall push-ups, stopping with 2 to 3 reps in hand, are our editorial starting point.
At least 5 minutes of slow breathing, 8 to 10 open-book turns each side, 1 to 3 minutes in child's pose and at least 5 minutes in corpse pose are the move pages' doses; sit instead of lying if lying still feels bad.
The walk and Pilates workout adds 20 minutes of walking to a Pilates circuit, closest to the effort the trials favour. The 10-minute starter is for low days, the somatic class for calm ones, and the chair class if getting down to the floor is hard.
These are the same warning signs as our exercise for depression and yoga for depression guides. A&E means accident and emergency.
Call 999 or go to A&E now
Call 999 or go to A&E if:
Your life is at risk: for example, you have seriously harmed yourself or taken an overdose.
You feel you may be about to harm yourself, or you can't keep yourself or someone else safe.
During exercise, you have chest pain that feels tight or like squeezing, or spreads to the arms, neck or jaw, or severe difficulty breathing, or someone collapses.
The NHS says it's not common, but some people have suicidal thoughts or an urge to self-harm when they start an antidepressant: speak to your doctor straight away if this happens. People aged 24 or under, or who have had these thoughts before, may be most at risk.
Don't stop an antidepressant suddenly or without talking to your doctor. If you take lithium, the NHS says "Drink plenty of fluids, especially if you're doing intense exercise or in hot weather".
Exercising compulsively, or to control your weight or make up for eating, can be a sign of an eating disorder. Our exercise and eating disorders guide explains the signs and where to get help.
During a class
If strong feelings come up in a slow or lying move, stop, open your eyes, sit up and look around. A class that feels like too much is a reason to do less, not a failure (our advice).
Myths
"Pilates can replace antidepressants or therapy"Strong evidence
No Pilates trial has tested this in diagnosed depression. Exercise did about as well as therapy in a few small trials, not better, and you shouldn't stop an antidepressant suddenly or without your doctor.
It may ease low mood. Across 18 small trials, mostly in women and mostly against doing nothing, depression scores fell by a moderate amount. It hasn't been tested in people diagnosed with clinical depression, so it's an addition to the help your GP offers, not a treatment on its own.
Is Pilates good for anxiety and depression?
Small trials found lower anxiety and depression scores with Pilates, and our Pilates for stress and anxiety guide covers anxiety. For depression, walking, yoga and strength training have more evidence.
Is Pilates or yoga better for depression?
Yoga has many more trials and is among the best-supported exercise for depression. In the one direct comparison, in stressed adults, Pilates and yoga helped mental health about equally. Choose the one you'll keep doing.
Can Pilates replace my antidepressants or therapy?
No. Exercise did about as well as therapy in a few small trials, and hasn't been shown to be better. Don't stop an antidepressant suddenly or without talking to your doctor.
What does NICE say about exercise for depression?
NICE lists group exercise as one of the treatments for less severe depression: a programme designed for depression, with moderate aerobic exercise, more than once a week for 10 weeks. A Pilates class plus brisk walking is close, and your GP may be able to refer you to exercise on prescription.
How often should I do Pilates for low mood?
Trials used 2 or 3 sessions a week of 40 to 70 minutes for 6 to 16 weeks. Build towards that, add brisk walking, and give it about 10 weeks before you judge it.
I have no motivation. How do I start?
Start very small: a 10-minute session or walk at a set time, and count it as done. Planning activity rather than waiting to feel like it is how behavioural activation works, and a class or online group gives you company and a reason to turn up.
Is gentle Pilates enough?
Gentle sessions help on low days, but across trials harder exercise eased depression more. Let some sessions warm you up, and add brisk walking.
Does Pilates release endorphins?
That's often said but not shown. One small back pain study found more β-endorphin in the blood after a session, but no Pilates trial of low mood has measured it, and exercise probably helps mood in several ways.
Is online or reformer Pilates OK for depression?
Yes. Online classes helped about as much as in-person ones in adults, and both mat and reformer Pilates appear in the trials. Pick what you can get to.
When should I get help?
See a GP if you've had a low mood for more than 2 weeks, you're struggling to cope, or self-help isn't working. If you are thinking about suicide or can't keep yourself safe, call 999 or go to A&E. For urgent help, call Samaritans free on 116 123, any time, or in England call 111 and select the mental health option. In the US, call or text 988.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
