Pilates guide
Pilates may ease stress, anxiety and low mood. In trials, mostly small ones in women, people who did Pilates two or three times a week felt less anxious and low than people who did nothing, and in stressed adults it worked about as well as yoga.
It isn't a treatment for an anxiety disorder or depression, and other exercise, such as walking, yoga and strength training, helps too. If you are thinking about harming yourself 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 the trials show for stress, anxiety, mood and sleep, how Pilates compares with other exercise, what a calming practice looks like, what's behind claims about cortisol and the nervous system, and when to get help.
Small trials, mostly in women and mostly against doing no exercise, found lower anxiety and depression scores with Pilates. For generalised anxiety disorder, NICE (the National Institute for Health and Care Excellence) recommends talking therapy, such as cognitive behavioural therapy (CBT), or applied relaxation, not exercise alone.
In 24 stressed adults, Pilates or yoga twice a week for 8 weeks lowered stress scores about equally. The NHS says exercise won't make stress disappear, but can reduce how intense it feels.
Walking, yoga and strength training have more trials for low mood than Pilates, and in a Cochrane review, exercise helped depression symptoms about as much as talking therapy.
Pooled trials found better sleep scores with Pilates, though the results varied a lot.
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A calming practice pairs slow breathing with slow moves, but effort matters too: across trials, harder exercise eased low mood and anxiety more.
Small studies of Pilates and cortisol, a stress hormone, point in opposite directions.
Stress is "usually a reaction to mental or emotional pressure". It can cause headaches, dizziness, muscle tension and a faster heartbeat; worry and feeling overwhelmed; and changes in how you sleep and eat.
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Anxiety is a normal feeling. Generalised anxiety disorder (GAD) is a long-term condition: a GP may diagnose it when worry about many things affects your daily life and you've felt anxious a lot of the time for at least 6 months. Panic disorder means having regular, sudden attacks of panic or fear. Both have effective treatments.
Slow, steady breathing, which raises heart rate variability (the small changes in time between heartbeats, partly controlled by the calming vagus nerve); moving with your attention on the movement, and mindfulness scores rose in students taking Pilates; physical effort, which eases low mood and anxiety across hundreds of trials; and, in a class, other people, which the NHS counts among its stress busters.
"It's best to tackle the cause of your stress", the NHS says. Exercise can take the edge off, but it doesn't remove the cause.
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Across 18 trials (827 people, mostly women), Pilates lowered depression scores by a moderate amount (a standardised mean difference, SMD, of 0.71) and anxiety scores a little less (SMD 0.58), mostly compared with no exercise. The trials ran 6 to 16 weeks, 2 or 3 times a week, in groups ranging from older women to students and people with multiple sclerosis (MS). An earlier review of 8 small trials, and reviews in people over 55 and in people with depression, point the same way. None rated how certain the evidence is.
A 2026 review of 32 trials (1,264 people) found clear gains in quality of life and self-esteem, and no clear effect on well-being or mental health. Its search required body-image or self-esteem terms, and it didn't pool depression, saying there wasn't enough data.
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In 110 women aged about 69, 12 weeks lowered anxiety and depression against no exercise. In 80 people with MS, home DVD Pilates eased depression and fatigue against a waiting list. In 28 women with high blood pressure, 13 weeks eased depression, anxiety and stress. Against other exercise, Pilates did no better in students and matched another programme in sedentary women.
Pilates teacher bodies cite a study of 25 people doing Pilates once a week for 3 months and 24 inactive people, aged 50 to 65: the Pilates group had less anxiety, depression and stress-related physical symptoms. People weren't randomly allocated, so the two groups may have differed in other ways.
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In 24 adults aged 30 to 39 with moderate stress, Pilates or yoga for 60 minutes twice a week for 8 weeks, at a moderate effort (12 on a 6 to 20 effort scale), lowered stress, anxiety and depression scores and improved heart rate variability about equally. There was no group that did neither, so some of the change may come from time or expectation.
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In 12 workplace trials, Pilates reduced disability from muscle and joint problems but not pain clearly; a wider review of 23 studies reported lower anxiety and job stress, at lower certainty.
"Exercise will not make your stress disappear, but it can reduce some of the emotional intensity that you're feeling, clearing your thoughts and letting you deal with your problems more calmly." Its anxiety pages suggest yoga or Pilates to help you relax, alongside breathing exercises and regular exercise.
Across 6 trials (477 people), Pilates improved sleep quality scores against no exercise, but results varied widely, and there was no clear effect in healthy people over 40 or in women after the menopause. In 110 older women, how long they slept and how often it was disturbed both improved.
Two network analyses ranked Pilates first among exercise types for sleep, but another, in older adults, found that muscle endurance training plus walking did better.
The NHS advises exercising regularly during the day but not in the 4 hours before bed, and relaxing for an hour before bed. We found no study of Pilates at different times of day. A slow breathing and stretching wind-down is relaxation rather than a workout, so it fits that advice (our reading); save harder sessions for earlier in the day.
In stressed adults, Pilates and yoga lowered stress, anxiety and depression about equally, and in women with MS, online Pilates and online yoga both helped mood. In older adults, network analyses ranked tai chi above Pilates for depression, and one analysis of 8 exercise types had only one Pilates study.
With 60 minutes 3 times a week for 8 weeks, Pilates and walking both improved depression, longer-term anxiety and quality of life; only walking eased anxiety in the moment.
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Across 97 reviews (128,119 people), physical activity eased depression, anxiety and distress, more so at higher intensity. Across 218 trials, walking or jogging, yoga and strength training were among the most effective for depression; no Pilates trials were included. A Cochrane review, read as an abstract, found exercise helped depression symptoms about as much as talking therapy.
The NHS breathing exercise for stress: breathe in for a count of 1 to 5 and out for 1 to 5, for at least 5 minutes, as part of your daily routine. Slow breathing raises heart rate variability, and breathwork lowered stress a little across 12 trials.
Choose a few simple moves, go at about half your usual speed, and pause between them to notice your breathing (our suggestion). Mindfulness rose in students taking Pilates. Our slow somatic Pilates class works this way.
Harder exercise eased low mood more across trials, so let some sessions warm you up: the hundred, the single-leg stretch, swimming and side kicks, or a brisk walk.
Trials used 2 or 3 sessions a week of 40 to 70 minutes for 6 to 16 weeks. For milder depression, NICE's group exercise is more than once a week for 10 weeks, and the NHS says "Any type of exercise is useful, as long as it suits you and you do enough of it".
Two Pilates sessions with some effort, a calming 15 to 20 minute practice on other days or in the evening, and brisk walking on most days, towards the NHS's 150 minutes a week (our editorial starting point).
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In 27 women aged 60 to 65, 8 weeks of Pilates raised average cortisol by 16% against a control group, while anxiety and depression fell. In 30 women with no comparison group, cortisol fell after 4 weeks in those aged 50 to 60, and in women with MS it fell with online Pilates and online yoga. The studies are small and conflict, and cortisol isn't a simple measure of stress; our exercise for stress guide explains why.
Slow breathing raises heart rate variability, and Pilates and yoga both improved it in one trial. Claims that Pilates "resets" or "regulates" your nervous system go further than that; our somatic Pilates guide covers them.
Start with the NHS breathing exercise: at least 5 minutes, counting 1 to 5 in and 1 to 5 out, which is the slow breathing move page's dose.
Go at about half your usual speed, with 5 or 6 slow repetitions of each and a breath or two between moves (our editorial starting point).
3D demoPelvic tilt into bridgeBeginner · No equipment
3D demoSupine heel slideBeginner · No equipment
3D demoCat-cowBeginner · No equipment
3D demoSide-lying open bookBeginner · No equipment
3D demoSpine stretch forward (Pilates spine stretch)Beginner · No equipment
3D demoMermaid (Pilates seated side bend)Beginner · No equipmentUse the move pages' starting doses, such as 50 beats of the hundred building to 100, and keep breathing steadily.
Finish lying still for at least 5 minutes, as the corpse pose page suggests, or sitting if that feels better.
For a calm session, try the slow somatic Pilates class or the breathing routine; for sessions with more effort, the beginner or full-body mat workouts, or the walk and Pilates workout.
A slow, 20-minute Pilates class with time to notice your breath and how each move feels. Every move is optional and you can pause or stop at any point.
20 minBeginner12 movesNo equipmentA 12-minute reset for stressful days: 4 minutes of brisk movement, 3 minutes to loosen your neck, shoulders and back, then 5 minutes of slow breathing.
12 minBeginner10 movesA bench or box, A wallA 6-minute breathing routine: slow breathing, crocodile breathing, alternate nostril breathing, box breathing and 4-7-8 breathing.
6 minBeginner5 movesNo equipmentA slow, 10-minute floor routine to unwind before sleep: child's pose, twists, happy baby and slow breathing.
10 minBeginner7 movesFirm cushion, A wallA 20-minute mat Pilates workout for complete beginners. It covers breathing, spine position and the foundation moves, each with an easier option.
20 minBeginner13 movesNo equipmentA 30-minute intermediate mat Pilates class that follows the classical order, from the hundred to the push-up, with prep versions of the hardest moves.
30 minIntermediate22 movesNo equipmentA 45-minute session for weight loss and health: a 20-minute brisk walk, which does more for the scales, then a short-rest Pilates circuit for strength.
45 minBeginner11 movesCardio machineA 4-week plan to build a Pilates habit, and a walking plan for the brisk activity that helps mood most.
A free 4-week, 3-day Pilates plan for complete beginners. Two mat days and one wall day, with clear rules for when to move each exercise to its harder version.
3 training days25 minBeginner6 days a weekA free 8-week walking plan for beginners: build to 150 minutes of brisk walking a week, with intervals, hills and two short strength sessions.
6 training days40 minBeginner"A mental health emergency should be taken as seriously as a physical one. You will not be wasting anyone's time."
The NHS also suggests calling a GP and asking for an emergency appointment, or contacting your mental health crisis team if you have one. Don't drive yourself to A&E: ask someone to drive you or call 999.
If you're struggling to cope with stress, the things you're trying aren't helping, or you'd like a referral; or if you think you might have generalised anxiety disorder, or treatment isn't helping. Adults can also refer themselves to NHS talking therapies.
Call 999 for chest pain that feels tight or like squeezing, or spreads to your arms, neck or jaw, or for palpitations with chest pain, breathlessness or fainting. Panic can feel similar: if you're not sure whether it's panic or your heart, treat it as your heart (our advice).
NICE's treatments for generalised anxiety disorder are talking therapies such as CBT or applied relaxation, and the NHS may also offer medicines. Exercise, including Pilates, is an addition, not a replacement.
If you feel dizzy, light-headed or tingly, make the breaths smaller or breathe normally. If strong feelings come up, stop, open your eyes, sit up and look around (the slow breathing move's caution and our somatic class's advice).
Trials found lower anxiety scores, mostly against doing nothing, but Pilates isn't a treatment for an anxiety disorder; NICE recommends talking therapies or applied relaxation.
In the one trial comparing them in stressed adults, both lowered stress about equally.
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Calming practice helps many people, but across trials, harder exercise eased low mood and anxiety more. Do both.
The NHS says not to exercise in the 4 hours before bed, but to relax for an hour before bed; a slow breathing and stretching wind-down is relaxation, not a workout (our reading).
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It can help. In one trial in stressed adults, 8 weeks of Pilates twice a week lowered stress scores about as much as yoga did, and the NHS says exercise can reduce how intense stress feels, though it won't make it disappear. Tackling the cause of stress matters too.
It may ease anxiety symptoms: across 8 trials, anxiety scores fell, mostly compared with doing nothing. It isn't a treatment for an anxiety disorder; NICE recommends talking therapies such as CBT or applied relaxation, and the NHS suggests yoga or Pilates as a way to relax alongside them.
It may help symptoms. Across 18 trials, mostly in women, depression scores fell compared with no exercise, and exercise in general helps depression symptoms about as much as talking therapy. Walking, yoga and strength training have more trials than Pilates; see a GP if low mood lasts.
Neither has been shown to be better. In the one trial comparing them in stressed adults, both lowered stress, anxiety and depression scores about equally. Choose the one you'll keep doing.
That isn't shown. In one small trial, cortisol rose after 8 weeks of Pilates even as anxiety fell, and in another study it fell. Cortisol isn't a simple measure of stress, so judge Pilates by how you feel.
It seems to help mood, self-esteem and quality of life, mostly in small trials against doing nothing. Any regular exercise helps mood, and harder effort helps more. If you're struggling, talk to a GP.
Possibly. Pooled trials found better sleep quality scores, but results varied a lot, and there was no clear effect in women after the menopause. The NHS advises regular exercise during the day for better sleep.
A gentle wind-down is fine; a hard workout isn't. The NHS says not to exercise in the 4 hours before bed, but to relax for an hour before. No study has tested Pilates at different times of day, so slow breathing and easy stretches are our suggestion for bedtime.
Trials used 2 or 3 sessions a week of 40 to 70 minutes for 6 to 16 weeks. A few minutes of slow breathing each day helps too: the NHS suggests at least 5 minutes.
Slow breathing, like the breathing in Pilates, raises heart rate variability, the small beat-to-beat changes in heart rate that partly reflect the calming vagus nerve, and Pilates and yoga both improved it in one trial. Claims that it "resets" or "regulates" your nervous system go beyond the evidence; our somatic Pilates guide explains why.
Some of each. Slow breathing and slow moves help you settle, but across exercise trials, harder effort eased anxiety and low mood more. If a hard session makes you feel panicky, slow down and breathe normally.
See a GP if you're struggling to cope or self-help isn't working; you can also refer yourself to NHS talking therapies. If you need help now, call 111 and select the mental health option, or call Samaritans free on 116 123; call 999 or go to A&E if a life is at risk. 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.
