How Pilates Supports Mental Health, According to Research

Winter brings shorter days, limited sunlight, and seasonal changes in mood commonly referred to as winter blues. For some individuals, these changes are more severe and meet the criteria for seasonal affective disorder (SAD), a form of seasonal depression. In the US SAD affects approximately 5% of adults and lasts about 40% of the year. Symptoms typically emerge during the fall and winter months and usually improve with the arrival of spring as daylight increases.

As we approach the final weeks of winter, the Health Time research team set out to explore recent mental health trends globally and, in the U.S., as well as investigate evidence-based non-pharmacological based strategies that can support mood and well-being. Among these, physical activity, and Pilates in particular, has received growing attention for its potential mental health benefits.

The symptoms of winter-pattern SAD overlap substantially with those of major depressive disorder (MDD), including persistent low mood, fatigue, feelings of hopelessness, and reduced interest in previously enjoyable activities. However, SAD often presents with a distinct symptom profile. Individuals may experience oversleeping, increased appetite (particularly carbohydrate cravings and subsequent weight gain) and social withdrawal. This contrasts with non-seasonal depression, where insomnia and loss of appetite are more common.

It is also important to note that seasonal changes in mood and energy exist along a spectrum. Many people experience milder seasonal shifts in sleep, motivation, or emotional well-being without meeting the diagnostic criteria for SAD.

Similar to US data, SAD is estimated to affect roughly 5% of the global population, although prevalence varies considerably by geographic location, latitude, and access to daylight. Beyond seasonal depression, mental health disorders remain a major public health concern worldwide.

According to the World Health Organization’s World Mental Health Today: Latest Data, anxiety disorders are the most prevalent mental health condition globally, affecting about 4.4% of the population, closely followed by depressive disorders (4%). Despite such high prevalence, access to effective treatment remains limited. Globally, it is estimated that fewer than 10% of individuals with depression receive minimally adequate care, highlighting a substantial treatment gap.

In the Americas, the WHO report indicates prevalence rates for anxiety and depression are the highest globally, with nearly 7% experiencing anxiety disorders and over 5% affected by depression. Seasonal changes in mood and behavior are also common, even among individuals without a formal SAD diagnosis.

A survey conducted by the American Psychiatric Association found that during winter months:

• Americans are twice as likely to say their mood declines (41%) vs. improves (22%)

• 41% sleep more

• 28% feel fatigued

• 27% experience low mood

• 20% lose interest in things they like

These findings highlight that seasonal shifts can meaningfully affect emotional well-being across the general population.

At the same time, broader societal and lifestyle factors contribute to rising rates of depression in many Western countries. Increased social isolation, economic pressures, inequality, and sedentary lifestyles all play a role. In the United States, fewer than half of adults meet federal aerobic physical activity guidelines (150 minutes of moderate‑intensity activity per week) and roughly one-quarter report no leisure-time physical activity at all reflecting ongoing challenges with sedentary lifestyles.

A substantial body of evidence supports the importance of physical activity for mental health across the lifespan. In the general population, regular exercise is associated with a lower risk of depression. Exercise appears to improve mental health through multiple mechanisms, including enhanced neurotransmitter activity (such as serotonin and dopamine), reduced inflammation and improved sleep quality. Importantly, research suggests a dose–response relationship, meaning greater levels of physical activity are generally associated with greater improvements in mood. Importantly, even modest activity can offer meaningful benefits.

A gold standard review of randomized trials found that exercise interventions can reduce depressive symptoms to a similar degree as psychological therapies and antidepressant medication, although the certainty of evidence for medication comparisons remains low. Other evidence reported that exercise combined with standard treatments led to greater antidepressant effects versus standard treatment alone.

In recent years, Pilates has emerged as a popular form of low- to moderate-intensity exercise, gaining widespread attention through studios, online platforms, and social media. Traditionally recognized for its benefits to core strength, flexibility, posture, and balance, Pilates also incorporates controlled breathing, focused attention, and precise movement, elements that align closely with mind-body practices known to support mental health. 

Recent research found that a 24-week Pilates program not only improved participants’ physical attributes, including body composition, strength, endurance, flexibility, balance, lung function, and immune response but also alleviated symptoms of anxiety and depression, with improvements in mental health closely correlated with physical gains. Additionally, a recent systematic review and meta-analysis inclusive of 18 randomized controlled trials with 827 participants reported that Pilates reduced both depression and anxiety compared with control groups.

The mental health benefits of Pilates likely stem from its integrated approach, which combines physical movement with breath control and mindful awareness. This combination may help regulate the stress response, reduce muscle tension, and promote a sense of calm and control, factors that are especially relevant for individuals experiencing anxiety or depressive symptoms.

Unlike purely aerobic exercise, Pilates emphasizes intentional movement and concentration, which may enhance body awareness and encourage present-moment focus. These qualities resemble aspects of mindfulness-based interventions, which have been shown to support emotional regulation and stress reduction.

One of Pilates’ key advantages is its accessibility. While studio-based classes and specialized equipment can be costly, many Pilates exercises can be performed at home with minimal equipment, such as a mat or resistance bands. Such flexibility makes Pilates a practical option for individuals facing financial, geographic, or mobility barriers to traditional fitness settings.

For individuals living with depression or anxiety, low-impact and adaptable forms of movement may feel more achievable than high-intensity or relatively prolonged aerobic exercise. Pilates can be modified to suit different fitness levels and physical limitations, allowing for gradual and sustainable engagement.

While no one lifestyle intervention can singularly address mental health challenges Pilates represents a promising, evidence-supported strategy that can complement established treatments. Its combination of physical conditioning and mental focus makes it particularly well suited to supporting emotional well-being, especially during periods of increased vulnerability such as the winter months. Indeed, Pilates is a highly accessible mode of exercise aligned to the ‘Exercise is Medicine’ mantra, promoted by the American College of Sports Medicine. As part of a holistic approach that may also include psychotherapy, medication when appropriate, and broader lifestyle changes, Pilates offers a low-impact, adaptable, and accessible option for individuals seeking to support both body and mind.