Effects of Acute Exercise on Mood and Well-Being in Patients with Major Depressive Disorder

John B. Bartholomew; David Morrison; Joseph T. Ciccolo

Disclosures

Med Sci Sports Exerc. 2005;37(12):2032-2037. 

In This Article

Abstract and Introduction

Purpose: This study was designed to determine if a single bout of moderate-intensity aerobic exercise would improve mood and well-being in 40 (15 male, 25 female) individuals who were receiving treatment for major depressive disorder (MDD).
Methods: All participants were randomly assigned to exercise at 60-70% of age-predicted maximal heart rate for 30 min or to a 30-min period of quiet rest. Participants completed both the Profile of Mood States (POMS) and Subjective Exercise Experiences Scale (SEES) as indicators of mood 5 min before, and 5, 30, and 60 min following their experimental condition.
Results: Both groups reported similar reductions in measures of psychological distress, depression, confusion, fatigue, tension, and anger. Only the exercise group, however, reported a significant increase in positive well-being and vigor scores.
Conclusion: Although 30 min of either moderate-intensity treadmill exercise or quiet rest is sufficient to improve the mood and well-being of patients with MDD, exercise appears to have a greater effect on the positively valenced states measured.

There is a growing recognition and acceptance of chronic exercise as a useful treatment modality for depression.[8,12,30] Cross-sectional studies have reported more depressive symptoms in physically inactive individuals.[20,33] A 16-wk exercise intervention found exercise to be as effective as antidepressants in treating older patients with depression.[8] Regular exercise has also been shown to protect against relapse to previous levels of depression.[6] A dose-response relationship between exercise and depression is plausible;[12] for example, a moderate exercise dose has a therapeutic effect for patients with major depressive disorder (MDD), but a low exercise dose does not.[13] The number of acute exercise bouts needed to produce a therapeutic effect is unknown; however, exercise training interventions have effected a substantial improvement in symptoms in only a few weeks.[8,13] In a recent review, Dunn et al.[12] suggest that a dose-response relationship may exist between exercise and depression, with a positive association between the amount of exercise and the reduction in depression. A moderate exercise dose, therefore, appears to have a greater therapeutic effect for patients with MDD compared with a low exercise dose.[13]

Although receiving little attention among clinicians, a single, an acute bout of exercise is sufficient to reduce transiently depressive symptoms and improve moods, according to numerous studies of nonclinical samples.[30,35] Although less consistent following intense exercisei.e., above lactate threshold,[14] mood has been shown to improve with moderate-intensity (50-70% VO2max) exercise,[35] and at durations of at least 10-15 min.[15] It may be that acute bouts of exercise will also serve as an intervention to aid daily mood regulation in patients with MDD. It is, however, more difficult to predict the influence of an acute bout of exercise in this population. The mood disorder that is associated with MDD, by definition, is less transitory than the mood disturbance scores found in healthy samples. It may be that the effect of MDD is simply too great to be overcome, even in the short term, with a single bout of exercise. Conversely, these effects appear to be moderated by preexercise scores.[23] Thus, healthy participants with higher preexercise symptoms of depression report the greatest improvement in mood. Because few studies have tested the effects of acute exercise in conjunction with clinically diagnosed, mental health patients, however, it is not clear that these effects will generalize to a clinical sample.

It is important to note that any single bout of exercise would not be expected to provide a lasting reduction in the underlying clinical disorder of depression. The lasting application of any treatment, whether exercise, counseling, or medication, is more likely to have an enduring effect on MDD. Acute bouts of exercise, in contrast, would be expected to provide a transient elevation of mood and well-being in clinical samples. This, however, does not minimize the potential mental health benefits of acute bouts of aerobic exercise. The use of alcohol, nicotine, or illegal drugs is a common practice among depressed patients.[1] Although numerous motivations exist to use these substances, it has been suggested that these behaviors may, in part, be attempts to regulate mood outside of treatment.[1,17] These forms of self-medication are common, even though they would not be expected to provide anything more than a temporary relief of depressive symptoms. In fact, the limited benefit of such efforts supports the need to provide alternative, healthy methods to regulate day-to-day variability in mood for these patients. Acute bouts of aerobic exercise offer a potentially healthy means of mood regulation for the MDD population.

This experiment was, therefore, designed to determine the impact of a single bout of aerobic exercise on the mood and well-being of individuals who are receiving treatment for MDD. Because previous investigations have found the effects of an acute bout of exercise to be similar to that of a quiet rest period,[7,31] we used quiet rest as the comparison condition. As reported by several investigators,[7,31] the positive effects of exercise on mood, although similar in magnitude, have been shown to persist significantly longer than that of quiet rest. We hypothesized, therefore, that 30 min of exercise would result in a longer duration improvement of mood and well-being.

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