Aerobic Exercise for Depression

Overseen By Natalia Jaworska, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: The Royal's Institute of Mental Health Research

Must not be taking: Psychoactive drugs

Disqualifiers: Other DSM-5 disorders, Neurological conditions, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 38

Duration: 12 weeks

40 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how different intensities of aerobic exercise (also known as cardiovascular exercise or fitness training) can ease depression symptoms in young people. Participants will engage in either moderate or high-intensity workouts three times a week for 12 weeks. The researchers aim to assess how exercise affects mood, thinking skills, and brain function. Individuals between 16 and 24, currently experiencing depression, and not on antidepressants or regularly exercising at a moderate or vigorous level, might be suitable candidates. As an unphased trial, this study offers a unique opportunity to contribute to understanding how exercise can improve mental health in young people.

Will I have to stop taking my current medications?

Yes, you must be free of antidepressant medication for more than 5 weeks and cannot be taking psychoactive drugs, although occasional use of anti-anxiety medication is allowed.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that aerobic exercise is generally safe for most people, including young individuals. Studies have found that activities like walking, jogging, or cycling can help reduce symptoms of depression. These exercises are typically easy to manage, with few side effects reported. Regular physical activity can lower the risk of various health problems, reinforcing its safety.

In this study, participants will engage in moderate to high-intensity aerobic exercise. Previous research has shown that these exercises can boost mood and mental well-being in young people. Some initial muscle soreness or tiredness might occur, but these effects are usually mild and temporary. Overall, aerobic exercise is a safe and effective way to manage depression symptoms. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using aerobic exercise for treating depression because it offers a non-pharmaceutical approach with potential mental health benefits. Unlike standard treatments that often involve medications like antidepressants, aerobic exercise utilizes physical activity to boost mood and energy levels. The trial explores both high-intensity and moderate-intensity exercise regimens, which are unique because they can be tailored to individual fitness levels, potentially reducing side effects and improving adherence. This approach could provide an effective alternative or complement to traditional treatments, offering a holistic way to manage depression symptoms.

What evidence suggests that this trial's treatments could be effective for depression?

Research has shown that aerobic exercise, such as walking or jogging, can reduce symptoms of depression. This trial will compare two intensities of aerobic exercise: high intensity, maintained for 30 minutes at 80-85% of each participant's individual heart rate reserve, and moderate intensity, maintained for 30 minutes at 50-55% of each participant's individual heart rate reserve. Studies have found that these activities can boost mood, especially in young people. Reviews of various studies also suggest that exercise benefits both short-term and long-term depression. Additionally, exercise enhances heart and lung function, which can improve mental health. ^{1 2 4 6 7}

Are You a Good Fit for This Trial?

This trial is for young people aged 16-24 who are struggling with depression and haven't been taking antidepressants or exercising regularly. They should be able to understand English, have a BMI under 40, and be medically okay to do aerobic exercise. Those at risk of suicide, with MRI issues, serious health conditions, nicotine use, pregnancy/breastfeeding or other major psychiatric disorders can't join.

Inclusion Criteria

Free of pharmacotherapy (ie. antidepressant medication) for >5 weeks;

You are not currently exercising regularly at a moderate or high intensity level.

Able to read/understand English;

Exclusion Criteria

You have a high risk of wanting to harm yourself.

You cannot have a magnetic resonance imaging (MRI) scan due to certain medical conditions.

You are currently participating in another exercise study.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in supervised aerobic exercise sessions, 3 times a week for 12 weeks, at either moderate or high intensity

12 weeks

36 visits (in-person)

Follow-up

Participants are monitored for changes in depression symptoms and cognitive function post-treatment

6 months

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Aerobic Exercise

Trial Overview The study is looking at how different levels of workout intensity affect depression in youth. Participants will do either moderate or high-intensity aerobic exercises three times a week for twelve weeks while being watched over by professionals to see changes in their mood, thinking skills and brain function.

How Is the Trial Designed?

Group I: Moderate Intensity Experimental Treatment 1 Intervention

Aerobic exercise maintained for 30 minutes at 50-55% of each participant's individual heart rate reserve (HRRes).

Group II: High Intensity Experimental Treatment 1 Intervention

Aerobic exercise maintained for 30 minutes at 80-85% of each participant's individual heart rate reserve (HRRes).

Who Is Running the Clinical Trial?

The Royal's Institute of Mental Health Research

Lead Sponsor

Trials

8

Recruited

1,300+

Published Research Related to This Trial

Aerobic exercise (AE) significantly reduced depression severity in patients compared to a control group doing basic stretching, with improvements measured by the Hamilton Depression Rating Scale and the Beck Depression Inventory over a 6-week period.

AE also showed additional benefits in cognitive performance, particularly in working memory, and these positive effects on mental toughness and body mass index were maintained for up to 6 months after the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aerobic exercise or stretching as add-on to inpatient treatment of depression: Similar antidepressant effects on depressive symptoms and larger effects on working memory for aerobic exercise alone. Imboden, C., Gerber, M., Beck, J., et al.[2021]

Aerobic exercise has been found to be more effective than no treatment for individuals with mild to moderate unipolar depression, based on a review of 12 studies, although it does not show significant differences compared to other therapies like psychotherapy.

Both aerobic and anaerobic exercises are equally effective in treating mild to moderate depression, and patients generally view exercise as a valuable therapeutic option, suggesting it could serve as an alternative or complement to traditional treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical activity and depression: clinical experience. Martinsen, EW.[2019]

In a study involving 99 inpatients with various forms of depression, both aerobic and nonaerobic exercise significantly reduced depression scores over 8 weeks, indicating that exercise can be beneficial regardless of type.

While the aerobic group showed a significant increase in maximum oxygen uptake (VO2 max), there was no difference in depression reduction between the aerobic and nonaerobic groups, suggesting that the antidepressant effects of exercise are not limited to aerobic activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing aerobic with nonaerobic forms of exercise in the treatment of clinical depression: a randomized trial. Martinsen, EW., Hoffart, A., Solberg, O.[2022]

Aerobic exercise (AE) has been shown to have a significant antidepressant effect in clinically depressed adults, with a large effect size (g = -0.79) based on a meta-analysis of 11 trials involving 455 patients.

The study found that AE was effective across various settings and formats, and it worked similarly for both outpatients and inpatients, regardless of the severity of their symptoms, suggesting its broad applicability as a treatment for depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta-analysis. Morres, ID., Hatzigeorgiadis, A., Stathi, A., et al.[2019]

In a study involving 15 female patients with major depressive disorder (MDD) and matched controls, it was found that MDD patients switched to anaerobic metabolism earlier during exercise, indicating a different physiological response to exercise intensity.

To optimize aerobic exercise treatments for MDD, it is recommended to use the individual anaerobic lactate threshold (IAT) and perceived exertion scales, rather than relying solely on standard heart rate or oxygen uptake percentages, to prevent overexertion and excessive anaerobic metabolism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dissociation of performance parameters at the IAT requires specific exercise recommendations for depressed patients. Donath, L., Boettger, S., Puta, C., et al.[2022]

In a study of 14,343 participants over an average of 12 years, higher levels of cardiorespiratory fitness (CRF) were linked to a significantly lower risk of developing depressive symptoms, with men showing a 31% lower risk at moderate CRF and 51% lower at high CRF.

Women also benefited from higher CRF, with a 44% lower risk at moderate levels and 54% lower at high levels, indicating that maintaining good fitness can be an important factor in mental health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prospective study of cardiorespiratory fitness and depressive symptoms in women and men. Sui, X., Laditka, JN., Church, TS., et al.[2022]

This systematic review aims to evaluate how different types of exercise—specifically aerobic, resistance, and meditative movement—affect sleep quality in patients with unipolar depression, using a comprehensive search of multiple databases and rigorous methodology.

The study will assess not only sleep quality but also secondary outcomes like sleep duration, daytime functioning, and the use of sleep medications, providing a thorough understanding of the potential benefits and risks of exercise interventions for improving sleep in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of aerobic, resistance, and meditative movement exercise on sleep in individuals with depression: protocol for a systematic review and network meta-analysis. Brupbacher, G., Gerger, H., Wechsler, M., et al.[2023]

A 3-week supervised aerobic exercise program significantly reduced depressive symptoms in Chinese patients with mild to moderate depression, showing a mean difference of 10.08 points on the MADRS scale compared to a control group.

The aerobic exercise group also improved physical performance, specifically flexibility, with a mean difference of 4.4 points, suggesting that exercise can enhance both mental and physical health during the early inpatient phase of treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of aerobic exercise training on chinese population with mild to moderate depression in Hong Kong. Ho, CW., Chan, SC., Wong, JS., et al.[2021]

A randomized controlled trial with 242 depressed adults found that combining brief advice with supervised and home-based aerobic exercise and cognitive-behavioral sessions significantly increased moderate-to-vigorous physical activity (MVPA) at 3 months.

While the intervention was effective in the short term, the benefits in increasing aerobic exercise did not persist at 6 or 9 months, indicating a need for ongoing support to maintain activity levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Project MOVE: A randomized controlled trial of Interventions for initiating and maintaining physical activity in depressed individuals. Uebelacker, LA., Epstein-Lubow, G., Sillice, MA., et al.[2023]

Depressed patients often have low physical fitness due to inactivity, suggesting that incorporating physical fitness training into treatment for depression could be beneficial.

Exercise, including both aerobic and nonaerobic forms, has been shown to have antidepressant effects in patients with mild to moderate depression, and many patients continue exercising after treatment, leading to lower depression scores.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Benefits of exercise for the treatment of depression. Martinsen, EW.[2022]

Regular aerobic exercise significantly reduces the risk and mortality associated with coronary artery disease, likely due to its positive effects on blood lipid levels and blood pressure.

In addition to cardiovascular benefits, aerobic exercise also provides mental health advantages, such as reducing anxiety and depression, making it a valuable component in weight-loss programs and the management of conditions like diabetes and aging.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Health benefits of aerobic exercise. Mersy, DJ.[2019]

A study involving 40 individuals with major depressive disorder showed that both moderate-intensity aerobic exercise and quiet rest improved mood, but exercise led to a significant increase in positive well-being and vigor.

Participants who exercised for 30 minutes reported greater improvements in positive mood states compared to those who rested, suggesting that even a single session of moderate exercise can enhance feelings of well-being in people with depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of acute exercise on mood and well-being in patients with major depressive disorder. Bartholomew, JB., Morrison, D., Ciccolo, JT.[2019]

In a study of 66 young adults with major depression, 8 weeks of moderate-intensity aerobic exercise significantly reduced depressive symptoms compared to light stretching, with a moderate effect size (gs = 0.66).

While aerobic exercise did not change neural markers of reward processing (RewP) or cognitive control (ERN), individuals with higher baseline RewP and greater depressive symptom severity were more likely to benefit from the exercise intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized trial of aerobic exercise for major depression: examining neural indicators of reward and cognitive control as predictors and treatment targets. Brush, CJ., Hajcak, G., Bocchine, AJ., et al.[2022]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38355154/

Effect of exercise for depression: systematic review and ... Conclusions: Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than ...

2. bmj.com bmj.com/content/384/bmj-2023-075847

Effect of exercise for depression: systematic review and ... 545556575859 One study found that both aerobic exercise and yoga led to decreased depression because participants ruminated less.

3. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-06013-6

Influence of aerobic exercise on depression in young people The results of the meta-analysis indicated that aerobic exercise could effectively improve depression in young people.

4. sciencedirect.com sciencedirect.com/science/article/pii/S1360859224004923

The effects of aerobic exercise for depression: An umbrella ... A review of the literature has concluded that physical activity may be an effective treatment for both acute and chronic depression in the general population ( ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8602192/

The Effects and Mechanisms of Exercise on the Treatment of ... Exercise is effective at reducing depressive symptoms and improving body functions such as cardiorespiratory system and cognitive function.

6. who.int who.int/news-room/fact-sheets/detail/physical-activity

Physical activity People who are insufficiently active have a 20% to 30% increased risk of death compared to people who are sufficiently active. Regular physical ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S0165032724014903

Association between physical activity and sedentary ... Our findings indicate that patients with higher PA and lower SB have a lower risk of depression than those with low PA levels and high SB levels.