Walk on the bright side: physical activity and affect in major depressive disorder

Abstract

Although prescribed exercise has been found to improve affect and reduce levels of depression, we do not know how self-initiated everyday physical activity influences levels of positive affect (PA) and negative affect (NA) in depressed persons. Fifty-three individuals diagnosed with Major Depressive Disorder (MDD) and 53 never-depressed controls participated in a seven-day experience sampling study. Participants were prompted randomly eight times per day and answered questions about their physical activity and affective state. Over the week, the two groups of participants did not differ in average level of physical activity. As expected, participants with MDD reported lower average PA and higher average NA than did never-depressed controls. Both participants with MDD and controls reported higher levels of PA at prompts after physical activity than at prompts after inactive periods; moreover, for both groups of participants, PA increased from a prompt after an inactive period to a subsequent prompt at which activity was reported. Depressed participants in particular showed a dose-response effect of physical activity on affect: longer duration and/or higher intensity of physical activity increased their PA significantly more than did short duration and/or lower intensity physical activity. Physical activity did not influence NA in either group. In contrast to previous treatment studies that examined the effects of prescribed structured exercise, this investigation showed that self-initiated physical activity influences PA. These findings also underscore the importance of distinguishing between PA and NA to gain a more comprehensive understanding of the effects of physical activity on affect in MDD.

Figure 1

Aggregated within-person affect (prompt level) separated by intensity level of activity and participant group. Error bars represent standard errors of the mean. Because HLM estimates the standard error of the difference between groups and not the standard errors of each mean value, the values shown in this graph are the aggregated mean of the intraindividual mean of each participant’s affect over the experience sampling week; the standard errors are derived from this aggregated mean. The PA and NA values shown here are not adjusted for time-of-day effects.

Figure 2

PA over subsequent prompts at which physical activity either occurred at neither occasion or occurred between the first and second occasions, separated by participant group. Error bars represent standard errors of the mean. Because HLM estimates the standard error of the difference between groups and not the standard errors of each mean value, the values shown in this graph are the aggregated mean of the intraindividual mean of each participant’s affect over the experience sampling week; the standard errors are derived from this aggregated mean. The PA values shown here are not adjusted for time-of-day effects.