The Win-Win of Doing Cardio Before Online Therapy
Thirty minutes of aerobic exercise before online CBT may enhance its efficacy.
Posted March 31, 2022 | Reviewed by Lybi Ma
- Moderate-to-vigorous physical activity can improve symptoms of depression in those with major depressive disorder.
- Moderate-intensity aerobic exercise can alleviate depressive symptoms for at least 75 minutes after a cardio workout.
- Doing online therapy sessions in the 75-minute window after a cardio workout may enhance the therapy's efficacy.
On its own, aerobic exercise helps depression. Additionally, new research suggests that 30 minutes of "pre-therapy" cardio may turbocharge the efficacy of cognitive-behavioral therapy (CBT) for people with major depressive disorders.
The first part of this ongoing research project (Meyer et al., 2022) was published online on March 12 in the peer-reviewed journal Psychology of Sport and Exercise.
The first phase of this research found that riding a stationary bike at moderate intensity for 30 minutes alleviated symptoms of depression (anhedonia, depressed mood state) in adults with MDD for at least 75 minutes after finishing a cardio workout. During this post-exercise time window, the researchers speculate that doing online therapy sessions may be ideal.
30 Minutes of Cardio Reduces Depressive Symptoms for at Least 75 Minutes
"These benefits to depressed mood state and anhedonia could last beyond 75 minutes," first author Jacob Meyer said in a news release. "We would need to do a longer study to determine when they start to wane, but the results suggest a window of time post-exercise when it may be easier or more effective for someone with depression to do something psychologically or cognitively demanding [CBT or psychotherapy]."
A second, soon-to-be-published feasibility study found that combining cardio workouts and online CBT sessions may be an effective intervention for the treatment of depression. This paper has been provisionally accepted for publication in an upcoming issue of Frontiers in Psychiatry.
For this eight-week feasibility study, Meyer et al. recruited a small number (N = 10) of adults with major depressive disorder and divided them into two groups of five. One group of participants did a moderate-intensity cardio workout for 30 minutes prior to each hour-long online CBT session. The other control group didn't exercise but simply went about their regular daily activities before logging online for a 60-minute therapy session.
Cardio Workouts May Prime the Brain for Therapy
At the end of this two-month pilot study, both groups (the exercise group and the non-exercise group) who did online CBT therapy self-reported fewer symptoms of depression. However, the reduction of depressive symptoms was more significant for those who did some moderate-intensity cardio before talking with a therapist remotely each week.
Study participants who did 30 minutes of moderate-intensity cardio before doing an hour-long online cognitive behavioral therapy session also reported having a "quicker and stronger connection" with their therapist.
"Overall, the pilot study showed people were interested and would stick with the combined approach," Meyer noted. "If someone feels a connection with their therapist, there's a higher chance they'll continue going to therapy and the sessions likely will have a greater impact."
The researchers speculate that pre-therapy cardio workouts may be priming or "fertilizing" the brain to engage during therapy. Future research will focus on pinpointing the optimal cardio "dose" (duration, intensity, frequency) and the best time window for moderate-to-vigorous physical activity to enhance the benefits of post-exercise therapy.
Jacob D. Meyer, Thomas A. Murray, Cassandra S. Brower, Gabriel A. Cruz-Maldonado, Maria L. Perez, Laura D. Ellingson, Nathaniel G. Wade. "Magnitude, Timing and Duration of Mood State and Cognitive Effects of Acute Moderate Exercise in Major Depressive Disorder." Psychology of Sport and Exercise (First published online: March 12, 2022) DOI: 10.1016/j.psychsport.2022.102172
Jacob D. Meyer, Seana L. Perkins, Cassandra S. Brower, Jeni Lansing, Julia A. Slocum, Emily B. Kroska, Thomas A. Murray, Duck-Chul Lee, and Nathaniel G. Wade. "Feasibility of an Exercise and CBT Intervention for Treatment of Depression: A Pilot Randomized Controlled Trial." Frontiers in Psychiatry (Provisionally accepted*: January 20, 2022) *The final version of this peer-reviewed article will be published pending final quality checks.