A randomized controlled pilot trial of low and high arousal resilience interventions for depressive symptoms.
Elissa S Epel, Brian P Don, Stefanie E Mayer, Robin Blades, Ashley E Mason, Elena Fromer, Julia F O'Bryan, Rebecca Dileo, Joanna Y Guan, Samantha J Schilf, Sylvia S Cheng, Aric A Prather, Wendy Berry Mendes
Annals of behavioral medicine : a publication of the Society of Behavioral Medicine January 4, 2025 DOI: 10.1093/abm/kaaf081 (opens in new tab) via PubMed
Summary
AI-generated from the abstractAll four stress-reduction interventions—mindfulness meditation, slow breathing with warm showers, fast-paced breathing with cold showers (the Wim Hof Method), and high-intensity interval training—reduced depressive symptoms by about 16% and perceived stress by about 10% after three weeks in women with high stress. No group outperformed the others immediately after the intervention. However, a post hoc analysis of participants who adhered to their assigned program suggested that the Wim Hof Method group maintained lower depression scores and greater daily positive affect three months later, a finding that requires replication with larger, more diverse samples.
Study at a glance
| Characteristics | Randomized controlled trial Pilot study Peer reviewed |
|---|---|
| Sample size | 141 |
| Population | Female adults reporting high perceived stress; predominantly White (63%) and Asian (34%) |
| Interventions | Mindfulness meditation Slow breathing with warm showers High-intensity interval training |
| Duration | 3-week intervention, 3-month follow-up |
| Topics | Breathwork Depression Meditation |
| Keywords | Exercise Hormetic stress |
| Key finding | All four interventions reduced depressive symptoms and perceived stress at three weeks, but the Wim Hof Method group showed better maintenance of reduced depression and increased positive affect at three-month follow-up in an as-treated analysis. |
Abstract
To cope with chronic stress, which can contribute to depression, humans often pursue arousal-reducing activities. Yet, hormetic stressors (intermittent, acute stressors) might also reduce chronic stress. We compared the effects of arousal-reducing and arousal-enhancing interventions on depressive symptoms and perceived stress. Female adults (N = 141; predominantly White, 63%, and Asian, 34%) reporting high perceived stress were randomized to 1 of 4 three-week stress resilience interventions in 2019-2020. Low arousal conditions included mindfulness meditation or slow breathing with warm showers (Control). Hormetic stress conditions included fast paced breathing with cold showers (the Wim Hof Method; WHM) or high-intensity interval training. We assessed depressive symptoms and perceived stress at baseline, postintervention, and 3 months later, and cortisol reactivity to a lab stressor. At postintervention, all 4 groups had decreases in depressive symptoms (15.93% reduction, r = .76, P < .001) and perceived stress (9.70% reduction, r = .48, P < .001), with no group differences. "As treated" analysis showed the WHM group had better maintenance of reduced depression 3 months later (r = .17, P < .01). The WHM group had greater increases in daily positive affect across days (r = .16, P ≤ .05) and at postintervention (r = .17, P < .015) compared to the control group. Groups were similar in cortisol reactivity pre- and postintervention. All groups experienced reduced stress and depressive symptoms and did not differ from each other after 3 weeks. After 3 months, a post hoc analysis of adherent subjects showed the WHM group had more sustained improvements in depression and positive affect, a finding that needs replication with larger and more diverse samples.