The role of momentary physical-activity subjective energy association in the prevention and treatment of depression

Abstract

Major Depressive Disorder (MDD) is a leading cause of disability worldwide, frequently characterized by anhedonia and deficits in subjective energy. Existing therapeutic approaches are often associated with high barriers to access, stigma, and long waiting times. To promote an easily accessible and individualized therapy approach, the MASE project investigates how a non-exercise activity (NEA; i.e., fast walking) intervention can increase subjective energy levels and lead to a mid-term decrease in depressive symptoms. We aim to recruit 180 participants (acute MDD, remitted MDD and healthy controls; n = 60 each). For the 5-week intervention we set up a within-person encouragement design (WPED) with Ecological Momentary Assessment and movement acceleration sensors. These ambulatory assessment methods offer real-time data acquisition, effectively overcoming limitations of retrospective bias and low ecological validity. The micro-intervention is individually triggered by a participant’s inactivity, i.e. after 30 minutes of inactivity. The prompts to engage in the NEA task or, in an active control condition, to engage in a working memory game are randomized. Momentary state, such as mood and energy levels are assessed repeatedly throughout the day to capture real-time changes. To maximize adherence, intervention triggers will be limited to a maximum of four per day. To assess long-term effects, additional follow-ups will take place at one month, three months, and six months post-intervention. Recruitment began in September 2025 and is ongoing. Preliminary results of the first enrolled 30 participants will be presented, focusing on adherence and initial trends in NEA - induced momentary changes in subjective energy. We anticipate that these targeted momentary micro-interventions will enable more individualized mental health strategies and foster both primary and secondary prevention of MDD.