Overview
This project explores whether heated yoga, sauna, and a mindfulness app reduce depressive symptoms
Description
This is a parallel group study design. The investigators plan to enroll 120 adults who have at least moderate depression and will be randomized in an equal allocation ratio (i.e., 1:1:1) across three groups: heated yoga vs. sauna vs. a mindfulness app. The interventions will be provided over a 12-week period and assessments will occur at baseline (Week 0), mid-intervention (Weeks 4 & 8), post-intervention (Week 12, primary outcome), and at a 6-week (Week 18) and 3-month follow-up (Week 24).
Eligibility
Inclusion Criteria:
- adults (18-65 years old)
- Ability to provide informed consent
- English language proficiency
- PHQ-9 score > 10, indicating at least moderate depressive symptoms 21
- Must have filled out the waiver for the community-based partners prior to enrolling in the study*
- Individuals of childbearing potential must use an acceptable form of birth control
- (if applicable) willingness to keep psychiatric medications and psychotherapy stable throughout the course of the study
- Must be able to the Insight Timer app on a device
Exclusion Criteria:
- Pregnant or planning to become pregnant
- Breast feeding
- Active suicidal thinking (i.e., PHQ-9 item 9 ≥1 and a positive response to C-SSRS screener items 3, 4, 5, or 6)
- Active eating disorders or substance use disorders within the past 12 months, as per the Composite International Diagnostic Interview Screening Scales (CIDI-SC)
- Primary OCD or PTSD, as per the Composite International Diagnostic Interview Screening Scales (CIDI-SC)
- History of bipolar disorder, psychotic disorders, as per the Composite International Diagnostic Interview Screening Scales (CIDI-SC)
- ≥25% drop in PHQ-9 score from screen to baseline
- Under the influence or withdrawal of drugs or alcohol
- Positive urine toxicology screen due to illicit drug use or other exclusionary medications. (Potential false positives will be addressed on a case-by-case basis at the discretion of the PI or designee)
- have had a bone fracture or joint surgery in the past 6 months
- not able to walk freely or without difficulty
- any serious, unstable medical condition as determined by the revised Physical Activity Readiness Questionnaire (PAR-Q+) and do not have approval from their treating physician (the investigator will check in with treating physician in the event that participants endorse any item on the PAR-Q+)
- participants must have a physician responsible for their medical care
- Significant exposure to heated yoga classes in the past 3 months (i.e., more than 6 classes)
- Significant exposure to sauna sessions in the past 3 months (i.e., more than 6 sessions)
- Significant exposure to mindfulness app in the past 3 months (i.e., more than 6 uses of the app)
- are on medications that make dehydration more likely (e.g., lithium, antipsychotics, insulin-dependent) diuretics, barbiturates, b-blockers, anticholinergics, current ETOH acute intoxication, reduced ability to sweat, hemophilia, pacemaker (magnets used to assemble saunas can interrupt the pacer), glomerular filtration rate (GFR) < 45 ml/min, BP >160/110.
- antidepressant or psychiatric medications that are initiated less than 8 weeks or a dose change less than 4 weeks prior to screening visit
- psychotherapy that has been initiated within the past 3 months
- psychiatric hospitalization within the past year
- diagnosed with any neurological disorders that would impact participation or make participation unsafe
- are currently in active ketamine, Electroconvulsive therapy, or Transcranial Magnetic Stimulation treatments
- are unable to follow the study procedures (e.g., not able to travel to the heated yoga or sauna studios)
- A subject who, in the opinion of the Principal Investigator, would not be able to safely complete the study or would jeopardize study integrity