Optimizing Interventions for Major Depressive Disorder and Provider Burnout: Self-speak Exercise Dosing (SED)

Major Depressive Disorder (MDD) is ranked highest among mental illnesses in the United States (US) and significantly contributes to the mental health care crisis. Patients experience resistance to pharmacologic interventions, side effects, co-morbidities, and mental health provider shortages. Subsequently, 33 % of Serious Mental Illnesses (SMIs) are being redirected to Primary Care Providers (PCPs). Concurrently, prescriber mental health is in crisis. Growing workloads for physicians and Advanced Practice Providers (APPs) have increased provider burnout syndrome (BOS). Major Depressive Disorder and BOS are positively affected by exercise, Cognitive Restructuring (CR), and Behavioral Activation (BA). Sports medicine and psychology research shows that movement performance, learning, self-regulation, cognition, and focus are improved via a self-directed and self-referential technique called self-speak. Pairing exercise with self-speak, neuroplasticity, and BA can increase patient engagement. Improving non-pharmacologic, autonomous techniques that effectively treat MDD and burnout syndrome could decrease the need for patient visits, minimize provider demand, and reduce prescriber burnout.