Lifestyle medicine for depression

Abstract

The prevalence of depression appears to have increased over the past three decades. While this may be an artefact of diagnostic practices, it is likely that there are factors about modernity that are contributing to this rise. There is now compelling evidence that a range of lifestyle factors are involved in the pathogenesis of depression. Many of these factors can potentially be modified, yet they receive little consideration in the contemporary treatment of depression, where medication and psychological intervention remain the first line treatments. “Lifestyle Medicine” provides a nexus between public health promotion and clinical treatments, involving the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing. This may also provide opportunities for general health promotion and potential prevention of depression. In this paper we provide a narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol. We also discuss other potential lifestyle factors that have a more nascent evidence base, such as environmental issues (e.g. urbanisation, and exposure to air, water, noise, and chemical pollution), and the increasing human interface with technology. Clinical considerations are also outlined. While data supports that some of these individual elements are modifiers of overall mental health, and in many cases depression, rigorous research needs to address the long-term application of Lifestyle Medicine for depression prevention and management. Critically, studies exploring lifestyle modification involving multiple lifestyle elements are needed. While the judicious use of medication and psychological techniques are still advocated, due to the complexity of human illness/wellbeing, the emerging evidence encourages a more integrative approach for depression, and an acknowledgment that lifestyle modification should be a routine part of treatment and preventative efforts.

Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis

“…There is clear evidence that lifestyle factors are linked to the pathogenesis of mood disorders [10]. Many lifestyle factors are modifiable yet there is often little consideration of this treatment strategy, and pharmacological and psychological therapies remain the first line treatment choices [10]. A recent randomized controlled trial showed that modification of lifestyle factors (diet, sunlight exposure, exercise and sleep patterns) was an effective treatment strategy for depression [11].…”

“…There is clear evidence that lifestyle factors are linked to the pathogenesis of mood disorders [10]. Many lifestyle factors are modifiable yet there is often little consideration of this treatment strategy, and pharmacological and psychological therapies remain the first line treatment choices [10].…”

“…The evidence for lifestyle medicine encourages an integrative approach whereby lifestyle modification is a routine part of prevention and treatment for depression. Lifestyle medicine for depression brings additional benefits to general health, particularly in reducing the likelihood of other high prevalence chronic western lifestyle related diseases such as cardiovascular disease and diabetes [10,13,16]. …”

Persistent Depressive Disorder or Dysthymia: An Overview of Assessment and Treatment Approaches

“…Lifestyle modifications, also known as lifestyle medicine, where people adopt healthier patterns of eating, physical activity, relaxation/sleep, substance use and social interaction are believed to improve depression (Sarris, O'Neil, Coulson, Schweitzer, & Berk, 2014).…”

Correlates of well-being among Canadians with mood and/or anxiety disorders

“…7 However, most studies examining well-being among people living with a mood and/or an anxiety disorder are based on small, clinical samples and are not representative of the Canadian population. The purpose of this study is to examine factors associated with well-being, as measured by high selfrated mental health (SRMH) and satisfaction with life in general, among a representative sample of Canadians living with a mood and/or an anxiety disorder from the 2014 Survey on Living with Chronic Diseases in Canada (SLCDC).…”