The Potential for Outdoor Nature-Based Interventions in the Treatment and Prevention of Depression

Abstract

There is growing interest in nature-based interventions (NBI) to improve human health and wellbeing. An important nascent area is exploring the potential of outdoor therapies to treat and prevent common mental health problems like depression. In this conceptual analysis on the nature–depression nexus, we distil some of the main issues for consideration when NBIs for depression are being developed. We argue that understanding the mechanisms, or ‘active ingredients’ in NBIs is crucial to understand what works and for whom. Successfully identifying modifiable mediating intervention targets will pave the way for interventions with increased efficacy. We highlight a non-exhaustive list of five clinically relevant putative, candidate mechanisms which may underly the beneficial effects of NBIs on depression: stress, rumination, mindfulness, sleep and exercise. We also make the case that when developing NBIs it is important to not neglect young people, explore personalised approaches and focus on both treatment and prevention approaches. To achieve these aims methodologically rigorous programmes of clinical research are needed that include well-powered and controlled experimental designs including randomised controlled trials, qualitative research, longitudinal studies and large prospective cohorts.

Nature-Based Meditation, Rumination and Mental Wellbeing

“…While there was evidence of benefits following both meditations, the overall pattern in the data suggests that nature-based guided meditation may be superior to its non-nature-based indoor counterpart. More broadly, the plausibility of the positive effects of mindfulness-based approaches on young people, including brief interventions, is consistent with previous research [ 89 , 90 , 91 ], as is the finding that depressive rumination decreased following nature-based meditation when compared to active control and the indoor, standard meditation [ 46 , 65 , 66 , 67 , 68 , 70 ]. There are a number of possible explanations for the reduction in rumination.…”

“…Brief self-guided nature-based meditation may have different applications to clinical practice and has merit in both a prevention and intervention context [ 46 ]. Given findings from this study on reducing rumination and depressive symptoms and improving wellbeing, this form of intervention may have utility for individuals in beginning the therapeutic process whilst waiting to access treatment.…”

“…However, the core mechanisms that underly the putative beneficial effect of NBIs on mental wellbeing are currently poorly understood. Several candidates have been posited in the literature [ 46 ], two of which, mindfulness and rumination, are the focus of the present study.…”

Effects of virtual reality natural experiences on factory workers’ psychological and physiological stress

“…Nature-based interventions have been studied and are considered effective strategies for alleviating stress and mental health illnesses ( Picton et al, 2020 ; Coventry et al, 2021 ). Nature-based interventions provide individuals with an opportunity to explore their relationship with nature in terms of connecting to and being impacted by the natural environment to reduce negative mental health issues ( Hartig et al, 2014 ; Owens and Bunce, 2022 ). However, infusing the natural environment in the workplace is challenging due to urbanization, and people who live and work in urban areas have very limited opportunities to connect with nature.…”

Group Nature-Based Mindfulness Interventions: Nature-Based Mindfulness Training for College Students with Anxiety

“…Nature-based mindfulness connects nature with mindfulness techniques to deepen meditation practices [ 27 ], encourage social activism, assist in coping with climate change [ 89 ], and improve well-being [ 90 , 91 ]. Mindfulness is an integral component of Shinrin-Yoku (i.e., forest bathing) [ 92 ], which aids in reducing anxiety [ 93 ]. Although the practice of integrating nature and mindfulness has been used for centuries [ 26 ], the evidence in support of nature-based mindfulness interventions to improve human health and well-being is in its infancy.…”