Eight lifestyle interventions for major depression

Written by Grant H. Brenner

We know that lifestyle changes are key to ensuring long-term health and well-being, positively affecting mental and physical health and the synergy between them when included in a comprehensive individualized treatment plan. It can be difficult to separate the signal from the noise when it comes to focusing time and energy on lifestyle-based changes given the proliferation of reliable, life-changing information on the web.

Evaluation of the evidence for investing in a lifestyle

Researchers Marx et al., in International Journal of Biology Psychiatry (2023), compiling the literature related to lifestyle and MDD. They reviewed thousands of articles and categorized the evidence into strong (“must”), limited (“could”), low (“may”) and no evidence. Eight key lifestyle factors associated with potential relief from MDD have been identified. Notably, none had a “strong” evidence base, making the Limited best-in-class.

Marks et al., 2023, open access

Source: Marx et al., 2023, Open Access

1. Physical activity and exercise interventions (limited)

depression It is associated with decreased activity levels, and increased movement and exercise may be beneficial. The mechanisms are unclear, but include a possible increase in BDNF (brain-derived neurotrophic factor). NeuroplasticityAnd Stress shorthand/Flexibility; reduce inflammation, stimulate different brain regions; and improving psychosocial factors (see below).

Marks et al., 2023, open access

Source: Marx et al., 2023, Open Access

2. smoking Stop interventions (low)

Smoking reduces the risk of many health problems, especially cardiovascular and pulmonary health, diabetes and premature death, which significantly leads to self-destruction. While studies show that reducing or quitting smoking may relieve symptoms of depression, limited evidence shows that quitting smoking definitively improves MDD. Stopping smoking now will secure better overall health in the future.

Marks et al., 2023, open access

Source: Marx et al., 2023, Open Access

3. Action-oriented interventions (limited)

Counseling through the workplace and other interventions (wellness programs, flexibility trainings, etc.), can offer relief to people with clinical depression. Work-related psychological educational programmes BurntPrevention can help relieve or prevent depression. Such interventions may also improve work performance and increase productivity and reduce lost days. Reducing stigma around mental health, building effective action-based programs, and removing barriers to mental health care are among the best practices.

Marks et al., 2023, open access

Source: Marx et al., 2023, Open Access

4. MindfulnessBase and pressure Administration interventions (limited)

Curricula including mindfulness-based Cognitive behavioral to treat MB-CBT and mindfulness-based stress reduction (MBSR) can be beneficial. Stress management and relaxation techniques, including breathing practice and progressive muscle relaxation, may also reduce symptoms of depression when used properly1.

Marks et al., 2023, open access

Source: Marx et al., 2023, Open Access

5. Dietary Interventions (Low)

Surprisingly, given the amount of media hype and intuitive appeal, the evidence for dietary changes preventing or relieving clinical depression is of low quality. There is more evidence, as with smoking cessation, that diet and feed affect physical health, which would be expected to improve mental health indirectly (eg by increasing the sense of Self-efficacy, enable exercise, etc.). True nutritional deficiencies may cause depressive-like syndromes, and dietary modification may contribute to reducing inflammation and stress reactions, improving brain health, and possibly alleviating depression.2.

Marks et al., 2023, open access

Source: Marx et al., 2023, Open Access

6. Sleep Interventions (Limited)

There is a relatively strong association with improved sleep and a reduction or prevention of clinical depression. insomnia It is a primary symptom of depression, and lack of sleep exacerbates underlying moods and irritability. Lack of sleep also impairs cognitive function. These factors, in turn, lead to problems in personal and professional functioning, creating a vicious cycle. Interventions that improve sleep, such as CBT-I (Cognitive Behavioral Therapy for Insomnia), are associated with improvements in depression. Likewise, treating depression improves sleep quality. Depression and insomnia feed off each other.

Marks et al., 2023, open access

Source: Marx et al., 2023, Open Access

7. Loneliness and social support interventions (low)

Depression includes social withdrawal and low self-esteem as core symptoms affecting the ability to secure social support. Loss of social support and loneliness can also precipitate depression and is associated with a negative impact on physical well-being. Perceived social support is a key factor in resilience, too. However, research has not looked in depth at whether interventions targeting social support and loneliness are effective with clinical depression.

Read the basics of depression

Marks et al., 2023, open access

Source: Marx et al., 2023, Open Access

8. Green space intrusions (low)

Evidence for green space interventions, eg natural therapyGardening or spending time in green urban spaces does not show a significant causal relationship. Studies have not examined in detail whether the type of green space matters, and factors such as pollution and noise in urban spaces may offset the benefits. In addition, increasing physical activity and exercise is a key factor in green space interventions, with a stronger evidence base. Structured interventions in green spaces often increase social support, making it difficult to dislodge the effects.

Make effective lifestyle choices

At the end of the day, since there is no solid evidence for any of the above interventions, individualized lifestyle programming is needed, along with appropriate treatment and clinical judgment, to determine what will be most effective for a particular individual. Do what makes you feel good and healthy, and consult the appropriate professionals as needed.

Given the state of the art, an open experimental approach is likely to yield the best results, with trials of different interventions designed to see what works best for a particular person at a particular time. It is advised to focus on interventions with the strongest basis, and to follow recommendations based on available evidence: physical activity and exercise, work-related interventions, alertness and stress-based management, and sleep-related interventions have the best available evidence.

The study authors provide guidance:

  • It is proposed to deliver lifestyle based mental health care in line with our proposed conceptual framework
  • Explore individual factors (such as financial, geographic, medical, and social considerations) when initiating behavior change to promote uptake and sustainability
  • Explore one’s ability and opportunities f motivation To initiate and maintain behavior change
  • Encourage the individual to seek formal programs related to lifestyle interventions that provide supervision and structured activity.
  • Encourage the individual to incorporate social components (eg clubs, community groups, friends and/or family) into the interventions.
  • Physicians are encouraged to engage with relevant allied health professionals and specialists, when necessary
  • Consider incorporating digital and online tools into lifestyle interventions to help with adherence and self-management

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