- Lifestyle-related modifications can contribute to clinical depression, both making depression work or helping to prevent or alleviate symptoms.
- There is a lot of advice regarding lifestyle factors, but the evidence-base is surprisingly limited, making decision-making challenging.
- Some factors have stronger data, including physical activity/exercise, work-related factors, sleep, mindfulness-based/relaxation, among others.
- At the end of the day, current lifestyle planning for depression is evidence-informed and personalized due to low overall causal research.
- We know that lifestyle changes are key to ensuring long-term health and well-being, positively impacting mental and physical health and the synergy between them when included in a comprehensive, individualized treatment plan. It can be hard to separate the signal from the noise when it comes to focusing time and energy on lifestyle-based changes, given the explosion of variably-reliable information on the web.
- Depression is associated with reduced levels of activity, and increasing movement and exercise may be of benefit. The mechanisms are unclear, but include potentially increasing BDNF (brain-derived neurotrophic factor), increasing neural plasticity, stress reduction/resilience; reduced inflammation, stimulating different brain areas; and improved psychosocial factors (see below).
- Counseling via the workplace and other interventions (wellness programs, resilience trainings, etc.), could offer relief to people with clinical depression. Work-related psychoeducational programs and burnout-prevention can contribute to alleviating or preventing depression. Such interventions may also improve work performance, increasing productivity and reducing days missed. Reducing mental health stigma, building effective work-based programs, and removing barriers to mental healthcare are among best practices.
- Approaches including Mindfulness-based Cognitive Behavioral Therapy (MB-CBT) and Mindfulness-Based Stress Reduction (MBSR) could be helpful. Stress management and relaxation techniques, including breathing practice and progressive muscle relaxation, also may reduce depressive symptoms when used properly1.
- There is a relatively strong association with improving sleep and reducing or preventing clinical depression. Insomnia is a core symptom of depression, and poor sleep worsens baseline mood and irritability. Sleep deficit also impairs cognitive function. These factors in turn drive problems in personal and professional function, leading to a vicious cycle. Interventions which improve sleep, such as CBT-I (Cognitive Behavioral Therapy for Insomnia), are associated with improved depression. Treating depression likewise improves sleep quality. Depression and insomnia feed off of each other.
- Depression includes social withdrawal and low self-esteem as core symptoms, impacting the ability to secure social support. Loss of social support and loneliness likewise can precipitate depression and are associated with negative impact on physical well-being. Perceived social support is a core factor for resilience, as well. Nevertheless, research has not robustly looked at whether interventions targeting social support and loneliness are effective with clinical depression.
- Given the state of the art, an open, experimental approach is likely to yield the best results, with trials of different interventions designed to find out what works best for a given person at a given time. It’s advisable to focus on interventions with a stronger base, and follow recommendations based on available evidence: physical activity and exercise, work-related interventions, mindfulness-based and stress management, and sleep-related interventions have the best available evidence.
- We know that lifestyle changes are key to ensuring long-term health and well-being, positively impacting mental and physical health and the synergy between them when included in a comprehensive, individualized treatment plan. It can be hard to separate the signal from the noise when it comes to focusing time and energy on lifestyle-based changes, given the explosion of variably-reliable information on the web.
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