Eight lifestyle interventions for major depression

By Grant H. Brenner

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 and individualized treatment plan. It can be difficult to separate signal from noise when trying to focus time and energy on lifestyle-based changes given the explosion of information of variable reliability on the web.

Assessing the Evidence for Lifestyle Investing

The researchers Marx et al., in The world journal of biology Psychiatry (2023), compiled the relevant literature on lifestyle and MDD. They reviewed thousands of articles and rated the evidence as Strong (“Should”), Limited (“Could”), Low (“May”), and No Evidence. Eight core lifestyle factors associated with potential alleviation of MDD were identified. Notably, neither had a “strong” evidence base, making “Limited” the best in class.

1. Physical activity and exercise interventions (Limited)

Depression it is associated with reduced activity levels, and increased movement and exercise may be beneficial. The mechanisms are unclear, but include potential increases in BDNF (brain-derived neurotrophic factor), increased neural plasticity, stress reduction/Resilience; reduction of inflammation, stimulating different areas of the brain; and improved psychosocial factors (see below).

2. Of smoking smoking cessation interventions (Low)

Smoking reduces the risk of many health problems, particularly cardiovascular and pulmonary health, diabetes, and markedly self-destructive premature death. While studies suggest that cutting down or quitting smoking can relieve depressive symptoms, limited evidence shows that quitting definitely improves major depressive disorder. Quitting smoking now will ensure better overall health in the future.

3. Work-directed interventions (Limited)

Counseling through the workplace and other interventions (wellness programs, resilience training, etc.) could offer relief to people with clinical depression. Work-related psychoeducational programs and exhaustion-Prevention can help alleviate or prevent depression. Such interventions can also improve job performance, increasing productivity and reducing lost days. Reducing mental health stigma, creating effective work-based programs, and removing barriers to mental health care are some of the best practices.

Four. consciousness-based and stress management interventions (limited)

Approaches including those based on Mindfulness Cognitive Behavioral Therapy (MB-CBT) and Mindfulness-Based Stress Reduction (MBSR) could be helpful. Relaxation and stress management techniques, including breathing practice and progressive muscle relaxation, can also reduce depressive symptoms when used correctly.^one.

5. Dietary interventions (Low)

Surprisingly, given the amount of media buzz and intuitive appeal, the evidence that dietary changes prevent or alleviate clinical depression is of low quality. There is more evidence, as with quitting smoking, that diet and nutrition have an impact on physical health, which is expected to improve mental health indirectly (eg, by increasing feelings of self-efficacy, authorization of the exercise, etc.). True nutritional deficiencies can cause depression-like syndromes, and dietary modification can help reduce inflammation and stress reactions, improving brain health and possibly alleviating depression.².

6. Interventions related to sleep (limited)

There is a relatively strong association with improved sleep and reduction or prevention of clinical depression. Insomnia It’s a core symptom of depression, and lack of sleep worsens baseline mood and irritability. Sleep deficit also affects cognitive function. These factors, in turn, cause 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 better depression. Treatment of depression also improves the quality of sleep. Depression and insomnia feed each other.

7. Loneliness and interventions related to social support (Low)

Depression includes social isolation and low self-esteem as core symptoms, which affects the ability to obtain social support. Loss of social support and loneliness can also precipitate depression and are associated with a negative impact on physical well-being. Perceived social support is also a central factor for resilience. However, research has not robustly examined whether interventions aimed at social support and loneliness are effective with clinical depression.

8. Interventions in green spaces (Low)

Evidence of interventions in green spaces, such as nature therapy, gardening or spending time in urban green spaces, does not show a substantial causal relationship. Studies have not looked in detail at whether the type of green space matters, and factors such as pollution and noise in urban spaces may offset the benefits. Furthermore, increased physical activity and exercise is a key factor in green space interventions, with a stronger evidence base. Structured green space interventions often increase social support, making it difficult to separate the effects.

Making effective lifestyle choices

At the end of the day, given the lack of strong evidence for any of the above interventions, individualized lifestyle programming, combined with appropriate treatment and clinical judgment, is needed to determine what will be most effective for any given individual. Do what makes you feel good and healthy, and consult with the appropriate professionals as needed.

Given the state of the art, an open experimental approach is likely to produce the best results, with trials of different interventions designed to find out what works best for a given person at a given time. It is advisable to focus on interventions with a more solid base and follow the recommendations based on the available evidence: physical activity and exercise, work-related interventions, those based on mindfulness and stress management, and those related to work. sleep have the best available evidence.

The study authors offer guidelines:

• It is suggested that lifestyle-based mental health care delivery be in line with our proposed conceptual framework.
• Explore individual factors (eg, financial, geographic, medical, and social considerations) when initiating behavior change to promote acceptance and sustainability.
• Explore the capacity, opportunity and motivation to initiate and sustain behavior change
• Encourage the individual to seek relevant formal programs for lifestyle interventions that provide supervision and structured activity.
• Encourage the person to incorporate social components (eg, clubs, community groups, friends and/or family) into interventions.
• Physicians are encouraged to interact with relevant allied health professionals and specialists, where warranted.
• Consider integrating online and digital tools into lifestyle interventions to help with adherence and self-management.