New ‘lifestyle’ guidelines provide more options for treating depression

An international research taskforce, led by Deakin University, has released the first set of clinical treatment guidelines for depression to comprise lifestyle interventions such as healthful eating, quitting smoking, establishing social connections and spending time in nature.

The guidelines are designed to support the application of ‘lifestyle based mental health care’ in any country or setting and provide evidence that they can make a positive difference to mental health.

Professor Adrienne O’Neil, Co-Director of Deakin’s Food & Mood Centre and co-chair of the international taskforce, said the guidelines were designed to provide clear evidence-based guidance on how health professionals can integrate lifestyle approaches into their mental health care, offering patients more options and improved outcomes.

“There is a rapidly growing demand from the general public and health professionals for more evidence-based options to improve mental wellbeing outside of, or in addition to, medication, particularly in the face of long wait times for psychologists and psychiatrists,” Professor O’Neil said.

“These guidelines provide clear recommendations on the effectiveness and safety of lifestyle approaches as well as implementation considerations.”

The nine lifestyle approaches covered by these guidelines include:

  1. Physical activity and exercise, including the importance of improving aerobic and resistance training while reducing sedentary behaviours,
  2. Relaxation techniques, such as guided breathing exercises,
  3. Re-engaging people with employment or volunteering,
  4. Adequate sleep,
  5. Mindfulness-based therapies,
  6. Healthy diet,
  7. Quitting smoking,
  8. Addressing feelings of loneliness and improving social connection, and
  9. Interaction with nature (green and blue spaces)

Dr Sam Manger, co-author of the guidelines, General Practitioner, and President of the Australasian Society of Lifestyle Medicine, said that recent census data had revealed more than two million Australians are living with a mental health condition as a long-term illness.

“We know that people with mental health conditions have a significantly greater risk of chronic diseases and early death,” Dr Manger said.

“We now have good evidence that a lifestyle-based approach to care can have dual benefits to mental and physical health.

“This is part of a new field of care known as ‘lifestyle-based mental health care’ which sees lifestyle approaches such as physical activity and diet as the foundation of managing clinical depression, together with, or perhaps instead of, other therapies like medication.

“Lifestyle-based interventions are generally very safe and benefit other outcomes, such as physical health and overall functioning,” Dr Manger said.

Dr Wolfgang Marx, Senior Research Fellow at Deakin’s Food & Mood Centre and lead author of the guidelines said the findings were especially significant as a means of expanding treatment options in the current climate where the global incidence of depression was increasing, and the mental health workforce was over-stretched.

“We see a real opportunity for allied and other health professionals, like dietitians and exercise physiologists, to be trained up in lifestyle-based mental health care and re-deployed to help ease the load of mental health clinicians whose waitlists are increasingly lengthy,” Dr Marx said.

This month also sees Deakin University’s Food & Mood Centre launch an online course for health professionals to upskill in this area including using these new guidelines.

The guidelines were developed based on a series of systematic reviews of existing literature and have been published in the World Journal of Biological Psychiatry