Psychotherapy is considered one of the most effective non-drug treatments for mood disorders, including depression and bipolar disorder.
Unfortunately, the growing demand for mental health services means many Australians face barriers to accessing timely care.
There is a growing body of evidence that suggests lifestyle interventions targeting diet, exercise, sleep and substance use can improve the symptoms of mental health disorders. What remains unclear is whether these lifestyle interventions can deliver outcomes comparable to psychotherapy, particularly for people experiencing moderate to severe symptoms.
As demand for psychological treatments continue to increase, there is a critical need to identify alternate strategies to support people and alleviate the pressure on Australia’s mental healthcare system.
Comparing treatment programs
Professor Adrienne O’Neil from the Deakin Food & Mood Centre is leading the HARMON-E trial, one of four signature trials being conducted via the Mental Health Australia General Clinical Trials Network (MAGNET).
The trial is investigating whether lifestyle therapy can match the clinical and cost effectiveness of psychotherapy, while improving depressive symptoms and physical health conditions in people living with depression or bipolar disorder. The study recruited adults diagnosed with either major depressive disorder or bipolar disorder, who may benefit from support with healthy lifestyle choices. Participants were randomly assigned to one of two online group programs. The first group received psychological therapy delivered by psychologists, while the second participated in a lifestyle program led by accredited practicing dietitians and exercise physiologists.
The lifestyle program focused on achievable changes across diet, physical activity, sleep and substance use to support both mental and physical health. The psychotherapy group helped participants understand the thoughts, behaviours and emotions that influence their mood, while developing practical strategies to support long-term mental wellbeing.
More ways to treat mood disorders
If lifestyle therapy is shown to be as effective as psychological therapy, it could expand treatment options for people living with depression and bipolar disorder while improving access to evidence-based healthcare.
‘A successful trial could provide people living with depression or bipolar disorder with another option that is both accessible and effective,’ Professor O’Neil says.
‘Because the program is delivered through telehealth, it also has the potential to improve access to care and remove long waiting times for psychological services’.
Beyond mental health, the trial will provide important insights into anxiety, sleep quality, aspects of diet quality, physical activity, cardiovascular health and the gut microbiome. These findings will help researchers better understand how lifestyle changes influence both mental and physical health.
Lifestyle therapies are not currently part of mainstream mental health care in Australia. By comparing it against standard psychological care, the HARMON-E trial could provide the evidence needed to inform future clinical guidelines and support broader integration into the mental health system. If successful, lifestyle therapy could become an accessible first-line treatment option, helping Australians receive timely support while reducing pressure on general practitioners and psychological services.
Where next?
The research team are hoping to see policy and clinical education reform that could aid the implementation of lifestyle based mental health care.
This could include subsidising allied health professionals across mental health settings, upskilling dietitians and exercise physiologists to be formally trained in mental health care delivery and promoting multidisciplinary models of care that support psychologists and other allied health professionals collaborating to deliver lifestyle-based mental health care.
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