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Cited by 450Health and Lifestyle StudiesTreatment of Major DepressionPhysical Activity and Health

Lifestyle medicine for depression

Open access
Sarris, Jerome, O’Neil, Adrienne, Coulson, Carolyn E, Schweitzer, Isaac, Berk, Michael·2014·BMC Psychiatry
DOI 10.1186/1471-244x-14-107PMC PMC3998225
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Abstract

The prevalence of depression appears to have increased over the past three decades. While this may be an artefact of diagnostic practices, it is likely that there are factors about modernity that are contributing to this rise. There is now compelling evidence that a range of lifestyle factors are involved in the pathogenesis of depression. Many of these factors can potentially be modified, yet they receive little consideration in the contemporary treatment of depression, where medication and psychological intervention remain the first line treatments. "Lifestyle Medicine" provides a nexus between public health promotion and clinical treatments, involving the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing. This may also provide opportunities for general health promotion and potential prevention of depression. In this paper we provide a narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol. We also discuss other potential lifestyle factors that have a more nascent evidence base, such as environmental issues (e.g. urbanisation, and exposure to air, water, noise, and chemical pollution), and the increasing human interface with technology. Clinical considerations are also outlined. While data supports that some of these individual elements are modifiers of overall mental health, and in many cases depression, rigorous research needs to address the long-term application of Lifestyle Medicine for depression prevention and management. Critically, studies exploring lifestyle modification involving multiple lifestyle elements are needed. While the judicious use of medication and psychological techniques are still advocated, due to the complexity of human illness/wellbeing, the emerging evidence encourages a more integrative approach for depression, and an acknowledgment that lifestyle modification should be a routine part of treatment and preventative efforts.

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Crossref · 10.1186/1471-244x-14-107

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  • Physical activity/exercise, dietary modification, adequate sleep, social interaction, and mindfulness-based meditation have shown treatment efficacy in separate clinical trials of depression.

    “These include physical activity/exercise, dietary modification, adequate sleep and social interaction, as well as mindfulness-based meditation, all of which have shown treatment efficacy in separate clinical trials of depression [4–16].”

    From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [4]

    The Review’s “Lifestyle elements with supportive data” section reports trial evidence for exercise and a meta-analysis finding improved mood symptoms with mindfulness-based training (page numbers unavailable). It also says no robust study had tested dietary changes as treatment for a diagnosed mental illness. The sleep and social-interaction evidence it describes does not establish efficacy in separate depression treatment trials; the Summary reports one trial combining dietary and sleep recommendations with other changes, not trials of each element separately. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Integrative behavioral health treatments are recommended first-line for mild-to-moderate depression.

    “Notably, the majority (~67%) of all depression cases fall in the category of mild-to-moderate depression [3] for which integrative behavioral health treatments are recommended first-line as effective and scalable solutions [4].”

    From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [4]

    The Conclusions (page unavailable) say lifestyle modifications have potential front-line application alongside medication and psychological treatments. The Introduction instead identifies medication and psychological interventions as first-line and describes lifestyle medicine as an option for augmenting care. The paper does not specifically recommend integrative behavioral treatments as first-line for mild-to-moderate depression or establish that they are scalable. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Lifestyle targeted behavioral interventions in depression have typically shown small-to-medium effect sizes of ~0.3-0.5, while the placebo effect of behavioral interventions is even smaller ~0.2 in RCTs.

    “Lifestyle targeted behavioral interventions in depression have typically shown small-to-medium effect sizes of ~0.3–0.5 [4–16], while the placebo effect of behavioral interventions are even smaller ~0.2 in RCTs [101, 102].”

    From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [4]

    The Review’s ‘Lifestyle elements with supportive data’ section describes modest effects for exercise in higher-quality depression trials and a moderate effect for relaxation techniques. It does not give the claimed ~0.3–0.5 range or establish that this is typical of lifestyle-targeted interventions generally. The placebo-effect clause cites other sources, not this paper. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Lifestyle interventional strategies incorporating diet, sleep and physical activity have been recognised as protective treatments for depression.

    “Recently, lifestyle interventional strategies incorporating diet, sleep and physical activity have been recognised as protective treatments for depression.17 18”

    From Comparative effectiveness of exercise, antidepressants and their combination in treating non-severe depression: a systematic review and network meta-analysis of randomised controlled trials (2022) · cites this paper as [18]

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Authors
Sarris, J., O’Neil, A., Coulson, C. E., Schweitzer, I., & Berk, M.
Affiliations
  • The University of Melbourne (AU)
  • Deakin University (AU)
Corresponding author
Sarris, Jerome
ORCID
Sarris, Jerome
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2014-04-10
Volume
14
Issue
1
Pages
107-107
ISSN
1471-244X (ISSN-L)
DOI
10.1186/1471-244x-14-107
PMC
PMC3998225
OpenAlex
W2054125742
Cited by
450
References
172
Citations by year
2026: 28 · 2025: 60 · 2024: 61 · 2023: 49 · 2022: 56 · 2021: 51 · 2020: 34 · 2019: 31 · 2018: 26 · 2017: 19 · 2016: 16 · 2015: 12 · 2014: 6 · 2012: 1
FWCI
3.01
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
  • Figshare (submittedVersion, cc-by)
  • Swinburne figshare (Swinburne University of Technology) (submittedVersion, cc-by)
  • Swinburne figshare (Swinburne University of Technology) (cc-by)
Funders
  • Medical Research Council
  • National Health and Medical Research Council (1052865)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
lifestyle medicine, depression, depression prevention, physical activity, dietary change, sleep, relaxation, social interaction, mindfulness meditation, substance use reduction, urbanization, environmental pollution, technology use, integrative therapy, mental health promotion
MeSH terms
Depression, Depressive Disorder, Diet, Health Promotion, Humans, Life Style, Mental Health, Social Behavior, Exercise

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