Lifestyle as the background on which treatment works
Research indicates that sleep, physical activity, nutrition, stress management and substance use have a significant impact on the severity of depressive and anxiety symptoms and stress levels. Lifestyle creates a "background" for the nervous system on which pharmacotherapy and psychotherapy act – it can support them or hinder stabilization.
For example, circadian and sleep disturbances are associated with poorer prognosis in depression, a higher risk of relapse and a lower remission rate. Similarly low levels of physical activity and unfavorable dietary patterns are linked to greater symptom severity and reduced resilience to stress.
Psychological stabilization and relapses – why do symptoms "come back"?
In the literature on relapses in mental disorders, the importance of not only pharmacological treatment and psychotherapy but also environmental factors and lifestyle is emphasized. Relapses may be related among others. to: chronic stress, lack of regular daily structure, insufficient sleep, lack of physical activity, and use of psychoactive substances.
It is suggested that recovery and psychological stabilization are multidimensional processes – they include both clinical symptoms and quality of functioning, relationships, work and sense of meaning. Without changes in daily habits, the brain and body remain exposed to the same factors that previously promoted symptom worsening.
Habits and recovery – which areas are most often analyzed?
Reviews and recommendations point to several main lifestyle components associated with the course of mental disorders:
physical activity – regular exercise is associated with reduced symptoms of depression, anxiety and stress;
nutrition – dietary patterns are linked to symptom severity, and dietary changes can affect wellbeing;
sleep and circadian rhythm – sleep quality and regularity correlate with relapse risk and treatment course;
stress management and mindfulness practices – relaxation techniques and mindfulness are described as elements supporting relapse prevention;
social relationships and support – a support network is associated with better functioning and lower relapse risk;
avoiding substances – alcohol and other substances are listed as important risk factors for mood disorders and relapses.
In integrative and holistic approaches, these areas are treated as potential intervention targets – alongside pharmacotherapy and psychotherapy, not in place of them.
Mental health and lifestyle – a holistic perspective
In the holistic psychiatry stream, attention is drawn to the fact that lifestyle change can be one element of a strategy to stabilize mental health – alongside medications, therapy and work on beliefs. The aim is not an "ideal life" but gradual introduction of modifications that are realistic for a specific person and their context.
In care models that include a psychiatrist, psychotherapist and health education, the importance of individually tailored recommendations is emphasized – taking into account the patient’s capabilities, coexisting somatic diseases and current life situation. Lifestyle information then has a complementary character and is part of a broader plan, not a standalone "recipe for mental health".
During consultations – both in person and in the form of online psychiatric consultations, psychiatric teleconsultations or e-visits with a psychiatrist – issues such as sleep, activity, nutrition, stress and relationships may be topics of discussion. Holistic psychiatry in-person and online emphasizes nervous system regulation and a comprehensive view of the patient’s health.
Selected sources
RACGP, Lifestyle interventions for mental health, Australian Journal of General Practice.
American Psychiatric Association, Lifestyle to Support Mental Health, psychiatry.org.
Xiang M. et al., Serial mediation effect of physical activity and sleep quality between dietary behaviour and depression symptoms, International Journal of Preventive Medicine.
Systematic review and meta-analysis: The Effect of Lifestyle Interventions on Anxiety, Depression and Stress, (96 RCTs), Nutrients.
HEPAS: Healthy Eating, Physical Activity, and Sleep Hygiene in prevention and management of neuropsychiatric disorders, Frontiers in Psychiatry.
The information in this article is general and educational in nature.
It does not constitute medical advice or individual diagnostic or therapeutic recommendations.
Decisions about starting, continuing or changing treatment, including modifying doses of antidepressant medications, should be made only after consultation with a physician, taking into account the patient’s full clinical picture.
