Research suggests healthy lifestyle behaviors and habits promote mental health and wellness and can be used to both prevent and treat mental health conditions including anxiety, depression, bipolar spectrum disorders, post traumatic stress disorder, and psychotic disorders. These lifestyle behaviors are grouped into five general categories:

• Physical activity
• Nutrition
• Mind-body and mindfulness practices
• Restorative sleep
• Social connections 

These practices require motivation and effort on the part of the individual. They can take many forms and be adapted in many ways. It is not all or nothing, individuals can approach the aspects that work and appeal to them and approaches can change over time.

In treating mental health conditions and working with mental health professionals, lifestyle interventions across these domains, such as daily movement or choosing nutritious foods to eat, can work to complement and augment the thereapeutic benefit of medication, psychotherapy, and other treatments used to treat mental health conditions. These interventions can also be used to prevent mental illness and have even been shown to promote physical health.

These practices require motivation and effort, but can take many forms and be personalized to meet individual needs. A guiding principle it so develop small sustainable habits across various domains as you see fit, working with professionals to strategize, modify, and incorporate these habits into daily life to improve your mental wellness

In time, changes in one area of lifestyle can often contribute to improvements in other areas, for example improved sleep and nutrition can contribe to energy for more physical activity. In what follows, each of the lifestyle psychiatry domains will be discussed in more detail.

Physical activity impacts mental health. Exercise has consistently shown to effectivly reduce symptoms of depression and maintain well-being both as a primary treatment and in conjunction with medication or therapy. There is also evidence that exercise benefits individuals with posttraumatic stress disorder (PTSD), anxiety, and attention-deficit/hyperactivity disorder (ADHD).

Physical activity may also help prevent cognitive decline in older adults. More broadly, regular exercise positively impacts cognitive function and increases neuroplasticity (the brain’s ability to change) which can enhance learning and adaptation. Physical activity can take many forms—walking, running, fitness classes, organized sports, etc. Much of the research has focused on the benefits of aerobic exercise and resistance training, such as weight training.

Exercise “snacks,” or brief episodes of exercise interspersed throughout the day, can be an easy way to incorporate daily movement into daily routines. This could involve a few minutes of climbing stairs or jumping jacks or pushups. Some people report using these brief exercise breaks every hour or so during sedentary tasks also helps with attention and concentration, which can give the added benefit of improved productivity.

Food is medicine, and research underscores the significant impact of nutrient-rich diets on mental health. Diet and nutrition can impact the symptoms of mental health conditions and the risk for them.

Diets focusing on whole foods, particularly vegetables, fruits, beans, unprocessed grains, nuts, seeds, olive oil, and fish, are associated with positive effects on mental health. Conversely, diets high in processed foods, artificial ingredients, refined grains, and excessive sugar have been associated with worse mental health outcomes. For example, some research has found that a healthy diet reduces the risk of depression and for people with depression, helps reduce depressive symptoms,

The Mediterranean diet — which includes substantial vegetables, fruits, nuts, and legumes and moderate poultry, eggs, and dairy and limited red meat — has been found especially beneficial. While the links between diet and mental health are not yet fully understood, it is believed that components of the Mediterranean diet like fiber, polyphenols (micronutrients found in plants), and polyunsaturated fats (such as omega-3 fatty acids) may foster gut biome diversity. Gut biome diversity may, in turn, contribute to positive mental health.

In addition, there is growing evidence supporting the use of specific nutrients to help treat various psychiatric disorders.

(Learn more about nutrition and mental health.)

Research has also identified the benefits of mind-body practices, such as yoga and tai chi, and meditation and mindfulness practices. These practices can reduce stress, improve well-being, and help reduce symptoms of mental health conditions.

While some stress is necessary, chronic stress decreases the ability to cope and can lead to negative physical and mental health. These practices can help calm the mind and body and reduce stress and are becoming increasingly popular practices. An estimated 33 million Americans practiced yoga in 2023, up from about 21 million in 2010. And nearly 4 million practice tai chi. An estimated 14% of adults practice some form of mindful or spiritual meditation.

Practices such as yoga have been shown to change the structure and function in the brain regions, including significant changes in areas involved in emotion regulation and stress.

Mindfulness-based stress reduction (MBSR) has well-established therapeutic benefits as well. For example, one study found an MBSR program to be as effective as medication for the treatment of generalized anxiety disorder. An MBSR program is provided by trained instructors and typically consists of eight weekly group sessions covering a variety of formal and informal meditation practices (such as sitting meditation, body scan, breathing techniques, mindful walking, and mindfulness of daily activities), mindful yoga practices and techniques, group discussions, and instruction and recordings for at-home practice.

More recently breathwork has been gaining interest as a distinct intervention. Breathwork practices have been asso¬ciated with reduced levels of stress and improve¬ment in anxiety and depressive symptoms. Breathwork involves using specific breathing techniques that can help calm the body and mind and reduce stress. Breathwork is often included in yoga and meditation practices.

(Learn more about mindfulness and meditation.)

Sleep is a basic human need and is critical to both physical and mental health, but many of us do not get enough sleep. Sleep problems can include issues related to the quality, timing, and amount of sleep. A third of adults report that they usually get less than the recommended amount of sleep and an estimated one in three Americans report their sleep quality as “poor” or “only fair.” More than 70 million Americans experience sleep disorders each year.

Sleep helps the brain function properly. Not getting enough sleep or poor quality sleep has many potential consequences. Poor sleep can lead to fatigue and decreased energy, irritability, and problems focusing. The ability to make decisions and mood can also be negatively affected. Sleep difficulties are linked to both physical and emotional problems and contribute to and exacerbate mental health conditions.

Many factors can contribute to lack of quality sleep and sleep problems including modifiable factors like distraction with screens and inconsistent routines. Developing healthy sleep habits and practices, such as consistent sleep times and routines and limiting screen time before sleeping, and exercising during the day, can help improve sleep. For persistent or more challenging sleep problems, cognitive behavioral therapy or other treatments can help.

(Learn more about sleep disorders and treatments.)

Decades of research have firmly established the positive contribution of having social support and physical health, mental health, and longevity.

It has been consistently demonstrated that people with limited social support experience poorer outcomes in both physical and mental health. This issue was highlighted in the U.S. Surgeon General’s 2023 advisory on loneliness and isolation that notes, “ loneliness and isolation increase the risk for individuals to develop mental health challenges in their lives, and lacking connection can increase the risk for premature death to levels comparable to smoking daily.”

The benefit of social connectcion can be seen in the pivotal role that psychosocial rehabilitation interventions play to enhance func¬tion and alleviate symptoms in conditions such as bipolar disorder and schizophrenia.

While the mechanisms through which social connections enhance mental health are not completely understood, it is known that social connections affect neurobiological pathways and psychological resilience. Social connection may also help buffer the impacts of stress by providing active coping mechanisms and emotional support. The positive feelings associated with social connection, such as a sense of belonging, security and self-worth, foster better stress responses.

In essence, creating and maintaining social connections contributes to broad enhancement of psychological well-being and health and can help in preventing and alleviating psychiatric symptoms.

Reference

Noordsy, D, Abbott-Frey, A., Chawla, V. 2024. Special Report: Lifestyle Psychiatry Emphasizes Behaviors Supporting Mental Health. Psychiatric News, Feb. 23, 2024.  (Includes links to additional references and resources.)

Physician Review

Douglas Noordsy, M.D.
Amelia Abbott-Frey, M.D.
Vanika Chawla, M.D.

May 2024