Rethinking the Fight Against Depression: What Lifestyle Changes Scientists Recommend

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In the search for more effective and long-lasting solutions for people living with major depressive disorder (MDD), science is increasingly focusing on lifestyle as a critical factor in improving mental health. This article presents key information gathered and analyzed by an international team of experts and researchers—psychiatrists, clinical scientists, dietitians, psychologists, and patient representatives—who are part of the taskforce of the World Federation of Societies for Biological Psychiatry (WFSBP) and the Australasian Society of Lifestyle Medicine (ASLM).

The findings have been published in the scientific article "Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder" (Marx W. et al., The World Journal of Biological Psychiatry, 2023), which summarizes the latest scientific evidence on the role of physical activity, nutrition, sleep, social support, and other lifestyle factors in treating depression.

In the following sections, you’ll find the most important points patients or their loved ones need to know to make informed choices in the fight against depression—all based on the most up-to-date global recommendations.

The Experts Speak 

In the last decade, research has increasingly shown that effective care for patients with major depressive disorder (MDD) goes beyond medication and psychotherapy. The clinical guidelines published in 2023 by the World Federation of Societies for Biological Psychiatry and the Australasian Society of Lifestyle Medicine focus on comprehensive lifestyle change. According to the authors, this approach not only reduces depressive symptoms but also contributes to physical health, social integration, and patient resilience.

Here are five key expert insights and research-based positions directly taken from the scientific publication. Each quote is accompanied by a clarifying question or heading that guides patients or their loved ones toward practical, evidence-based advice.

1. How important is movement and physical activity?

“Physical activity and exercise interventions could be used to reduce depressive symptoms in people with Major Depressive Disorder” Recommendation Grade: 2. Strength of evidence: Limited; Grade B. Meta-analyses report medium to large effect sizes (standardized mean difference = 0.66–1.11).

Explanation: Regular physical activity—even moderately intense forms like walking, biking, or light exercise—has been shown to significantly reduce depressive symptoms. A gradual goal of 150–300 minutes of moderate activity per week is recommended, but any amount of movement is better than complete inactivity. The best results occur when physical activity is combined with social support and a personalized routine.

2. What role does sleep and sleep management play?

“Cognitive behavioral therapy for insomnia (CBT-I) could be used to reduce depressive symptoms in people with Major Depressive Disorder” Recommendation Grade: 2. Strength of evidence: Limited; Grade B.

Explanation: Sleep disturbances often go hand-in-hand with depression, and treating insomnia—especially through cognitive behavioral therapy for insomnia (CBT-I)—is one of the most effective and low-side-effect ways to support standard therapy. Better sleep not only alleviates depressive symptoms but also improves overall quality of life.

3. What are the benefits of dietary changes?

“Dietary counseling to improve nutritional habits that is in line with healthy dietary guidelines and/or nutrient-dense dietary patterns may be used to reduce depressive symptoms in people with Major Depressive Disorder” Recommendation Grade: 3. Strength of evidence: Low; Grade C1.

Explanation: Working with a dietitian and shifting to a more balanced, nutrient-rich diet can lead to noticeable mood improvement. Although the evidence is not as strong as it is for movement or sleep, a healthy diet—especially one that includes more fruits, vegetables, fish, and whole grains—has the potential to reduce the severity of depressive symptoms.

4. What options exist for stress management and mindfulness?

“Mindfulness-based therapies (e.g. Mindfulness-Based Cognitive Therapy [MBCT] and Mindfulness-Based Stress Reduction [MBSR]) could be used to reduce depressive symptoms in people with Major Depressive Disorder” Recommendation Grade: 2. Strength of evidence: Limited; Grade B.

Explanation: Mindfulness-based therapies and stress reduction approaches are effective both as a supplement and as standalone methods for managing depression symptoms. These help individuals build resilience, reduce anxiety, and become more present in the moment—often resulting in a significant easing of hopelessness and stress.

5. How important is social support and how can isolation be addressed?

“Improving social support and reducing loneliness may be used to reduce depressive symptoms in people with Major Depressive Disorder” Strength of evidence: Low; Grade C3. Recommendation based on expert opinion.

Explanation: Lack of social contact and isolation are among the strongest factors that worsen depression. Seeking support—through peer support groups, family, friends, or professionals—can make a major difference. Getting involved in communities, volunteering, or joining group activities has been shown to improve both social functioning and mental health.

Questions and Answers

1. Are lifestyle changes safe for treating depression, and can they be combined with medication and therapy? 

Answer: According to the clinical guidelines, lifestyle interventions such as physical activity, diet, sleep improvement, and social support are generally safe for most people with depression. They can be used on their own or alongside proven treatments like medication and psychotherapy. The article notes that such changes are “generally considered safe, with low risk of side effects or serious adverse events,” and that they can be “delivered at relatively low cost across a wide range of settings and patient groups.”

2. If I can’t do this on my own, who can help me make these changes? 

Answer: The authors strongly recommend working with a team of specialists: doctors, psychologists, dietitians, physical therapists, and other relevant professionals. It's also important to involve close friends and family as part of your support network. The guidelines emphasize that “engaging allied health professionals and supportive networks, along with behavior change strategies, is key to success.”

3. Do I need to change everything at once or can I start small? 

Answer: The article clearly highlights that “effectiveness will be greatest when behavior change techniques are tailored to your personality and situation.” This means it’s more important to begin with small, sustainable steps—like adding short walks or improving one meal a day. Gradually building positive changes is more realistic and sustainable over time.

4. What should I do if I struggle to stick to a new routine or give up easily? 

Answer: The guidelines offer specific practical advice: “Explore your individual capabilities, motivation, and environment when starting behavior change to increase your chance of sustaining it long-term.” They recommend joining groups or programs with support, using apps or online tools to track progress, and seeking social support—“social components (groups, clubs, friends, family) improve adherence and enjoyment of a new lifestyle.”

5. Why is it important for the recommendations to match my culture, customs, and personal background? 

Answer: The document states that “the approach should be applied within a biopsychosocial-cultural framework.” This means your personal preferences, cultural environment, beliefs, and daily life are very important when choosing a strategy. For example, if a certain diet or type of physical activity is more acceptable or feasible for you due to cultural reasons, it should be preferred. This increases the likelihood of success and lowers the risk of quickly giving up on the changes.

Conclusion Depression is a complex condition that requires a comprehensive and personalized approach. The clinicians and researchers who contributed to the global lifestyle-based treatment guidelines for depression unanimously emphasize that success lies in sustainable, realistic, and individualized steps. The recommendations summarized in this article offer not just hope, but also a practical framework for action—with a focus on safety, support, small wins, and cultural sensitivity.

Even the smallest positive changes can make a big difference to your mental and physical well-being. Turn to professionals, involve your loved ones, and remember: you are not alone in this journey.

Source Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce. The World Journal of Biological Psychiatry, 2023, 24:5, 333–386. DOI: 10.1080/15622975.2022.2112074