How to improve depression through lifestyle? These questions are worth asking

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Lifestyle-based mental health care promotes the prevention, treatment and rehabilitation
of mental disorders by assessing and intervening lifestyle factors that influence health.
The important position of lifestyle in depression management has been recognized by RANZCP, NICE and other authoritative institutions, and complements other evidence-based antidepressant treatment methods
.

In this context, the World Federation of Biological Psychiatric Societies (WFSBP) and the Australian Society of Lifestyle Medicine (ASLM) jointly released the Clinical Guidelines for Lifestyle-Based Mental Health Care for Patients with Depression (hereinafter referred to as the "Guidelines"), the full text of which was published in the official journal of WFSBP World J Biol Psychiatry on October 6, 2022.

。

Figure 1 A stepwise model of lifestyle-based mental health care

For clinical assessment of lifestyle, the guidelines give a series of examples
of questions around each topic.
In fact, these questions can be valuable not only for questioning patients, but also for the healthcare worker himself:

1.
Exercise

"How many minutes or hours of exercise per day?"

"What days and when do you exercise?" Why these times? ”

"How do you usually exercise? What form of exercise do you prefer? ”

"Do you sit still for long periods of time all day long?"

2.
Diet

"What did you eat at the last meal, can you tell me?"

"What do you usually eat for breakfast, lunch, and dinner?"

"What time do you usually eat dinner?" Where to eat? ”

"What snacks do you usually eat?" What time to eat? ”

"What do you drink mainly at the end of the day?"

3.
Sleep

"How many hours do you usually sleep every night?"

"What do you usually do before going to bed?"

"How much do you think your sleep quality can score?"

"Do you feel tired when you wake up?"

"Dozing off during the day? If so, why? ”

4.
Quit smoking

"How many cigarettes a day?"

"How long after waking up do I start smoking the first one?"

"Where do you usually smoke?" What time to draw? ”

"When did you start smoking?"

"Have you tried to quit smoking before?"

"What are the benefits of smoking? What do you 'get' from smoking? ”

"What are the harms of smoking?"

5.
Alcohol

"How much do you drink on average per day?"

"What time to drink?" (A distinction must be made here between weekdays and weekends, as patients may drink heavily only on weekends)

"What are the good and bad outcomes of drinking?"

6.
Other substances

"What addictive drugs and the like?"

"What are the benefits of these substances? What do you 'get' from these substances? ”

"What are the harms of these substances?"

7.
Gambling

"Do you or your family have problems with gambling?"

"What are the benefits of gambling?"

"What are the harms of gambling?"

"What are the (biopsychosocial-cultural-spiritual) effects of gambling?"

8.
Work-oriented interventions

"Are you currently at work or volunteering or something?"

"What are the (biopsychosocial) benefits of these things?"

9.
Social support and loneliness

"How often do I see friends and/or family?"

"Who can you turn to when you need to be heard?"

"What are the benefits and barriers to connecting with friends and/or family?"

"How is the use of social media, can you tell me?"

"Is it particularly urgent to use social media, sometimes without realizing that you have already used it, playing in bed before bed, or playing as soon as you wake up?"

10.
Green space

"How long do you spend in a 'green' or 'blue' space each week?"

"What 'green' or 'blue' spaces are safe for you to go to?"

"How does it feel to come back from the outdoors?"

11.
Stress

"Where does the stress in your life come from?"

"How do you feel these pressures have affected you?"

"How do you reduce and manage stress?"

"What are some things or people that can help you reduce, cushion, or manage stress?"

12.
Resilience

"How do you adapt and cope with the misfortunes in life?"

"How much do you rate yourself about the ability to keep cheering up in the face of misfortune?"

"What useful lifestyle or social support do you have in times of trouble?"

"When you encounter misfortune, what do you do to keep yourself mentally and physically healthy?"

"Does foresight and determination help you in times of misfortune?"

Bibliographic index: Marx W, Manger SH, Blencowe M, et al.
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.
World J Biol Psychiatry.
2022 Oct 6:1-54.
doi: 10.
1080/15622975.
2022.
2112074.
Epub ahead of print.
PMID: 36202135.