Transform Your Life with Evidence-Based Lifestyle Psychiatry

Lifestyle Psychiatry: An Emergent Evidence-Based Field

Introduction

Psychiatry has undergone several evolutions over the years. From the incarceration of mentally insane patients to the era of Freudian psychoanalysis and finally to the discovery of psychotropic medications. A new potential evolution may be at the horizon with research stemming from fMRI, connecting the brain-gut-microbiota system, and neuroplasticity. One such approach that has compelling data is lifestyle psychiatry.

What is Lifestyle Psychiatry?

Lifestyle psychiatry is an emerging evidence-based field that employs a conventional medicine lens to psychopathology and focuses on lifestyle interventions that can often be used as adjuncts to decrease symptoms of syndromal and subsyndromal states and at times may treat chronic diseases. It finds its roots in the field of lifestyle medicine, which aims to prevent and treat chronic medical illnesses like diabetes, cardiac conditions, and cancer using lifestyle interventions. Expanding this discipline to include mental health is compelling because of the impact and the bidirectionality between physical and mental health.

The Six Pillars of Lifestyle Medicine

Lifestyle medicine is based upon 6 pillars that include:

Eating healthier
Getting appropriate levels of sleep
Exercising adequately
Having healthy relationships
Decreasing stress
Avoiding harmful substances

Lifestyle psychiatry applies these evidence-based principles to improve brain health and encourages a more patient-centered approach to change by partnering with patients to promote agency and self-efficacy. Evidence has shown that patients find this approach acceptable, as it aligns with their personal values, and that it would be effective as well.

Lifestyle Psychiatry and its Effects on Mental Health

Evidence shows that lifestyle psychiatry may be a more effective way of targeting the underlying processes instead of treating the specific symptoms of a diagnosis. Meta-analyses have shown the benefit of exercise for overall mental and physical health, depression, anxiety, and negative symptoms of schizophrenia, as well as improved sleep quality. These 5 components of physical health have been shown to be associated with fewer mental health symptoms: strength training, cardiovascular, flexibility, balance, and endurance.

Nutrition

Individuals with mental health problems experience food insecurity and lack essential vitamins, minerals, proteins, and fiber in their diets. Many develop unhealthy relationships with food and tend to get the majority of their caloric intake from ultra-processed foods and convenience foods. Lifestyle psychiatry recommends that health care professionals provide health nutrition education that focuses on the type and processing of food instead of focusing only on macronutrients. Finally, communal kitchens, where meals are prepared and eaten together, have improved mental health and social connections.

The Importance of Sleep

The consequences of inadequate sleep’s impact on mental health are underappreciated. Sleep maintains properly functioning autonomic, neuroendocrine, and immune systems. Sleep is also essential for brain health, improving mood, increasing energy, and reinforcing positive, healthy decisions. Sleep quality can be enhanced with physical activity, daily mindfulness practices, and improved social connections. Additionally, cognitive behavioral therapy for insomnia (CBT-I) can help patients fall asleep faster and stay asleep longer than other interventions. CBT-I has been recommended as first-line therapy.

Stress Management

Stress is inevitable, and acute stress may sharpen and focus concentration, while chronic stress maintains heightened cortisol levels, disrupts sleep, promotes neuroinflammation, and disrupts the gut microbiota. Those experiencing stress are more likely to have unhealthy eating patterns, poor sleep quality, and worse physical health. Mindfulness, particularly mindfulness-based cognitive therapy, and other metacognitive practices can help decrease the effects of chronic cortisol release and improve brain health by promoting the function of the parietal lobe, the posterior and anterior cingulate cortex, and the prefrontal cortex.

Promoting Social Connections

A significant consequence of mental illness is isolation, loneliness, and aloneness. Social isolation is also linked with worse physical health, worsening sleep, increased substance use, and an increase in addictive behaviors. Societies that promote members to develop compassion for others are healthier. These communities may incorporate support groups, spiritual or religious organizations, gardening or conservation activities, community, sports or recreation, or work. They can also promote attachment, connection, mentorship, and a healthier self-identity.

Substance Abuse and Environmental Exposures

Substance use and environmental exposures to toxic substances are addressed in this pillar. Substance use and addictive behaviors may have self-perceived benefits of escaping or improving social interactions. Long-term use of substances (e.g., alcohol, opioids, methamphetamine, cannabis) do not improve mental health. Long-term substance use results in neuroplastic and behavioral changes, which alter an individual’s ability to think long-term and experience novel experiences, and make them focus on the immediacy of their wants.

Conclusion

Lifestyle interventions should be part of all comprehensive treatment plans and include adjunctive treatments for psychiatric disorders. Our medical curriculum needs to be updated to include lifestyle modalities in the toolbox of options for patients. With the Lifestyle Psychiatry Caucus within the APA (under the Council on Medical Education and Lifelong Learning (CMELL), textbooks on lifestyle psychiatry, and the 2025 APA Annual Meeting focusing on lifestyle, we are in a position to build resources for wide dissemination and implementation of the research in this exciting emerging evidence-based field of lifestyle psychiatry. The time is now to expand our biopsychosocial model into a biopsychosocial-lifestyle model.

Originally Post From https://www.psychiatrictimes.com/view/lifestyle-psychiatry-evidence-based-lifestyle-interventions-for-mental-and-physical-health