Received date: September 03, 2015; Accepted date: September 16, 2015; Published date: September 22, 2015
Citation: Serrano-Ripoll MJ, Oliván-Blázquez B, Vicens-Pons E, Roca M, Gili M, et al. (2015) How to Make Lifestyle Change Recommendations in Major Depression. J Yoga Phys Ther 5:203. doi:10.4172/2157-7595.1000203
Copyright: © 2015 Serrano-Ripoll MJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Depression is a worldwide common disease that is predicted to be the second largest contributor to the global burden of disease by the year 2020 . In the next ten years it has been suggested the necessity to look for interventions that help to fight depression in a community environment promoting mental and physical wellness . Depression is a complex and multifactorial condition; different biological and psychosocial factors interact in a particular and a dynamic form in each patient [3-5]. Depression incidence is increasing and this may be partly explained due to changes in people lifestyle [3,6], such as being more sedentary, shorter sleeping times, higher stress levels, changes in sunlight exposure and diet, among others . Coherently, depressed patients suffer sleep disorders, less energy and activity level, fast-food preference, etc. As these bad habits worsen their depression, patients are kidnapped in a vicious circle, so changes in their lifestyle are important.
First-line treatments for depression are psychotherapy and/or antidepressant medication. Their efficacy and availability are limited, so more research is needed to improve depressive patient’s outcomes. Modifying some lifestyle factors can be useful in depression, at least as an adjuvant treatment. Combining different lifestyle interventions seems to be an adequate strategy to increase their antidepressant efficacy according with preliminary studies [8,9]. There is a growing bulk of studies that supports the following gist: The need to develop treatment options aimed to modify lifestyles at least as an adjuvant treatment for depression.
Some studies show that unhealthy lifestyle rarely occurs alone but tend to associate themselves [10,11]. Therefore, taking into account the additives effects of lifestyle factors, interventions focused on multiple changes could have a greater impact. In our experience, a simple intervention based on making hygienic-dietary recommendations could be enough to improve the symptoms of depressed patients . This intervention consisted of delivering a paper sheet in a closed envelops with 4 recommendations to improve lifestyle (physical exercise, Mediterranean diet, sleep hygiene and sunlight exposure) for depressed patients.
Nevertheless, in a confirmation study with very few methodological changes was negative . Previously, some studies showed positive results of diet, exercise, sunlight exposure and sleep in depression [6,13,14]. We learned that comparing the methodology of all these studies, it could be necessary to assess motivation and compliance levels of patients before clinicians want to prescribe lifestyle recommendations. Depressed patients often need a continued support and supervision . Therefore, it is crucial to adapt the intervention to the patient's circumstances, be gradual and flexible in their goals and recognize and encourage any patient effort. The more activities the patient can gradually try the better outcome will get, starting with what might be easier for each patient. All of them may prevent the patient from depressive ruminations. But we must encourage the patient to try it without feeling pressured or blamed. Following this research line we have a positive experience combining lifestyle programs with Mindfulness that is proven useful in depression .
In summary, lifestyle changes recommendations work or do not work on depression depending on how they are presented to patients and on monitoring systems of their implementation.