How healthy habits help to improve our mental health

We’ve learnt a lot over the last decade about how diet and nutrition can affect mental health. Much of the new research focuses on the ‘brain-gut microbiota axis’ – how the bacteria in the gut interacts with brain health and vice versa.

Studies have found a long list of bacteria (or ‘flora’) that are less common among people with symptoms of depression. These microbes are believed to affect neurotransmitters (chemicals which help different parts of the brain and nervous system to communicate) and the brain and body’s inflammatory response, both of which are linked to depression.

But rather than going straight in to adapt the gut flora, even though there is increasing evidence that some probiotics may be effective, a balanced diet is a better solution for improving mood and your general health. For example, sticking to a Mediterranean diet was found in one review to reduce the risk of depression by 33%.

Being physically active, whether that’s taking more steps, gardening, doing more cardio or strength training, all seem to contribute to your psychological wellbeing too. There are many pathways for how being active helps to improve brain function. As with some gut flora, physical activity can reduce inflammation in the body, which is associated with poor mental health states.

There are also endorphins, a naturally produced morphine in the body that blocks pain and produces feelings of pleasure, which is usually released in response to vigorous activity. Many people also report a pleasant experience when exercising – which is most consistent at moderate levels of activity.

Incorporating exercise into your daily habits can also help you to sleep well, which in turn is associated with improved mood and wellbeing (getting enough sleep can also strengthen your immune system and reduce inflammation). The effectiveness of exercise for improving depression is so well established that it is a recommended treatment and is effective even for people with severe depression.

Evidence shows that for people with depression, exercise has a similar effect to antidepressants. Even a single bout of exercise increases hormones that are associated with the antidepressant effect of exercise. One study found that the equivalent of 15 minutes running every day instead of sitting (or one hour of brisk walking if running isn’t your thing), was associated with a 26% reduction in depression risk.

For those who can’t avoid sedentary time, research in Sweden found that mentally active sedentary time, like desk-based office work and surfing the internet, was associated with a lower risk of depression compared to passive sedentary time, like watching the TV. Swapping 30 mins per day of passive for mentally active sedentary time reduced the risk of getting depression by 5%.

Fortunately, these health behaviours can be changed, and in turn improve mental wellbeing. While some people are able to establish new habits themselves, many struggle to do this without external support. Studies have shown that providing behavioural support and advice through digital media, such as text messages or smartphone apps, can help people to change their behaviour. For example:

• Diet: Evidence shows positive effects of mobile phone based support, although it is weaker than other areas currently

• Physical activity: A review of 21 studies shows mobile interventions can help people reduce sedentary time and very likely increase physical activity, although the impact is modest. Technology-based approaches seem to be as effective as face-to-face or written approaches.

• Alcohol: A recent review of 41 studies found mobile phone based approaches can help people reduce drinking by about 3 units per week on average and seems as effective as face-to-face approaches.

• Smoking: A review of 26 studies provides good evidence that text message-based support can increase quitting, but no evidence yet that smartphone apps are effective.

Health and public services rely more than ever on digital approaches since Covid-19 has reduced face-to-face engagement and routine services have shifted. But this can have a positive side. We can expect to see more effective digital support being developed and made available as services change, and hopefully many will benefit as a result – mentally as well as physically.

Author: Dr. Felix Naughton