Updated: Oct 29, 2021
In recent years there is increasing evidence around the interface of Lifestyle Medicine and psychiatric disorders. We are now in the midst of a mental health crisis due to the Covid-19 Pandemic; therefore we need to be equipped with all possible interventions we can utilise, including Lifestyle Psychiatry, to support our patients (and to empower them to support themselves.)
This secondary epidemic of individuals who are struggling with the financial, emotional, health and social impacts of the pandemic is unprecedented in our lifetimes. Lifestyle Medicine affords an opportunity to improve the mental health of our society at scale.
This article has been written by Dr Charlotte Marriott, NHS Consultant Psychiatrist and Certified Lifestyle Medicine Physician and edited by Dr Angela Goyal, GP and Founder of Inspired Medics
Charlotte is an NHS Consultant Psychiatrist, and a certified Lifestyle Medicine Practitioner. She is member of the Royal College of Psychiatrists and the British Society for Lifestyle Medicine. Charlotte has written and presented a module for Inspired Medics detailing Lifestyle Psychiatry for clinicians who want to learn more. She is also a mother and a retired yoga teacher and loves to spend as much time as possible outdoors, often covered in mud.
Our collective 21st Century lifestyles with too much stress, too little sleep, too many substances, too little physical activity, too much sedentariness and too much processed and ultra-processed food, is having an impact on both our physical and mental health. These aspects have been negatively exacerbated in the past year.
With regards to mental health, Cartesian dualism can be disregarded as mind and body are inextricably linked, not as two interconnected and communicating entities, but as one complete whole – what affects the body equally affects the mind and vice versa, and in complex ways that we are only just beginning to comprehend. The more we can understand the science and evidence around this, then we can advise our patients on the small changes they can make to have a positive impact on their mental health.
For example, more evidence is emerging on the gut-microbiota-brain axis – the afferent and efferent pathways between our gut and our central nervous system and the role our individual microbiota plays in this. Research into the microbes in the gut and how they affect mental health, and vice versa, demonstrates this is likely to be through complex mechanisms including immune dysregulation and inflammation.
There is no health without mental health
It is also true that there is no health without mental health. There is increasing evidence that lifestyle factors such as regular physical activity, sufficient sleep and whole-food plant-based or Mediterranean style diets have a significant impact on our mental health, reducing our risk of developing depression, anxiety and cognitive decline, for example, but also improving and reversing the same conditions.
Crucially, though, these lifestyle factors can also positively impact the physical health of people with mental illness; patients with serious mental illnesses such as schizophrenia have a 15-20 year excess mortality compared to the general population, largely attributable to cardiovascular and metabolic disease, to which they are inherently more prone. Add to this the medications we prescribe that increase their risk of cardiometabolic disease, and further add to this the lack of parity of esteem for mentally ill patients’ physical health and you have a perfect storm.
Lifestyle Medicine and Lifestyle Psychiatry have a crucial role to play in improving our
patients’ (and our own!) physical and mental health and offer evidence-based non-pharmacological interventions that can also improve patients’ social engagement, cognitive function, subjective well-being and quality of life.
How can clinicians implement Lifestyle Psychiatry?
In Primary Care consider referrals to Social Prescribers, Dieticians and Health Coaches for patients presenting with mild-moderate depression or anxiety disorders. Simply talking to patients about small steps they can take, for example, committing to daily time in nature, can be very powerful coming from a healthcare professional. There are resources we can direct patients which reinforce these messages. Primary Care Networks have opportunities to bring health coaches into their localities with the Personalised Care framework, which can support the delivery of Lifestyle Psychiatry.
In Secondary Care, mental health services have access to a range of psychosocial interventions including Reablement, Individual Placement and Support (IPS) for education and employment, eco-therapy, physical activity groups, and more, making recovery about much more than symptom-reduction. As the evidence-base grows and healthcare services become more innovative and holistic Lifestyle Medicine really will become the future of healthcare.
During COVID-19 we have transformed services, adopted digital consultations and learned new ways of working very quickly. By also embracing Lifestyle Psychiatry we can find a way to tackle the mental ill health crisis that now presents itself to us.
If you would like to learn more about Lifestyle Psychiatry and Lifestyle Medicine checkout our digital courses on the website. You will learn not only the evidence base for lifestyle interventions, but also how to apply them in day to day practice. This is relevant for not only GP's and psychiatrists but doctors in all disciplines as well as allied healthcare professionals.
Also don't forget to download our free ebook to start using lifestyle medicine immediately!