Health Psychology is a branch of psychology (specifically Division 38 of the American Psychological Association) that seeks to “advance psychology’s contribution to the understanding of health and disease through basic and clinical research, education, and service activities.”
In practice, health psychologists engage in patient care, research, and system-level activities to advance the treatment and management of serious illnesses. Health psychologists are now increasingly specialized and practice in areas such as pain psychology, obesity and weight management psychology, psycho-oncology, diabetes psychology, heart psychology and smoking cessation.
Few people know that health psychologists often also treat general mental illnesses such as depression. In addition, the way health psychologists support people with depression is fundamentally different from the conventional psychotherapy and psychotropic offerings available in most mental health treatment settings. As you will learn here, the health psychology intervention model for depression is no less evidence-based than conventional treatments and has at least three unique advantages in the form of: a) less treatment stigma; b) the ability to carry out the treatment more independently; and c) the transfer of health benefits beyond the improvement of depressive symptoms.
Individuals who either: 1) have not benefited from psychotherapy or psychotropic treatments; 2) Have physical or financial barriers to participating in conventional depression treatments; or 3) Experience with professional or personal concerns related to mental health treatment may consider the health psychology approach as an alternative option.
In the following paragraphs, I outline some of the recent scientific evidence that supports the specific approaches used by health psychologists to treat depression. Here, however, in a simple checklist form, is the evidence-based formula that I use with my own patients (of course, tailored to the individual circumstances):
1. ______ 7-8 hours of sleep, practiced regularly
2.______ Exercise at least 3-5 days / week (including aerobic and strength training)
3. ______ 1.75-2.5 grams of omega-3 fatty acids / day through food or high-quality food supplements
4.______ Reduction in added sugar (maximum 6/9 grams / day for women / men)
5.______ Reduction of processed foods (replacement with whole foods)
6. ______ 2+ servings of fermented foods per day
7. ______ 25+ grams of fiber / day
8. ______ At least 15 minutes of morning sun
In practice, I ask people to rate each of these factors for themselves – sometimes supplemented with a diary or two of the week for more specific information – to rank them individually. It is usually counterproductive to try to change multiple health behaviors at the same time. Instead, it is more practical to start with the areas furthest from the recommended standards. This is usually the behavior that is most likely to bring mood benefits to the person.
As mentioned above, none of these health interventions require psychotherapy or prescription drugs. This enables, for example, that some of my treatments only consist of one or two conversations with one person to describe the procedure and to discuss the logistics of implementation in their individual situation. After that, many can do the program on their own or with regular follow-up examinations. This does not mean that there is no benefit in working with a health psychologist on a regular basis; As with most other treatments for depression, people usually get better results with the help of a professional.
With my own students and colleagues, I enjoy discussing the rapidly advancing science that supports health psychological treatments for depression. While this research is far too extensive to be summarized in a brief post, here are the highlights and some recent clinical trial evidence:
Sleep. A healthy sleep schedule is essential for emotional wellbeing (1). Several clinical studies and systematic reviews have shown that cognitive behavioral therapy for insomnia (CBT-I) improves symptoms of depression (including symptoms ranging from fatigue to thoughts of suicide).
exercise is known to most people to improve muscle and cardiovascular function. Fewer realize, however, that the benefits of regular exercise on cognitive function are just as profound, if not more profound. The good news is that both aerobic and weight training seem to offer these benefits (2).
Omega-3 fatty acids, perhaps EPA in particular, have repeatedly shown in clinical studies to improve depressive symptoms. Some can get EPA and other omega-3 fatty acids in sufficient quantities from the diet; others will benefit from a supplement (3).
Essential reading for depression
Sugar reduction improves both metabolic health and cognitive function, often in surprisingly short periods of time. Reduced mood and anxiety symptoms are among the latter cognitive benefits (4).
Processed foods. Food has medicinal effects, including physical and emotional health. As Western societies increasingly lean towards diets consisting primarily of highly processed foods, the detrimental consequences appear to be increasingly higher rates of depression (5).
Fermented foods. The gut microbiome – made up of trillions of bacteria that inhabit the stomach, small intestine, and large intestine – has recently been a topic of intense research interest and is showing increasing evidence of an impact on mental health (6).
Fiber. Through mechanisms such as improving gut microbiota and reducing systemic inflammation, high fiber intake is another food pathway for improving physical and mental health (7).
Daily sunlight. Lack of sunlight has long been linked to seasonal affective disorder. However, recent evidence suggests that the emotional benefits of regular sun exposure extend to all forms of depression (8).
Finally, those who are still not convinced of the emerging evidence to support behavioral treatments for depression should note that in some countries these recommendations are already part of national guidelines for the management of depression. For example, the 2020 version of the Royal Australian and New Zealand College of Psychiatry includes many of the health interventions summarized here for their first tier of recommended treatments for depression (9).
To find a therapist, visit the Psychology Today Therapy Directory.
