Lifestyle medicine for the prevention and treatment of depression

There is compelling evidence that modifiable lifestyle factors contribute to the pathogenesis of depression. However, lifestyle targets are frequently not considered for contemporary depression treatment. Rather, medication and psychological intervention remain first-line treatments. This chapter will outline lifestyle factors that can contribute to the pathogenesis of depression, with these lifestyle elements being potentially modifiable via a prescriptive approach. We will then explore the evidence for their clinical application, firstly those for which there is sound evidentiary support (diet, physical activity and exercise, mindfulness meditation, management of recreational substance misuse, sleep, and social interaction) and secondly, lifestyle and environmental elements that have a more nascent evidence base (greenspace and pollutant exposure, hobbies and relaxation, and animal/pet therapy). Considerations for future directions are also outlined.