Lifestyle Psychiatry

Learning Objectives:

1. Identify the mechanisms through which physical exercise stimulates neuroplasticity and brain health;
2. Discuss the efficacy of physical exercise in management of major depression, cognitive decline of aging and schizophrenia; and
3. Develop strategies to support people in iteratively setting goals, evaluating response and refining goals to achieve sustained lifestyle behavior change.

Abstract:

With decades of biological psychiatry, neuroscience and advanced imaging techniques, the interface of mind and brain and their contributions to psychiatric disease remains an area of active discovery. This creates ongoing opportunities to optimize the balance between providing expert advice and empowerment of people in their own lifestyle choices as they assume responsibility for their mental health outcomes. The psychiatry of the future must balance advances in genetics, epigenetics, proteomics and brain biomarkers with strong grounding in lifestyle, health behaviors and wellness to meet the expectations of consumers and society. We have an opportunity to provide leadership on health behaviors that can transform public perceptions of mental health and disease. Being a student of lifestyle psychiatry and integrating it skillfully into your practice will prepare you to provide precise, effective and practical care that will serve you and your patients well, align psychiatry with general medicine, demonstrate integrity and engender trust. Psychiatry in the 21stcentury can leverage the intersection of neuroscience and behavioral science with technologic savvy to approach each individual holistically and engage the power of informed consumers taking ownership of their mental health and wellness. I will review the neuroscience of exercise, followed by a detailed review of evidence of the impact of physical exercise on specific psychiatric disorders, including major depression and schizophrenia. I will then review the impact of mind-body practices, nutrition, and the gut microbiome on psychiatric disorders. I will conclude with a review of effective methods for supporting behavior change and the impact of physician behavior on their lifestyle medicine practices. This presentation will summarize evidence on the impact of lifestyle interventions on prevention and treatment of psychiatric disorders, and leave you better prepared to implement them in your clinical practice.

Literature References:

1. Noordsy DL, editor. Lifestyle Psychiatry. Washington DC: American Psychiatric Association Publishing, 2019
2. Ho PA, Dahle DN, Noordsy DL. Why do people with schizophrenia exercise? A mixed methods analysis among community dwelling regular exercisers. Frontiers in Psychiatry, ePub Open Access, November, 2018, doi: 10.3389/fpsyt.2018.00596
3. Dahle DN, Noordsy DL. Factors motivating spontaneous exercise in individuals with schizophrenia-spectrum disorders. Schizophrenia Research, 199(Sept):436-437, 2018 doi: 10.1016/jschres.2018.03.022
4. Noordsy DL, Gonzales-Flores B, Ballon JS, Blasey CM. Impact of independent exercise on recovery, well-being and motivation among individuals with early psychosis. 11th International Early Psychosis Association meeting. Early Intervention in Psychiatry, 12(Supplement S1):166, 2018
5. Noordsy DL, Burgess J, Hardy KV, Yudofsky LM, Ballon JS. Therapeutic potential of physical exercise in early psychosis. The American Journal of Psychiatry, 175(3):209-214, 2018