Major Depressive Disorder: Could Nature Be a Cure?

Now that the seasons have changed and daylight savings time is doing the heavy lifting of shifting our circadian rhythms and our inner sense of time, there may be an uptick in symptoms of depression. Daylight hours are diminishing, as are easy opportunities for outdoor exercise, which is unfortunate, as nature-based interventions for depression have been increasingly explored for their efficacy as non-pharmacological methods of improving mood and decreasing symptoms of depression and anxiety (Owens & Bunce, 2022). While pharmacological treatment may be the most efficient and effective treatment for depression, there are self-help approaches that may be worth trying.

Researchers are digging deeper into the ways in which nature-based interventions actually promote mental health (Nguyen et al., 2023). Five functional areas related to depression have been identified as those that can be positively influenced by nature (Owens & Bunce, 2022):

1. Stress
2. Rumination
3. Mindfulness
4. Sleep
5. Exercise

Nature-based interventions have empirically been proven to support individuals in these areas (Owens & Bunce, 2022). Forest bathing and time in nature decreases the production of cortisol, the stress hormone, thus lowering stress. Spending time in a natural setting decreases rumination and increases positive mood. Mindfulness activities in natural settings increase awareness of the external world, which may also contribute to decreased rumination. Spending time outdoors also supports restorative sleep. And it’s no surprise that outdoor exercise positively affects physiological functioning as well as mood and self-esteem.

MDD is more than just a passing bout of the blues or grief at the loss of someone you cared about. It is estimated that approximately 8.4 percent (SAMHSA, 2021) of the adult population experience depressive disorder in the course of a year; this makes depression the most prevalent mental disorder among adults. But depression can occur anytime throughout the lifespan, from childhood through older adulthood. To receive a diagnosis of MDD, the symptoms must be present virtually all day, every day, with no real relief or respite.

Understanding that depression is different than sadness is similar to understanding that climate is different than weather. Everyone can experience a bout of sadness, like a temporary weather change, but when loss of interest in life and unshakable sadness are present, the climate may support a diagnosis of depression.

Individuals who exhibit at least five of the following symptoms for two or more consecutive weeks may have MDD; at least one of the symptoms must be a depressed mood or the absence of pleasure in the things that once interested that person (APA, 2013):

1. Consistently depressed mood that lasts virtually all day; the person may express feelings of sadness or hopelessness or exhibit behaviors such as crying or verbalizing feelings of emptiness and sadness.
2. Lack of pleasure or interest in life or in activities that once were satisfying and pleasurable. This could be described as despondency by an observer.
3. Changes in appetite, in either direction – hungrier or less hungry – and accompanying loss or gain of body weight.
4. Disruptions in sleep that last over time; this can include sleeping too much or insomnia.
5. Exhibiting extreme restlessness, such as inability to be still or content, or extreme lethargy or the loss of the ability to “get moving.”
6. Persistent lack of energy or a feeling of exhaustion that is not the result of activity.
7. Loss of a sense of self-worth or value to others. This can also be reflected in feelings of unwarranted and inappropriate guilt.
8. Atypically indecisive behavior or obstructed ability to think clearly or concentrate on tasks. Chores may be left half-finished, or a person may not be able to choose where to begin on a task due to their uncharacteristic indecision.
9. Persistent or recurrent thoughts of death, suicidal ideation, or thoughts of “disappearing.” The person may or may not have a plan for or attempt suicide.

Sometimes individuals with depression are hesitant to admit feelings related to sadness to their healthcare providers and may describe their lack of energy and difficulty in getting a good night’s sleep. Stigma related to mental health challenges may be the obstacle that keeps us from sharing depressed feelings. However, by opening up about symptoms, the likelihood of effective treatment increases.

Incorporating Nature into Treatment

Depression can be addressed in a variety of ways, including medication and anti-depressants, mindfulness-based interventions, exercise programs, counseling, and psychotherapy. One of the biggest challenges in dealing with depressive symptoms is the absence of motivation, feelings of inertia, and negative thinking. When we’re trying to start a new health regimen, of any type, we may feel overwhelmed by the effort and the lack of immediate visible benefits. Trying to overcome depression can feel exponentially more difficult due to the lack of hope and lack of energy that are symptoms of the condition.

Finding easy ways to begin, similar to using light therapy to address seasonal affective disorder, can include brief “mindful moments.” Stand on the doorstep and notice the world outside – the sights, the sounds, and the scent, taste, and feel of the air on your skin. Progress to a few steps on the walkway after a few doorstep mindful moments. The goal is to begin taking increasingly longer mindful walks outdoors.

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Conclusion

While there is no “one size fits all” treatment plan, a wide variety of effective treatments can be tailored to fit an individual’s needs. Always seek professional help if depressive symptoms are interfering with your normal daily routine or functioning. To find a therapist, visit the Psychology Today Therapy Directory. You can call the 988 Lifeline if you, or someone you care about, is in distress; it is available 24 hours a day and provides free and confidential support.