Quality Statement 5: Adjunct Therapies and Self-Management

Resources Quality Statements Advisory Committee About

5

Adjunct Therapies and Self-Management

People with major depression are advised about adjunctive therapies and self-management strategies that can complement antidepressant medication or psychotherapy

Background

Therapies and self-management strategies such as light therapy, yoga, physical activity, behavioural activation, sleep hygiene, and good nutrition can be effective complements to antidepressant medication or psychotherapy for major depression, potentially resulting in faster improvement and fewer residual symptoms. Therapies that are more feasible and pleasurable for people improve their likelihood of being effective.

What This Quality Statement Means

For Patients

In addition to medication and psychotherapy, your health care professional should offer you educational materials about other steps you can take that might improve your depression, such as light therapy, yoga, and exercise.

For Clinicians

Advise people with major depression about adjunct therapies and self-management strategies that can complement antidepressant medication or psychotherapy. These include light therapy, yoga, physical therapy, sleep hygiene, and nutrition.

For Health Services

Ensure the availability of relevant education materials about adjunct therapies and self-management strategies for major depression.

Quality Indicators

Process Indicator

Percentage of people with major depression who receive information about adjunct therapies and self-management strategies

Denominator: total number of people with major depression
Numerator: number of people in the denominator who receive information about adjunct therapies and self-management techniques
Data source: local data collection

Definitions Used Within This Quality Statement

Adjunct therapies

These include light therapy, yoga, and physical activity.

Light therapy: This therapy involves daily exposure to bright light, usually administered at home with a fluorescent light box. The standard “dosage” of light is 10,000 lux (intensity) for 30 minutes per day, given early in the morning
Yoga: This is a discipline that integrates physical postures, breath control, and meditation. The duration should be at least 4 weeks, with an average frequency of 4 sessions a week, and 45 to 60 minutes per session
Physical activity: Physical activity of any sort administered for at least 8 weeks, usually 3 times a week for 30 to 60 minutes per session

Self-management strategies

These include sleep hygiene and nutrition.

Sleep hygiene: The habits and practices of maintaining a regular sleep schedule; avoiding excess eating, drinking, or smoking before going to sleep; and establishing a proper sleep environment
Nutrition: Maintaining a healthy, balanced diet and correcting any nutritional deficiencies

Evidence to Improve Care