Even after depression lifts, your symptoms may return. But healthy habits can help keep away the blues, experts say. Read on for 10 tips that help manage moods…

After months of battling depression, you’re finally feeling normal again. Your doctor or therapist has given you tools for staying positive, and you know the warning signs of a depressive episode so you can get help as soon as you sense them.

Now’s the time to enjoy life – and to take better care of your physical and mental well-being. Depression is a lifelong, chronic condition, and it needs to be maintained like any other disease.

“You have to approach depression the same way you would diabetes. There’s a vigilance you have to maintain for a balanced life,” says Alan Manevitz, M.D., associate professor of clinical psychiatry at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City.

Besides medication or therapy, that means practicing healthy habits associated with better moods.

Healthy living is an important part of self-care, Manevitz says. For example, when you eat right, brain cells get appropriate nutrition so “the brain works at its maximum,” he explains. And exercise releases endorphins, brain chemicals that act as natural antidepressants.

Here are 10 lifestyle changes that can keep you feeling your best.

1. Lose the booze.
People with chronic depression sometimes use alcohol to self-medicate.

Drinking releases neurotransmitters that may make you feel better, but only temporarily. And as you develop a tolerance, you need larger amounts, and then it becomes even more of a depressant on your central nervous system, Manevitz says.

If you’re taking antidepressants, alcohol can also increase their side effects, making you drowsy, more intoxicated than usual, or in some cases, causing a blood pressure spike that could lead to a stroke, according to the Mayo Clinic.

2. Work up a sweat.
Exercise is great for mental well-being, says Jasper Smits, Ph.D., director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas.

It can head off a recurrence of mild to moderate depression, or help you overcome an episode, according to his team’s research.

With severe depression, exercise can augment traditional treatments, including psychotherapy or antidepressant medication, adds Smits, co-author of the upcoming Exercise for Mood and Anxiety: Proven Strategies for Overcoming Depression and Enhancing Well-Being (Oxford University Press).

Researchers are still determining how physical activity helps, but evidence suggests it may act as a form of behavioral activation, a depression treatment strategy that encourages people to be productive rather than inactive.

“If you’ve been productive, your mood improves,” Smits says.

Smits recommends aiming for the government’s physical-activity recommendations: 150 minutes per week of moderately intense movement (brisk walking, water aerobics, gardening); 75 minutes of vigorous activity (jumping rope, running, hiking); or a combination of the two.

Multiple studies have found benefits from doing 20-60 minutes of exercise per session, so aim for at least 20 minutes. But if you’re new to exercise or short on time, that doesn’t mean you should skip it.

“Even a 10-minute walk has short-term positive effects on mood,” Smits says.

3. Eat like a Spaniard.
Closely following a Mediterranean diet is strongly associated with lower depression risk, according to a 2009 Spanish study published in the Archives of General Psychiatry.

Researchers speculate that the diet’s heart-healthy benefits – reducing inflammation, improving blood vessel function and decreasing the risk of metabolic syndrome – may play a role in keeping the brain fit.

Mediterranean-style eating is simple: When you’re grocery shopping, fill your cart with fresh fruits and vegetables, whole grains, olive oil, beans, fish, poultry, nuts and low-fat dairy. Meanwhile, cut back on refined carbs, fatty meats and highly processed foods.

4. Get your zzz’s.
It’s no surprise that too little rest can worsen your mood, but depression itself can keep you from sleeping through the night, according to the National Sleep Foundation.

The connection between the conditions is significant: People with regular insomnia are nearly 10 times more likely to have significant depression, and 17 times more likely to develop anxiety, according to a 2005 University of North Texas study.

If you’re having trouble sleeping – whether or not you’re currently depressed – talk to your doctor or a sleep expert so you can get the 7-9 hours you need.

5. Get more vitamin D.
Low levels of vitamin D have long been linked to depression. And research is ongoing about whether the fat-soluble vitamin can improve rates of seasonal affective disorder (SAD), or winter depression.

SAD hits when days get shorter and there’s less sunlight, our prime natural source of vitamin D. But we don’t always get enough of the vitamin in summer, either, because the sunscreen we slather on to protect against skin cancer blocks D-producing rays.

It’s also hard to get the amount of D we need from food. Only certain fish (salmon, sardines, tuna, mackerel and cod), D-fortified milk and a few other foods contain much of this important nutrient.

How much do you need? Expert opinions vary. Government recommendations suggest 200 international units (IU) per day until age 50, 400 IU between 51 and 70, and 600 IU after that.

But some researchers recommend considerably more. Vitamin D expert Michael F. Holick, M.D., Ph.D., professor of medicine, molecular medicine physiology and biophysics at Boston University Medical Center, thinks adults actually need closer to 1,500-2,000 IU of vitamin D per day.

Since one 8-ounce glass of milk only has about 100 IU, your best bet is taking a multivitamin or vitamin D supplement.

6. Embrace your inner yogi.
Yoga relaxes you, but does it fight depression? Researchers at Boston University School of Medicine think it could. And the more you practice, the better off you may be.

In their study, published in the Journal of Alternative and Complementary Medicine in 2007, participants spent three hours a week either walking or practicing Iyengar yoga, a form of hatha yoga that uses blocks, belts and other props to ensure correct body alignment during postures.

Their moods and anxiety levels were measured at the start of the study and at weeks 4, 8 and 12. MRI brain scans were also done to measure levels of a neurotransmitter called gamma aminobutyric acid (GABA), low levels of which are associated with mood and anxiety disorders.

At the end of the study, the scans showed higher GABA levels in the participants who practiced yoga. (Those new to the discipline saw a 13% increase, while experienced yoga practitioners had a 27% rise.) By contrast, those who only walked had no bump in GABA levels.

According to researcher Chris Streeter, M.D., associate professor of psychiatry and neurology, yoga boosts the activity of the parasympathetic nervous system, which is associated with rest and rejuvenation.

So why didn’t walking offer the same benefits? In this study, participants were limited to ambling around the periphery of a gymnasium. Walking outside or walking faster could make it a more effective mood booster, Streeter says.

The key to getting the most out of any workout is to choose a physical activity you like and do it in a setting you’ll enjoy, she adds.

7. Just say om.
People who practiced transcendental meditation (TM), a form of “mantra meditation” in which you mentally repeat a sound, had fewer depression symptoms than those who didn’t, according to researchers who presented two studies at a 2010 meeting of the Society of Behavioral Medicine.

In fact, participants with clinically significant depression who meditated twice a day for a year had an average 48% reduction in symptoms.

Not only does TM decrease psychological stress, it may also reduce a person’s reactions to environmental stress and reduce the amount of brooding about problems, says lead study author Sanford Nidich, Ed.D., senior researcher at the Institute for Natural Medicine and Prevention at Maharishi University of Management in Fairfield, Iowa.

It may also have a positive effect on serotonin, the brain’s feel-good chemical, Nidich adds.

You don’t need to join a particular group to learn healthy meditation techniques – just read How to Meditate to get started.

8. Keep your cool.
Too much mental stress can harm your ability to maintain a steady mood. But stress overload varies by person – some can't function outside a calm environment, while others may do fine in stressful situations.

For example, “some people thrive as a fireman or ER doctor,” Manevitz says. “Others get so stressed out they’re vulnerable to depression.”

His solution? Balance your life based on the amount and kinds of stress you can handle. “You need to know what your abilities and trigger points are.”

9. Kick the habit.
Here’s another reason to put away that pack: Women who smoke have a greater risk of developing major depression than non-smokers, according to a 10-year Australian study published in 2008 in the British Journal of Psychiatry.

Among heavy smokers – those who smoked more than 20 cigarettes per day – the depression risk was more than double that of non-smokers: 15% of the smokers studied went on to develop major depression, while only 6.5% of the non-smokers did.

Smoking can be another way of self-medicating for a depressed mood, so ask your doctor or therapist to help you quit. Click here for tips to quit smoking.

10. Build a support system.
People who care about you can help you through tough times, and that includes mental illnesses.

In fact, a 2005 study published in the American Journal of Psychiatry reported that women who feel more loved and have more support from friends and family members face lower risk for major depression.

If you have a tendency to isolate yourself, make an extra effort to spend time with friends and family. Support groups, social clubs and interest-based organizations can also help bring you out of your shell.

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Catherine Winters wrote:

Drinking releases neurotransmitters that may make you feel better, but only temporarily.