A Flagstaff Guide · By Joseph Tris, PMHNP-BC, Flagstaff Psychiatric Care
A 2023 study following 287,282 participants over nine years confirmed what many of us have long suspected: healthy habits and routines are protective against depression. This doesn’t mean you should stop taking your antidepressant medication — always talk with your provider before making changes there — but it does support the idea that effective mental health treatment is multifaceted, combining medications, therapy, and behavioral interventions. Below is a summary of the major healthy lifestyle habits shown to protect against depression, along with Flagstaff-specific activities, recommendations, and resources where relevant. These are meant as suggestions, not a checklist — feel free to build your own version of this.
Frequent Social Connections
Decreases depression risk by 18%
Social connections include social supports (friends, family), social networks (peer groups, family), and the absence of social isolation. While the overall risk reduction is 18%, frequent social connection is the single strongest protective factor against recurrent depressive episodes. Connection provides emotional and material support during hard times, along with a sense of purpose, belonging, and optimism day to day. Exploring community events is a great way to make friends, especially once formal schooling — and its built-in social structure — is behind us. And when you can, get off the screen and spend time with people in person; there’s little evidence that virtual socializing offers the same benefit as the real thing.
Suggested activities
- Poet Brews: An Open Mic for Writers — Tuesdays, Flagstaff Brewing Company. See updated info on their Facebook page.
- Wednesday Night Blues at Charly’s — Wednesdays, 7–9:30 pm, Charly’s Pub & Grill in the Weatherford Hotel. See the event page or the venue’s Facebook page for weekly lineups.
- Open Chess Nights — Flagstaff Chess Club meets weekly; check chess.com/club/flagstaff-chess-club for the current day, time, and location (this changes from time to time).
- NAU lectures, films, concerts, and more (many free) — events.nau.edu
- Downtown Flagstaff’s full events calendar, including Taco Tuesday, live music, writing groups, trivia nights, and more — downtownflagstaff.org/events/calendar
Regular Physical Activity / Decreased Sedentary Time
Decreases depression risk by 13–14%
Exercise can be as effective as — or more effective than — antidepressant medication in treating depressive disorders. The U.S. government recommends 150 minutes per week of moderate to strenuous cardiovascular exercise; I’d add 60–120 minutes of weight training, which supports balance, posture, bone density, and testosterone levels. Whenever possible, exercise outdoors — the combination of sunshine and fresh air adds real benefit. As a general rule, aim to keep leisure screen time to an hour or less a day; this alone will help get you up and moving.
Suggested activities
- Take a class at Northern Arizona Yoga Center
- Walk, run, or bike the 2-mile loop at Buffalo Park
- Hike Humphreys Peak (Arizona’s highest point)
- Take a climbing lesson at Flagstaff Climbing
- Work out at Planet Fitness — Flagstaff (East) (memberships from roughly $15/month)
Healthy Sleep
Decreases depression risk by 22%
We spend roughly a third of our lives sleeping, so it’s not surprising that of all the protective factors studied, healthy sleep had the single greatest impact on lowering depression risk. Most people need 7–9 hours per day. The neuro-psychological benefits of adequate sleep include promoting synaptic plasticity — which improves our response to stress — and reducing cortisol levels, which supports better frustration tolerance.
Recommendations
- Avoid screens for at least an hour before bed.
- Reserve the bed for sleep, sex, and being sick — nothing else.
- Eat a light dinner.
- Avoid caffeine within 8+ hours of bedtime.
Suggested resources
Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered the first-line, evidence-based treatment for insomnia. Read more in Cleveland Clinic’s overview of CBT-I, or contact Rise Sleep Clinic for virtual CBT-I (most insurances accepted).
Never Smoking
Decreases depression risk by 20%
Don’t smoke — and if you do, make a plan to quit. I’ll spare the full lecture, but smoking is linked to brain lesions and encephalopathy that are, in turn, associated with depressive symptoms. The state and federal government offer free or low-cost cessation medications and coaching.
Suggested resources
- Arizona Smokers’ Helpline (ASHLine) — 1-800-556-6222
- National Quitline — 1-800-QUIT-NOW; see the CDC’s tobacco cessation resources
Source: Zhao, Y., Yang, L., Sahakian, B.J., et al. “The brain structure, immunometabolic and genetic mechanisms underlying the association between lifestyle and depression.” Nature Mental Health 1, 736–750 (2023). https://doi.org/10.1038/s44220-023-00120-1