background The fact that environmental factors and lifestyle play a role in mental health is well known. In the last decades more research has gone into the link between environment and genetics: epigenetics has shown us the molecular link between these two, and the influence of the microbiome on mental health has demonstrated the importance of food. Still, ethical questions remain about how lifestyle advice can be integrated in clinical practice in an ethical way.
aim To describe the normative import of our view on biology and individual responsibility and the place of lifestyle in the debate.
method A consideration of ethical aspects of lifestyle and lifestyle advice.
results The normative import of our view on biology and individual responsibility and the place of lifestyle in the debate is described. It is argued that lifestyle has a unique place between biological and psychosocial concepts. Finally, the pitfalls and opportunities of introducing lifestyle in clinical practice are shown.
conclusion Lifestyle is conceptually situated between the biological and the psychosocial, and sheds new light on the importance of certain explanations for recovery, and the relation with specific treatments. Lifestyle advice can only be used optimally in therapy if mental health care professionals also include a dialogue about assumptions and expectations.