THE ROLE OF FOREST BATHING IN THE TREATMENT OF DEPRESSION- A NARRATIVE REVIEW

Keywords: Forest Bathing, Shinrin- Yoku, Nature Therapy, Depression

Abstract

Introduction: Forest bathing (shinrin- yoku) is a Japanese practice, involving immersion in forested areas with engaging all five senses. Its potential preventive benefits have increasingly attracted interest within the international scientific community, since forest bathing appears to be a safe and low- cost complementary approach, while offering therapeutic value. This narrative review summarizes current evidence on the physiological and psychological benefits of forest therapy, with particular focus on its importance in the treatment of depression- a prevalent mental health disorder, that affects approximately 332 million people worldwide. Studies showed that forest bathing alleviates depressive symptoms, reduces stress, increases feelings of relaxation, happiness and overall mental well being, through several biological pathways, including serotonin modulation, oxytocin increase, cortisol reduction and increased parasympathetic activity. However, further high quality research is needed to clarify its clinical value and long term effects in the treatment of depression.

Methodology: A narrative review of literature available in the PubMed database was undertaken, incorporating recent randomized controlled trials, cohort studies, and meta-analyses published in peer- reviewed journals. Articles  were  searched  in  English using key terms such as: forest bathing, shinrin- yoku, nature therapy, depression.

References

Piva, G., Caruso, L., Gómez, A. C., Calzolari, M., Visintin, E. P., Davoli, P., Manfredini, F., Storari, A., Spinozzi, P., & Lamberti, N. (2022). Effects of forest walking on physical and mental health in elderly populations: a systematic review. Reviews on environmental health, 39(1), 121–136. https://doi.org/10.1515/reveh-2022-0093

Pfeifer, E., Pothmann, K., Claaßen, S., & Wittmann, M. (2023). Increased relaxation, less boredom, and a faster passage of time during a period of silence in the forest. Progress in brain research, 277, 157–180. https://doi.org/10.1016/bs.pbr.2022.12.010

Park, B. J., Tsunetsugu, Y., Kasetani, T., Hirano, H., Kagawa, T., Sato, M., & Miyazaki, Y. (2007). Physiological effects of Shinrin-yoku (taking in the atmosphere of the forest)--using salivary cortisol and cerebral activity as indicators. Journal of physiological anthropology, 26(2), 123–128. https://doi.org/10.2114/jpa2.26.123

Yeon, P.-S., Jeon, J.-Y., Jung, M.-S., Min, G.-M., Kim, G.-Y., Han, K.-M., Shin, M.-J., Jo, S.-H., Kim, J.-G., & Shin, W.-S. (2021). Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 18(23), 12685. https://doi.org/10.3390/ijerph182312685

Li Q. (2022). Effects of forest environment (Shinrin-yoku/Forest bathing) on health promotion and disease prevention -the Establishment of "Forest Medicine". Environmental health and preventive medicine, 27, 43. https://doi.org/10.1265/ehpm.22-00160

Li, Q., Morimoto, K., Nakadai, A., Inagaki, H., Katsumata, M., Shimizu, T., Hirata, Y., Hirata, K., Suzuki, H., Miyazaki, Y., Kagawa, T., Koyama, Y., Ohira, T., Takayama, N., Krensky, A. M., & Kawada, T. (2007). Forest bathing enhances human natural killer activity and expression of anti-cancer proteins. International journal of immunopathology and pharmacology, 20(2 Suppl 2), 3–8. https://doi.org/10.1177/03946320070200S202

Li, Q., Otsuka, T., Kobayashi, M., Wakayama, Y., Inagaki, H., Katsumata, M., Hirata, Y., Li, Y., Hirata, K., Shimizu, T., Suzuki, H., Kawada, T., & Kagawa, T. (2011). Acute effects of walking in forest environments on cardiovascular and metabolic parameters. European journal of applied physiology, 111(11), 2845–2853. https://doi.org/10.1007/s00421-011-1918-z

Park, B. J., Tsunetsugu, Y., Kasetani, T., Kagawa, T., & Miyazaki, Y. (2010). The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environmental health and preventive medicine, 15(1), 18–26. https://doi.org/10.1007/s12199-009-0086-9

Ochiai, H., Ikei, H., Song, C., Kobayashi, M., Miura, T., Kagawa, T., Li, Q., Kumeda, S., Imai, M., & Miyazaki, Y. (2015). Physiological and Psychological Effects of a Forest Therapy Program on Middle-Aged Females. International journal of environmental research and public health, 12(12), 15222–15232. https://doi.org/10.3390/ijerph121214984

Keller, J., Kayira, J., Chawla, L., & Rhoades, J. L. (2024). Forest Bathing Increases Adolescents’ Mental Well-Being: A Mixed-Methods Study. International Journal of Environmental Research and Public Health, 21(1), 8. https://doi.org/10.3390/ijerph21010008

Stephen Kaplan, The restorative benefits of nature: Toward an integrative framework, Journal of Environmental Psychology, Volume 15, Issue 3, 1995, Pages 169-182, ISSN 0272-4944, https://doi.org/10.1016/0272-4944(95)90001-2.

Roger S. Ulrich, Robert F. Simons, Barbara D. Losito, Evelyn Fiorito, Mark A. Miles, Michael Zelson, Stress recovery during exposure to natural and urban environments, Journal of Environmental Psychology, Volume 11, Issue 3, 1991, Pages 201-230, ISSN 0272-4944, https://doi.org/10.1016/S0272-4944(05)80184-7

2021 Global Burden of Disease (GBD) [online database]. Seattle: Institute for Health Metrics and Evaluation; 2024 (https://vizhub.healthdata.org/gbd-results/, accessed 13 August 2025)

WHO, The global burden of disease: 2004 update, World Health Organization, Geneva, 2008

Cho, K., & Kim, M. (2023). Effects of aromatherapy on depression: A meta-analysis of randomized controlled trials. General hospital psychiatry, 84, 215–225. https://doi.org/10.1016/j.genhosppsych.2023.08.003

Heissel, A., Heinen, D., Brokmeier, L. L., Skarabis, N., Kangas, M., Vancampfort, D., Stubbs, B., Firth, J., Ward, P. B., Rosenbaum, S., Hallgren, M., & Schuch, F. (2023). Exercise as medicine for depressive symptoms? A systematic review and meta-analysis with meta-regression. British journal of sports medicine, 57(16), 1049–1057. https://doi.org/10.1136/bjsports-2022-106282

Jakobsen, J. C., Katakam, K. K., Schou, A., Hellmuth, S. G., Stallknecht, S. E., Leth-Møller, K., Iversen, M., Banke, M. B., Petersen, I. J., Klingenberg, S. L., Krogh, J., Ebert, S. E., Timm, A., Lindschou, J., & Gluud, C. (2017). Selective serotonin reuptake inhibitors versus placebo in patients with major depressive disorder. A systematic review with meta-analysis and Trial Sequential Analysis. BMC psychiatry, 17(1), 58. https://doi.org/10.1186/s12888-016-1173-2

Undurraga, J., & Baldessarini, R. J. (2012). Randomized, placebo-controlled trials of antidepressants for acute major depression: thirty-year meta-analytic review. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 37(4), 851–864. https://doi.org/10.1038/npp.2011.306

Pillinger, T., Arumuham, A., McCutcheon, R. A., D'Ambrosio, E., Basdanis, G., Branco, M., Carr, R., Finelli, V., Furukawa, T. A., Gee, S., Heald, A., Jauhar, S., Ma, Z., Mancini, V., Moulton, C., Salanti, G., Taylor, D. M., Tomlinson, A., Young, A. H., Efthimiou, O., … Cipriani, A. (2025). The effects of antidepressants on cardiometabolic and other physiological parameters: a systematic review and network meta-analysis. Lancet (London, England), 406(10515), 2063–2077. https://doi.org/10.1016/S0140-6736(25)01293-0

Oliva, V., Lippi, M., Paci, R., Del Fabro, L., Delvecchio, G., Brambilla, P., De Ronchi, D., Fanelli, G., & Serretti, A. (2021). Gastrointestinal side effects associated with antidepressant treatments in patients with major depressive disorder: A systematic review and meta-analysis. Progress in neuro-psychopharmacology & biological psychiatry, 109, 110266. https://doi.org/10.1016/j.pnpbp.2021.110266

Cuijpers P, Berking M, Andersson G, Quigley L, Kleiboer A, Dobson KS. A Meta-Analysis of Cognitive-Behavioural Therapy for Adult Depression, Alone and in Comparison with other Treatments. The Canadian Journal of Psychiatry. 2013;58(7):376-385. doi:10.1177/070674371305800702.

Siri Kvam, Catrine Lykkedrang Kleppe, Inger Hilde Nordhus, Anders Hovland, Exercise as a treatment for depression: A meta-analysis, Journal of Affective Disorders, Volume 202, 2016, Pages 67-86, ISSN 0165-0327, https://doi.org/10.1016/j.jad.2016.03.063.

Cramer, H., Anheyer, D., Lauche, R., & Dobos, G. (2017). A systematic review of yoga for major depressive disorder. Journal of affective disorders, 213, 70–77. https://doi.org/10.1016/j.jad.2017.02.006

Verrusio, W., Renzi, A., Cecchetti, F., Gaj, F., Coi, M., Ripani, M., & Cacciafesta, M. (2018). The Effect of a Physical Training with the Use of an Exoskeleton on Depression Levels in Institutionalized Elderly Patients: A Pilot Study. The journal of nutrition, health & aging, 22(8), 934–937. https://doi.org/10.1007/s12603-018-1044-2

Yeon, P.-S., Kang, S.-N., Lee, N.-E., Kim, I.-O., Min, G.-M., Kim, G.-Y., Kim, J.-G., & Shin, W.-S. (2023). Benefits of Urban Forest Healing Program on Depression and Anxiety Symptoms in Depressive Patients. Healthcare, 11(20), 2766. https://doi.org/10.3390/healthcare11202766

Elhwuegi A. S. (2004). Central monoamines and their role in major depression. Progress in neuro-psychopharmacology & biological psychiatry, 28(3), 435–451. https://doi.org/10.1016/j.pnpbp.2003.11.018

Li, Q., Ochiai, H., Ochiai, T., Takayama, N., Kumeda, S., Miura, T., Aoyagi, Y., & Imai, M. (2022). Effects of forest bathing (shinrin-yoku) on serotonin in serum, depressive symptoms and subjective sleep quality in middle-aged males. Environmental health and preventive medicine, 27, 44. https://doi.org/10.1265/ehpm.22-00136

Li, Q., Takayama, N., Katsumata, M., Takayama, H., Kimura, Y., Kumeda, S., Miura, T., Ichimiya, T., Tan, R., Shimomura, H., Tateno, A., Kitagawa, T., Aoyagi, Y., & Imai, M. (2025). Impacts of Forest Bathing (Shinrin-Yoku) in Female Participants with Depression/Depressive Tendencies. Diseases (Basel, Switzerland), 13(4), 100. https://doi.org/10.3390/diseases13040100

Han, J. W., Choi, H., Jeon, Y. H., Yoon, C. H., Woo, J. M., & Kim, W. (2016). The Effects of Forest Therapy on Coping with Chronic Widespread Pain: Physiological and Psychological Differences between Participants in a Forest Therapy Program and a Control Group. International journal of environmental research and public health, 13(3), 255. https://doi.org/10.3390/ijerph13030255

Chun, M. H., Chang, M. C., & Lee, S. J. (2017). The effects of forest therapy on depression and anxiety in patients with chronic stroke. The International journal of neuroscience, 127(3), 199–203. https://doi.org/10.3109/00207454.2016.1170015

Kim, W., Lim, S. K., Chung, E. J., & Woo, J. M. (2009). The effect of cognitive behavior therapy-based psychotherapy applied in a forest environment on physiological changes and remission of major depressive disorder. Psychiatry investigation, 6(4), 245–254. https://doi.org/10.4306/pi.2009.6.4.245

Shin, W.S., Shin, C.S. & Yeoun, P.S. The influence of forest therapy camp on depression in alcoholics. Environ Health Prev Med 17, 73–76 (2012). https://doi.org/10.1007/s12199-011-0215-0

Furuyashiki, A., Tabuchi, K., Norikoshi, K. et al. A comparative study of the physiological and psychological effects of forest bathing (Shinrin-yoku) on working age people with and without depressive tendencies. Environ Health Prev Med 24, 46 (2019). https://doi.org/10.1186/s12199-019-0800-1

Yeon, P.-S., Jeon, J.-Y., Jung, M.-S., Min, G.-M., Kim, G.-Y., Han, K.-M., Shin, M.-J., Jo, S.-H., Kim, J.-G., & Shin, W.-S. (2021). Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 18(23), 12685. https://doi.org/10.3390/ijerph182312685

Kang, M. J., Kim, H. S., & Kim, J. Y. (2024). Development and effects of a non-face-to-face forest therapy program for nurses during the COVID-19 pandemic. Japan journal of nursing science : JJNS, 21(1), e12566. https://doi.org/10.1111/jjns.12566

Published
2025-12-30
Citations
How to Cite
Klaudia Zackiewicz, Michał Ziemba, Agata Wińska, Oliwia Sędziak, Hanna Pietruszewska, Agata Ogórek, Irmina Czerepak, Izabela Majchrzak, Paweł Liszka, & Karolina Żylińska. (2025). THE ROLE OF FOREST BATHING IN THE TREATMENT OF DEPRESSION- A NARRATIVE REVIEW. International Journal of Innovative Technologies in Social Science, 4(4(48). https://doi.org/10.31435/ijitss.4(48).2025.4523

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