When mood is low, do the highest-value moves first: get moving, get more light, sleep on schedule, talk to someone, call 12356

Brisk walking, jogging, yoga, and strength training all ease depression; higher intensity works better. Details are in Section 22, Item 6 (when mood is bad, walk or run). Light therapy is strong for seasonal depression and also helps non-seasonal depression. Online self-help cognitive behavioral courses work; when symptoms are heavier, guided versions work better. When you cannot see a way through, call 12356 first.

Cost

No money, or very little. A few brisk walks, jogs, or strength sessions a week. Go outdoors in daylight. Fix the schedule. When you cannot see a way through, make one call.

Benefit

Pooling 218 randomized controlled trials and 14170 people (network meta-analysis). The comparison group was people doing other activities. Versus them, walking or jogging had an effect size on depression of g = -0.62 (95% confidence interval -0.80 to -0.45). Yoga -0.55, strength training -0.49. Higher intensity worked better. Pooling several light-therapy studies: seasonal depression effect size 0.84 (0.60 to 1.08), non-seasonal 0.53 (0.18 to 0.89). Another analysis pooled individual-patient data across studies. It looked at internet cognitive behavioral therapy (online self-help courses). Guided and unguided both beat controls. For moderate to severe (PHQ-9 above 9), guided was better. 12356 is the national mental-health assistance hotline, open no fewer than 18 hours a day.

Notes

These are adjuncts for mild to moderate depression. Moderate to severe cases and anyone with suicidal thoughts should seek care; call 12356 first (see Section 1, Item 25). Exercise trials are often small and cannot blind who is exercising the way drug trials do. Light-therapy research only runs to 2003 and samples are small. Those studies used dedicated light boxes, not sunlight. Swapping that for daytime outdoor light is an inference from light therapy. “Sleep on schedule” and “talk to someone” are author experience with no separate citation. Do not treat “get moving” as a demand on someone with depression; ten minutes of walking counts.

Sources · 4

1. Noetel M 等 (2024). Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ. doi.org/10.1136/bmj-2023-075847
2. Golden RN 等 (2005). The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. American Journal of Psychiatry. doi.org/10.1176/appi.ajp.162.4.656
3. Karyotaki E 等 (2021). Internet-Based Cognitive Behavioral Therapy for Depression: A Systematic Review and Individual Patient Data Network Meta-analysis. JAMA Psychiatry. doi.org/10.1001/jamapsychiatry.2020.4364
4. 国家卫生健康委 (2024). 关于应用"12356"全国统一心理援助热线电话号码的通知（国卫医政函〔2024〕259 号）. gov.cn/zhengce/zhengceku/202412/content_69944…