Best low-cost actions when you’re feeling down: move, get sunlight, stick to a schedule, talk to someone, call 12356

18. Best low-cost actions when you’re feeling down: move, get sunlight, stick to a schedule, talk to someone, call 12356

Cost: Costs little to nothing. Just a few brisk walks, runs, or strength workouts each week. Spend time outdoors in daylight. Keep a regular sleep schedule. When you’re feeling stuck, give someone a call.

In plain terms: Extensive clinical trial data confirm that brisk walking and running produce the strongest benefits for depression, with yoga and strength training also helpful — the greater the intensity, the better the effect. Sunlight therapy works very well for seasonal depression and also helps with non‑seasonal cases. Online self‑guided cognitive‑behavioral therapy programs are effective; having a therapist guide you makes them even better, especially if your symptoms are moderate to severe. When you’re feeling overwhelmed, dial 12356 first.

Benefit: This meta-analysis combined data from 218 randomized controlled trials involving 14,170 participants; the control group performed other activities. Compared with them, walking or running lowered depression scores by g = -0.62 (95% CI -0.80 to -0.45). Yoga produced g = -0.55 and strength training g = -0.49; higher intensity further improved outcomes. Pooled data from multiple light‑therapy studies showed an effect size of 0.84 (0.60–1.08) for seasonal depression and 0.53 (0.18–0.89) for non‑seasonal cases. Another analysis aggregated individual‑patient data from various studies on internet‑based cognitive‑behavioral therapy; both self‑guided and therapist‑supervised programs outperformed controls, with therapist guidance yielding better results for moderate‑to‑severe depression (PHQ‑9 score >9). The 12356 hotline provides nationwide psychological support for at least 18 hours each day.

Evidence grade: A

Sources: Noetel M et al. (2024). Effect of exercise for depression: systematic review and network meta-analysis of randomized controlled trials. BMJ. <https://doi.org/10.1176/appi.ajp.162.4.656>; Karyotaki E et al. (2021). Internet-Based Cognitive Behavioral Therapy for Depression: A Systematic Review and Individual Patient Data Network Meta-analysis. JAMA Psychiatry. <https://doi.org/10.1001/jamapsychiatry.2020.4364>; National Health Commission of China (NHC) (2024). Notice on the application of the "12356" national unified psychological assistance hotline number (National Health Medical Administration Letter [2024] No. 259). <https://www.gov.cn/zhengce/zhengceku/202412/content_6994470.htm>

Notes: These measures serve as adjuncts for mild‑to‑moderate depression. Individuals with moderate‑to‑severe depression or suicidal thoughts should seek professional care; they may also call 12356 first (see Section 1, Item 25). Most exercise trials involve relatively few participants and cannot employ the placebo blinding used in drug studies. Light‑therapy research available up to 2003 also includes limited sample sizes. The advice to “stick to a schedule” and “talk to someone” reflects the authors’ experience rather than specific published evidence. Remember, even a ten‑minute walk counts as “getting active” for someone dealing with depression.