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When your mood is low, go for a walk or a run: the antidepressant effect size grows with intensity

  • Moderate value
  • Evidence A
  • Buys life
  • Disputed
  • Free
  • Takes some hours
  • Long-term effort

In plain words

When your mood is low, brisk walking or jogging helps most clearly. Next come yoga, strength training, and tai chi or qigong, with little difference among them. The higher the intensity, the better the effect, and strength training and yoga are the easiest to stick with. The quality of evidence here is on the low side. What can be said is that moving is better than not moving, so pick the kind you can keep doing.

Cost

Free. About half an hour each time. The hard part is that when your mood is low, you least want to move, and you have to give yourself a push.

What you get

This is the result of pooling 218 controlled trials with random assignment to groups. They involved 495 arms and 14,170 participants who met the clinical criteria for major depression. The method compares the different kinds of exercise with each other (Bayesian network meta-analysis). The comparison was against usual care and placebo pills (active control). The effect size is given as Hedges' g, and the more negative the number, the more the symptoms improved. Brisk walking or jogging −0.62 (95% credible interval −0.80 to −0.45, meaning the true value probably falls within this range). Yoga −0.55 (−0.73 to −0.36). Strength training −0.49 (−0.69 to −0.29). Mixed aerobic exercise −0.43 (−0.61 to −0.24). Tai chi or qigong −0.42 (−0.65 to −0.21). The paper says "the effect of exercise was proportional to the intensity prescribed": the higher the intensity, the better the effect. Strength training and yoga had the best acceptability and were the easiest to stick with.

Notes

Disputed. The authors themselves state that of the 218 studies, only 1 was done cleanly enough not to be easily skewed by its design. By the usual grading method, brisk walking and jogging are rated only "low" certainty and the rest "very low." Exercise also can't be hidden from participants: people who know they are exercising tend to feel better, and that expectation can't be removed. The direction of the conclusion is still usable: moving is better than not moving, don't make the intensity too low, and choose something you can keep up. This expands on "get moving first when your mood is low" in §3, and it cannot replace proper treatment after a diagnosis.

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. Noetel M, Sanders T, Gallardo-Gómez D, et al. (2024). Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ, 384, e075847. https://doi.org/10.1136/bmj-2023-075847

Mentioned in

Translated from the Chinese original. Original book, section 22, tip 6. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer