Aerobic exercise

The single best-evidenced non-therapy intervention in this whole programme.

How it works

Build toward 45–60 minutes, three or more times a week, at least 180 minutes weekly, at an intensity that makes conversation hard. This is not a wellness garnish — it has its own effect size, comparable to some psychological interventions, and it makes the cognitive work land better.

How good is the evidence

Strong evidence

Wipfli et al. (2008) meta-analysed 49 RCTs and found an effect size of −0.48 vs. no-treatment controls (Level 1, Grade A). A recent three-level meta-analysis in clinical anxiety samples (27 RCTs, 1,447 participants) found d ≈ −0.42, with optimal dosing around 45–60 min, 3+ times/week.

Related techniques

• Worry triage — Sort each worry into one you can act on today and one you cannot. They need opposite treatment.
• Worry postponement — Capture worries as they arrive, and deal with them only in a fixed daily slot.
• Detached mindfulness — Notice a thought arrive, and take no action on it whatsoever — including not arguing with it.
• Decatastrophising — Realistic worst case, most likely case, and — the part people skip — how you would actually cope.