If you’re feeling down, break out the mahjong set. New research shows that regularly playing the tile-based game has been linked to lower depression rates among middle-aged and older adults.
Mahjong is a game of strategy and skill developed centuries ago in China. It is played with a set of 144 domino-like tiles based on Chinese characters and symbols.

University of Georgia researchers have found that playing the ancient four-player game can positively affect mental health, partly due to the social interactions it creates.

The U.S. researchers and their collaborators in China analyzed survey data from nearly 11,000 people who were age 45 and older. They compared the frequency and type of their social interactions, including mahjong, with their depression symptoms. The results showed an association between improved mental health and the level of social participation.

Interestingly, there were lower feelings of depression among urban residents who played mahjong. The same could not be said for rural residents, and researchers theorize that’s because the game is more competitive and sometimes a means of gambling in some rural areas.

The researchers say their findings are a window to designing new policies and interventions that can improve mental health among older adults. They also anticipate the findings could be a boon to Asian American communities, where research has found higher levels of people with suicidal thoughts.

For players, winning a game is called “going mahjong.” But even if your hand isn’t a winner, your mental health likely will benefit from being active and involved.