Behavioral activation is a way to cope with depression, which is oftentimes combined with other forms of depression treatment, such as therapy or psychotropic medications. One of the most common symptoms of depression is withdrawing from regular activities or social supports, oftentimes by avoiding activities that one normally finds enjoyable. This can often lead to depressive symptoms worsening, as one can feel more detached from others and from enjoyable occasions. Behavioral activation works by identifying goals for each week and working towards those goals. These goals are aimed at making one’s life more of the life they desire to live.
For example, if an individual wants to live an active lifestyle, it would be beneficial for this person to come up with goals focused on activity. For some people they may choose to implement a step goal each day or to take it a bit farther and plan activities to participate in such as going for bike rides, or finding work out classes to attend throughout the week. The idea behind this is to incorporate more positive activities into daily life. This means that if one were to notice themselves feeling incredibly down, this would be an ideal time to utilize one of the activities that they decide on while creating their behavioral activation plan. The way this can be helpful in the long run is by serving as a tool to illuminate the way behavior can impact mood, therefore, encouraging a change of behavior when feeling depressed or overwhelmed, as well as by actually making these changes in order to lead a more fulfilling and stimulating life.
Just as choosing to do things that are enjoyable can have a positive impact on mood, doing things that bring up sad thoughts or feelings can lead to a negative mindset. For example, if an individual is feeling depressed and starts listening to sad music, it may likely lead to these depressive symptoms lingering longer or even intensifying. Oftentimes, individuals who are feeling depressed participate in activities less due to low mood and low energy, yet this ends up leading to less opportunities to feel positive emotions, such as pleasure from doing activities that are enjoyable, achievement from developing and growing skills, and connection to others from being around loved ones and meeting new people.
Utilizing behavioral activation can be trying to implement, especially as it can be challenging to develop the motivation to utilize these goals. In order to find success in this process, it is important to start out learning about the cycle of inactivity and depression. Next, it involves monitoring daily activities that assist in evaluating the relationship between activity level and corresponding mood. Third involves looking at what values and goals we have in regards to the future and what we hope to achieve. Next, it is important to schedule and carry out these activities, which is referred to as simple activation. Lastly, look at any barriers there are in the way and how to solve these problems in order to utilize behavioral activation more effectively.
The first step involves keeping a log of activities and the associated mood that accompanies each action. This is not just about recording the big things, such as going to the store or taking a walk, but should also include small things such as talking on the phone or having a snack. There are many different ways to log this, such as putting it into an excel spreadsheet, keeping a journal with bullet points indicating the mood experienced during each part of the day, jotting down notes in a cell phone, or even making an hour by hour chart to detail what each hour of the day consisted of and the accompanying mood. In order to identify how each activity felt, it is important to use some sort of scale to measure out the differences. This could be a scale of 1-10, a sticker system, or any type of scale that can be used to make comparisons. Ideally, there should be a big enough range, such a 1-10, in order to be able to specify a difference between each hour and activity. It is noteworthy to do this for a period of time that provides enough data to display any patterns. Typically a week is a good amount of time to utilize.
Upon completion of recording activity and moods associated, it is time to review this information and look for patterns. Consider which activities were associated with high moods and which were associated with lowest moods. Think about the days that were less active: what was the average mood on those days? What about days that were more packed with activities such as seeing loved ones or participating in enjoyable hobbies: were there any changes in mood during these days? After looking at all of these activities, make a list of which activities were associated with good moods and which were associated with bad moods.
Values and Goals
Consider what values are most significant in life. Some people would say they value family, marriage, children, career, education, faith, health, hobbies, etc. Write these down and rate them from most important to least important, in order to identify which values should be prioritized. With each value, consider what the current situation is with that value and what things can be improved upon. For instance, if family is the number one value, are the relationships with family members fulfilling and enjoyable? Do any of the relationships feel distant and if so, are these relationships that should be worked on? If career is the number one value, what is the current status of the desired career path and if it has not yet been achieved, then are there any steps in place towards acquiring the desired career?
Planning and Engaging
Next is to start planning and implementing activities. The idea behind the first step was to see that even though there may be resistance in leading a more active lifestyle, it often leads to better moods when doing activities that are desirable or lead to achieving goals. Look at what activities improved mood and the values that are ranked the most important. Are there any activities and values that matched up? For example, if there was a desire to be closer with family and the log of moods showed increased mood during time spent with family, this would be an indication that time with loved ones should be prioritized. If no sort of pattern is found between values and activities, simply think of which two could go together. For example, if the value is faith, but attending religious services has been neglected recently, think about trying to implement prayer time daily or going to religious services weekly.
In addition to these activities, think of daily routines that would be beneficial to implement, such as brushing your teeth regularly, showering daily, picking out a day to get laundry done, cooking meals, going grocery shopping, and other daily tasks that may have fallen off of the normal schedule due to feeling down and neglecting these needs. It can also help to look at what other people do to help their mood, which can be collected by asking loved ones to make their own lists or by looking up activity menu’s online. This could include multiple things that help each person to feel better or that they use to pull themselves out of a down or depressive state. Activities could include things like working out, spending time with friends, getting a massage, listening to music, reading a book, etc.
Implementing Behavioral Activation
Now pick out which activities should be implemented for the coming week and rank them in order from most to least difficult. Each activity should have a number on a scale of 1-10 indicating how difficult the specific task is expected to be. Each time an activity is completed, record the associated mood experienced during this task from a scale of 1-10. Keep in mind when making the decision on what activities to incorporate not to start with things that are too difficult. For instance, if the desire is to be more physically active but the lifestyle being led has been fairly sedentary recently, planning to work out two days during the course of the week may be a good place to start, as opposed to trying to work out five or six days out of the week. It also can help to put these activities into smaller steps, rather than trying to do everything at once. For instance, if cleaning has been neglected over the course of weeks or months and the goal is to get the housing location organized, starting with one room may be a good place to start, rather than trying to tackle the entire unit, which could likely lead to feeling overwhelmed. It may help to have a checklist for each activity so as to check it off or cross it off as each task is completed, which can in itself feel rewarding. It also may help to implement a reward of some sort when a task is accomplished, such as allowing some leisure time or an activity that is not often allotted. It can also help to provide a larger reward if all tasks for the week are completed, such as making a purchase or giving oneself a self-care day.
Finally, keep in mind that these changes are aiming to improve mood overall. It can be easy to put things off when we do not feel up to it or are feeling down on ourselves, but the point of behavioral activation is to recognize that doing these tasks often lead to feeling better. Developing an individualized behavioral activation routine can be central to refining mental health and living a more meaningful lifestyle. Whether participating in behavioral activation in the way explained above, or come up with a unique way of developing a plan, choosing to start this process is the first step towards combatting depressive episodes. As discussed in the beginning, therapy can oftentimes accompany behavioral activation, which can help to keep oneself accountable when speaking with a therapist, as well as having support with developing a plan. Therapy is always a great option for anyone needing additional support and guidance. Online-Therapy offers a free program that gives users access to 25 CBT-based worksheets, a personal journal, an activity plan, tests, and yoga and meditation videos. For those needing additional support, our basic program incorporates daily therapists comments Monday-Friday on worksheets, as well as the services offered through the free program. The standard plan incorporates all services offered through the basic plan, plus one session per week. The premium program offers all services included in the standard plan, plus an additional session per week. Here is link to learn more and to get started: Online Therapy
Tull, Matthew. (2020, August 14). 8 Tips for Using Behavioral Activation to Treat Depression. Very Well Mind. https://www.verywellmind.com/increasing-the-effectiveness-of-behavioral-activation-2797597
Psychology Tools. (2021). How to Use Behavioral Activation (BA) to Overcome Depression. https://www.verywellmind.com/increasing-the-effectiveness-of-behavioral-activation-2797597