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Behavioural activation

One of the key symptoms in depression is withdrawal from activities, including those that once brought enjoyment. It can be very hard to motivate yourself to do something that either brings no joy or for which you have no energy to do. It is very easy to fall into a cycle of waiting until you feel ready, energised or motivated enough to do something. However, the reality is that we must learn to break the cycle ourselves rather than expecting change to happen by itself. The elusive day of feeling ‘ready and able’ to do something may not arise without a bit of a nudge.

This is why CBT for depression in particular focusses on behaviour and getting us activated again. This component of CBT has been proven to be extremely effective in improving low mood. Changing our behaviour and activity levels can in fact improve our emotional wellbeing. This isn’t about doing something huge and radical; it isn’t about trying to run a marathon or change your whole lifestyle. It is about making small and gradual changes to increase engagement in activities that bring joy or a sense of achievement and to decrease engagement in activities that may maintain low mood or depression.

Imagine that we as humans are like a car battery that has gone flat: we will need a jump start in order to get going initially, and the more our engines tick over, the more they recharge themselves.

There will inevitably be challenges and barriers to overcome, some of which will be practical and require problem solving. Others may be cognitive and will need some gentle re-evaluation. And this is why it can be helpful to do this with someone in therapy.

However, if you want to try some things for yourself, you might like to try the following:

  • Keeping a diary of your activities and mood (what are you doing every morning / afternoon / evening and how good is your mood from 0-10)
  • Scheduling activities into your week, ensuring that these are realistic and achievable. It can be helpful to arrange to do something with someone else so that you have an external motivation to make sure you do it
  • Setting a graded hierarchy of activities that you want to get back into your life. Whilst the long-term goal might be running four times a week, you might start by taking a 10-minute walk daily or a 30-minute walk twice a week
  • Setting yourself rewards for achieving your goals, making sure that the goals you set are gentle and achievable