Depression is a debilitating mental health condition that affects 1 in 6 adults in the UK alone. In a 2023 study conducted by Champion Health, it was found that 56% of UK workers are currently experiencing at least mild symptoms of depression. These are staggering statistics, and discourse around the topic of mental health has, rightfully, picked up traction in all corners of our society.
Fortunately, there are effective treatments available, and one such approach gaining recognition is behavioural activation.
Behavioural activation is a therapeutic technique rooted in cognitive-behavioural therapy (CBT) that focuses on increasing engagement in rewarding activities to alleviate symptoms of depression. It recognises the strong connection between behaviour and mood and aims to break the cycle of inactivity and negative thinking that often characterises depression.
So, how does behavioural activation work, how can it be applied to overcome depression, and what can you do to implement it into your daily routine?
Understanding Behavioural Activation in Cognitive-Behavioural Therapy (CBT)
Behavioural activation is a core component of CBT, and focuses on addressing a person's behavioural patterns, particularly those associated with depression or other mood disorders. The main principle of behavioural activation is that engaging in positive and rewarding activities can improve mood and alleviate symptoms of depression.
The goal of behavioural activation is to reverse this cycle by encouraging individuals to actively participate in activities that bring joy, purpose, and a sense of accomplishment, even if the activity is small. By increasing engagement in positive experiences, those suffering with depression can experience a gradual improvement in their mood and overall wellbeing.
Here's how it works:
Targeting Behavioural Patterns
In CBT, therapists work with clients to identify problematic behaviours that might be reinforcing their negative emotions or maintaining their mental health issues. Behavioural activation specifically targets these behaviours, and aims to increase positive and healthy activities that can help improve mood and reduce negative emotions.
Breaking the Cycle of Depression
Depression often leads to a cycle of inactivity, withdrawal, and isolation, which further exacerbates the negative feelings experienced. Behavioural activation intervenes in this cycle by encouraging individuals to engage in activities they used to enjoy or find rewarding, even if they don't feel like doing so initially. By breaking the cycle of inactivity, people begin to experience more positive emotions, which can help combat depression.
Focus on Present Behaviour
While CBT addresses both thoughts (cognitive) and behaviours, behavioural activation places a primary focus on the present behavioural patterns. It acknowledges that changing behaviour can lead to changes in mood and thinking.
Graded Task Assignment
Therapists using behavioural activation often employs a technique called "graded task assignment," where they help clients set achievable goals and gradually increase their engagement in positive activities over time. This approach prevents overwhelming the individual and provides a sense of accomplishment as they achieve their goals.
Integration with Cognitive Restructuring
While behavioural activation primarily deals with behaviours, it typically complements cognitive restructuring, a key cognitive technique in CBT. By challenging negative thoughts and incorporating positive behavioural changes, clients experience a more comprehensive therapeutic effect.
Implementing Behavioural Activation for Depression
1. Set Goals
Start by identifying specific goals that align with your values and interests. These can be simple, achievable tasks that you can work towards daily or weekly. Breaking larger goals into smaller, manageable steps can make them more attainable and boost motivation in the long run.
2. Create an Activity Schedule
Develop a daily or weekly schedule that includes activities that you enjoy or have found rewarding in the past. This can range from hobbies, exercise, spending time with loved ones, or engaging in creative pursuits. Ensure a balance between activities that provide immediate gratification and those that contribute to long-term goals.
3. Monitor Your Mood
Keep a journal to track your mood before and after engaging in different activities. This allows you to identify patterns and recognize which activities have a positive impact on your well-being. It can also help you identify any negative thinking patterns that may hinder your progress.
4. Challenge Negative Thoughts
Depression often accompanies negative and self-defeating thoughts. Practice challenging these thoughts by identifying evidence that contradicts them. Replace negative thoughts with positive and realistic affirmations that support your efforts towards behavioural activation.
5. Seek Support
Consider enlisting the help of a mental health professional who specialises in behavioural activation or CBT. They can guide you through the process, offer support, and provide additional strategies to overcome obstacles that may arise on your journey.
Examples of Behavioural Activation in Everyday Life
While the concept of behavioural activation is often associated with therapy, its principles can be applied by anyone seeking to improve their mood and overall well-being. Here are a few examples of how behavioural activation can be integrated into daily life:
1. Engage in Physical Activity
Regular exercise has been shown to boost mood and alleviate symptoms of depression. Incorporate activities such as walking, jogging, or yoga into your routine to experience the positive effects on your mental health.
Here’s a video outlining the value of simple action through body and breath movement.
2. Pursue Hobbies and Interests
Dedicate time to activities that bring you joy, whether it's painting, playing a musical instrument, gardening, or cooking. Engaging in hobbies provides a sense of accomplishment and can serve as a valuable outlet for self-expression.
3. Socialise and Connect
Spending time with loved ones and building meaningful relationships is crucial for mental well-being. Plan outings or gatherings with friends and family, join clubs or groups centred around shared interests, or volunteer for a cause you care about.
4. Practice Self-Care
Prioritise self-care activities that promote relaxation and self-nurturing. This can include taking long warm baths with your favourite bath salts, practising mindfulness or meditation, reading, or indulging in a hobby that brings you peace.
Conclusion
Behavioural Activation is an intervention of choice for depression and is widely used in psychology services. By actively engaging in positive and rewarding activities, individuals can regain a sense of control over their lives, experience improved mood and wellbeing, and develop healthy coping mechanisms to carry into the future.
The first steps in the “doing”, can create a launch pad and enough momentum to help you feel better and re-engage with life, just that little bit more. The path to better mental health is a journey. So, take it one day, one movement, one breath at a time, and remember to be kind to yourself.
For more information on how behavioural activation can enhance your wellbeing, you can email maudsleylearning@slam.nhs.uk.
A note from the hosts of our video
For more information on what we do, visit Saya at https://gentlehumankind.wixsite.com/sayayoga.
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For more in-depth behavioural activation info and resources:
https://www.therapistaid.com/therapy-guide/behavioral-activation-guide
https://www.psychologytools.com/professional/techniques/behavioral-activation/
We also have a course, Non-drug Treatment in Depression: Behavioural Activation and Beyond, which is a one-day Maudsley Masterclass, aimed at clinicians working in mental health, covering the basics of non-medical treatments for depression, as well as the latest research and evidence.
Participants attending the course will learn to assess patients with depression to identify problematic lifestyle, cognitive, and interpersonal factors. After attending this course, participants will be able to integrate CBT for sleep, exercise, triple chronotherapy, and nutritional interventions into their management plans. There will be a focus on a functional understanding of rumination, avoidance, and compensatory behaviours that are used to avoid painful emotions that maintain depression.