How Does Behavioral Activation For Depression Work?
Depression is a serious mental health condition that impacts an estimated 5% of adults globally. Depressive disorders can affect an individual’s motivation, interest in their passions, and energy levels. This can lead to a common quandary: symptoms of depression often make it hard to engage with the activities that may improve those very symptoms. One approach that is commonly utilized to address this potentially frustrating cycle is behavioral activation, a technique that focuses on using healthy behaviors to promote positive feelings. Below, we’re going to discuss what behavioral activation is, how it works, and how it can help improve symptoms of depression.
What is behavioral activation?
Behavioral activation is a therapeutic intervention centered around the use of behaviors to alleviate symptoms of mental health concerns. While it is used to help manage symptoms of conditions like PTSD and anxiety, it is most frequently utilized to help treat depressive disorders.
Often, depression makes it difficult for individuals to engage in healthy activities, which can exacerbate feelings of hopelessness, anhedonia (trouble experiencing pleasure), and sadness. Using behavioral activation strategies, people with depression can incorporate such activities into their lives in order to address those feelings. Behavioral activation is a technique that is often used as part of cognitive behavioral therapy (CBT), though it can also be a standalone approach.
How does behavioral activation work?
Often, a therapist using behavioral activation techniques will talk with the participant about the specific challenges depression is presenting in their life. Based on the information the client provides, the professional may identify certain behaviors that are connected to depressive symptoms.
From there, they can help the client come up with activities that may have the opposite effect, promoting positive feelings and helping improve symptoms of depression. The therapist and client may then develop strategies for implementing these behaviors regularly. This may include setting attainable goals, creating a detailed schedule, and monitoring progress over time.
Take, for example, a situation in which an individual is experiencing depression due to the loss of their job. In response, they may engage in maladaptive behaviors like withdrawing from family and friends, which can make their sadness and loneliness. And because their work provided them with a sense of purpose, they may experience a lack of motivation and a loss of interest in that passion.
By utilizing behavioral activation principles, a therapist can help this person recognize the maladaptive behaviors (isolating) that lead to negative feelings and the healthy activities that make them feel better (socializing, working). The individual may then schedule times to catch up with friends and family consistently, which can help improve their mood and decrease loneliness. They might also find side gigs relevant to their line of work as they look for a new job, which can help provide them with a sense of purpose and increase their motivation. This could, in turn, help them engage in even more healthy behaviors, creating a cycle of positive reinforcement.
Behavioral activation strategies
Behavioral activation is generally focused on determining which activities are personally meaningful, fulfilling, and helpful, then using various methods to incorporate them into your life. While you can utilize behavioral activation strategies yourself, a mental health professional may be able to provide you with guidance and insights that lead to more comprehensive treatment. The following are several tips for using behavioral activation for depression.
Identify beneficial activities
To start, it is important to know which actions will be most likely to foster feelings of achievement, motivation, pleasure, etc. Try to develop a list of activities that make you feel fulfilled, energized, and engaged. You may already have an idea of what you’d like to do more of, whether it’s connecting with friends and family more, exercising, or getting out of the house each day.
To get an idea of which behaviors lead to positive feelings, it can help to track your activities and mood each day. Consider keeping a log that details the activities you engage in and how you feel afterward so that you can start to identify patterns over time. As you compile examples of the connections between your actions and mood, you may notice that certain behaviors engender more positive or negative feelings. You might discover that playing an instrument leads to joy, or that journaling helps you feel more motivated. There may also be activities that you do not necessarily enjoy, but that you know make you feel better.
It can also be helpful to determine what values are important to you, and then identify activities that align with those values. For example, if you feel strongly about safeguarding the environment, volunteering with a non-profit organization that focuses on conservation could produce positive feelings in your life. Pinpointing activities that are meaningful, beneficial, and rewarding is key to successful behavioral activation.
Identify detrimental activities
Conversely, it can be important for you to determine which activities may contribute to worsening symptoms of a depressive disorder. Knowing which activities lead to low mood, a lack of motivation, etc., can contribute to your understanding of your depression and help you identify which behaviors you’d like to replace. For example, you may find that you start to feel sad when you struggle getting out of bed. In this case, one aspect of behavioral activation could be creating habits geared toward helping you start your day when you wake up.
Set achievable goals
Once you’ve determined which behaviors you’d like to practice regularly, it can help to create actionable, attainable objectives for each activity. A widely utilized framework for goal-setting is SMART, which stands for specific, measurable, achievable, relevant, and time-bound.
- Specific – Try to ensure the activities are well defined; for example, instead of saying you’d like to read more, you can say you’d like to read 10 pages of a novel each night.
- Measurable – You should be able to track your progress; for example, a goal of “texting one friend per day” is easier to measure than “reaching out to friends more”.
- Attainable – Setting small goals at the outset can help ensure you’ll stick with the activity; for example, you may start by trying to go for a 1-mile run once a week and then slowly increasing the mileage and frequency.
- Relevant – The activity should be something that will produce the desired positive reinforcement; for example, cooking healthy meals can be helpful if you’d like to experience more energy and feelings of satisfaction.
- Time-Bound – There should be a timeframe within which the goal will be achieved; for example, behavioral activation goals are typically set within a 1-week time period.
Monitor your progress
Keeping tabs on how your actions are affecting your feelings can be an important part of the process. One way of monitoring how behavioral activation therapy is progressing is to continue tracking your activity. Writing down your feelings and the day's activities can help you assess your progress, recognize certain patterns, and make adjustments. There are several worksheets and diaries you can find online to help you keep an organized and easy-to-read log.
Utilize social support
A common component of behavioral activation is revealing your plan with friends and family who can help motivate you and keep you on track. You might tell your support network about your specific goals and ask them if they have suggestions for achieving them. They may have helpful insights given their knowledge about you. They can also engage in healthy activities with you, such as exercise. Additionally, the simple act of strengthening bonds with loved ones can help improve your emotional well-being.
You can also ask people in your support system to assist you in limiting behaviors that may exacerbate depression. For example, if drinking is a behavior that makes you feel down, you can ask your friends to help you avoid situations in which you might be tempted to consume alcohol.
Reward yourself
Behavioral activation depends, in part, on creating a cycle of positive reinforcement, through which an individual experiences feelings of happiness, well-being, etc., after being rewarded—and then continues seeking more rewards. So, it can be important to reward yourself after achieving a goal. For example, consider treating yourself to a cheat meal each time you’re able to exercise four times a week; or allow yourself to have a night in with a movie on Sundays when you’ve gone out with friends twice the week prior.
Work with a professional
While you may be able to implement some behavioral activation techniques on your own, a therapist can help you develop a more comprehensive and effective approach. In addition to providing emotional support, a mental health professional can help you identify the sources of your symptoms and the behaviors that may be exacerbating them. And, based on their unbiased perspective, they may identify beneficial activities—and techniques for implementing them—that you hadn’t considered. They can also be a source of motivation, helping you stay consistent as you work to incorporate healthy behaviors into your life.
Healthier behaviors through online therapy
Research suggests that online therapy is an effective way of utilizing behavioral activation techniques for depression. For example, in a trial published in the Journal of Affective Disorders, researchers found that an online behavioral activation intervention was “effective in reducing symptoms of depression”. These results can be added to those of an increasingly large number of studies suggesting that therapists using online platforms can use a variety of techniques to address a wide range of mental health concerns.
If you’d like help incorporating healthy behaviors into your life as you navigate a depressive disorder, consider getting matched with a licensed therapist through BetterHelp. BetterHelp works with thousands of qualified mental health professionals—who utilize a wide variety of strategies—so you’ll have a good chance of connecting with someone who can address your specific concerns regarding depression. Your therapist can also help you get useful resources, such as at-home worksheets meant to help you stay consistent as you implement healthy behaviors.
Takeaway
What is behavioral activation?
Behavioral activation is a therapeutic approach that is often used in treatment for depression and other mood disorders. It is based on the idea that behaviors and activities may play an important role in influencing and managing emotions. The primary goal of behavioral activation is to help individuals increase their engagement in positive and rewarding activities, which, in turn, can lead to improvements in mood and overall well-being. In a clinical psychology review and meta-analysis of peer reviewed studies, behavioral activation was shown to be effective at treating implementing behavioral changes that may reduce depression.
What are the activities for behavior activation?
Behavioral activation involves engaging in a variety of activities to help individuals overcome depression and improve their mood. The activities chosen are often based on the individual's interests, values, and preferences. The goal is to increase positive reinforcement and create a sense of achievement. Here are 10 examples of activities commonly used in behavioral activation:
- Routine Activities: Establishing a daily routine can provide structure and stability. This may include waking up and going to bed at consistent times, as well as incorporating regular meals and self-care activities.
- Physical Exercise: Engaging in regular physical activity has been shown to have positive effects on mood as well as physical health. This could include activities such as walking, jogging, swimming, or participating in fitness classes.
- Hobbies and Interests: Encouraging individuals to reconnect with hobbies or activities they once enjoyed can bring a sense of pleasure and accomplishment. This might include reading, gardening, painting, playing a musical instrument, or any other activities that bring joy.
- Social Activities: Spending time with friends and family or participating in social activities can provide social support and help combat feelings of isolation. This could involve meeting a friend for coffee, joining a club, or participating in group activities.
- Work and Productive Activities: Engaging in meaningful work or productive activities can contribute to a sense of purpose and achievement. This might include pursuing work-related tasks, volunteering, or taking on responsibilities at home.
- Self-Care: Prioritizing self-care activities is essential. This includes activities like taking a warm bath, practicing relaxation techniques, getting a massage, or engaging in other forms of self-nurturing.
- Chores and Responsibilities: Accomplishing daily chores and responsibilities, such as cleaning, cooking, or organizing, can provide a sense of order and achievement.
- Graded Exposure: Gradual exposure to activities that may be anxiety-provoking or challenging can be part of behavioral activation. This involves breaking down tasks into smaller, more manageable steps to build confidence and reduce avoidance.
- Learning Opportunities: Pursuing opportunities for learning, whether through classes, workshops, or online courses, can contribute to a sense of personal growth and accomplishment.
- Mindfulness and Relaxation: Incorporating mindfulness exercises, meditation, or deep breathing exercises can help individuals stay present and manage stress.
What is behavioral activation for students?
Behavioral activation for students involves applying the principles of behavioral activation—an evidence-based therapeutic approach—to address mental health conditions or challenges and enhance well-being among students. It is particularly relevant for students experiencing symptoms of depression, anxiety, or other mood-related difficulties. The goal is to help students increase positive behaviors, engage in meaningful activities, and improve their overall mental health.
What is behavioral activation for youth?
Behavioral activation for youth is an approach to mental health treatment that focuses on encouraging positive behaviors and increasing engagement in meaningful and rewarding activities. It may often be used to address depression and other mood-related challenges in children and adolescents. Behavioral activation for youth discusses similarities with the approach used for adults but is tailored to the developmental needs and interests of younger individuals. According to a systematic review study and empirical literature related to behavioral activation in children, using behavior activation reduces depression.
What is behavioral activation and activity scheduling?
Mental health professionals may use behavioral activation or suggest activity monitoring to help establish patterns of thinking. Behavioral activation and activity scheduling are closely related components of a therapeutic approach used in the treatment of depression and other mood disorders. Both are integral parts of behavioral activation therapy, which aims to increase engagement in positive and rewarding activities to improve mood and well-being, breaking the sometimes vicious cycle of negative thought patterns.
Behavioral Activation:
Behavioral activation is a therapeutic approach based on the principle that behaviors that may play an important role in influencing and managing emotions. The goal is to encourage individuals to increase their engagement in activities that bring pleasure, a sense of accomplishment, and positive reinforcement.
Core Concepts:
- Cycle of Depression: Behavioral activation recognizes a cycle of depression in which individuals withdraw from activities, leading to increased negative thoughts and emotions, further reinforcing the pattern of withdrawal.
- Breaking the Cycle: By encouraging individuals to gradually resume or increase their participation in positive activities, behavioral activation aims to disrupt the cycle of depression and improve mood.
Activity Scheduling:
Activity scheduling is a specific technique within behavioral activation that involves planning and scheduling positive and rewarding activities throughout the day or week. It's a practical tool for implementing the broader principles of behavioral activation.
Steps in Activity Scheduling:
- Activity Identification: Individuals work with their therapists to identify a range of activities that are enjoyable, meaningful, or contribute to a sense of accomplishment.
- Scheduling: These activities are then scheduled into the individual's daily or weekly routine. The schedule should be realistic, taking into account the person's current energy levels and other commitments.
- Activity Monitoring: Individuals track their adherence to the schedule and monitor changes in mood or energy levels. This feedback helps in refining and adjusting the activity schedule over time.
What is behavioral activation for low motivation?
Behavioral activation for low motivation is a therapeutic approach designed to address a lack of motivation, which is often a common symptom in conditions such as depression. Behavioral activation aims to help individuals gradually increase their engagement in positive and rewarding activities, even when motivation is low. This approach is based on the idea that taking small, meaningful actions can lead to positive changes in mood and overall well-being.
What is behavioral activation for intellectual disability?
Behavioral activation for intellectual disability (BA-ID) is an adaptation of behavioral activation therapy specifically designed for individuals with intellectual disabilities. Intellectual disabilities involve limitations in intellectual functioning and adaptive behaviors, affecting a person's everyday social and practical skills. Behavioral activation aims to help individuals with intellectual disabilities overcome challenges related to mood and engagement in positive activities.
What are activating events in behavioral therapy?
In the context of behavioral therapy, "activating events" refers to specific events or situations that trigger emotional or behavioral responses in an individual. These events are considered external factors that contribute to the person's emotional or behavioral reactions. Understanding activating events may be important in cognitive-behavioral therapy (CBT), a widely used therapeutic approach, as it helps individuals recognize and evaluate the connection between events, thoughts, emotions, and behaviors.
Here is a behavioral activation example:
Activating Event: A person receives critical feedback at work during a team meeting.
Beliefs/Thoughts: The individual interprets the feedback as a sign of personal failure, thinking, "I'm not good enough. I always mess things up."
Emotional Response: The person feels sad, anxious, or demoralized.
Behavioral Response: The person may withdraw from social interactions at work, procrastinate on tasks, or engage in other behaviors influenced by the negative emotions.
According to a randomized controlled trial, behavioral activation or behavioral therapy may be effective at reducing depression and changing thought patterns. By identifying and challenging maladaptive beliefs related to activating events, individuals can develop more adaptive and constructive ways of interpreting and responding to situations. This process is a central aspect of cognitive restructuring in CBT and behavioral activation treatments, and may be used by a trained crisis counselor or therapist to promote healthier cognitive and emotional patterns.
Who invented Behavioral activation?
Behavioral activation treatment is a therapeutic approach that evolved within the broader framework of cognitive-behavioral therapy (CBT). While it doesn't have a single inventor, its development is associated with several key figures in the field of psychology and psychotherapy. The roots of behavioral activation can be traced back to behavior therapy and cognitive therapy traditions.
Albert Ellis:
Albert Ellis, an influential psychologist, is known for developing Rational Emotive Behavior Therapy (REBT). While not specifically focused on behavioral activation, his work laid the groundwork for understanding the role of beliefs and thoughts in influencing emotions and behaviors.
Aaron T. Beck:
Aaron T. Beck, a psychiatrist, is a central figure in the development of cognitive therapy, which later evolved into cognitive-behavioral therapy (CBT). Beck's work emphasized the cognitive behavioral treatment processes involved in emotional and behavioral responses. Elements of behavioral activation are integrated into CBT, which Beck pioneered.
Peter Lewinsohn:
Peter Lewinsohn, a psychologist, is often credited with the development of behavioral activation as a distinct therapeutic approach. In the 1970s, Lewinsohn and his colleagues conducted research on depression, leading to the formulation of the behavioral model of depression. This model emphasized the role of reduced positive reinforcement and increased avoidance in maintaining depressive symptoms.
Lewinsohn's work laid the foundation for what would later be recognized as behavioral activation. He highlighted the importance of identifying and modifying behavioral patterns, increasing positive reinforcement, and addressing avoidance behaviors as key elements in treating depression.
What is the ABC of behavioral activation?
The ABC model in behavioral activation is a conceptual framework used to understand the connection between activating events, beliefs, and consequences. It is a cognitive-behavioral approach that helps individuals recognize and analyze the sequence of events that contribute to their emotional and behavioral reactions. The ABC model is often associated with Albert Ellis, a psychologist who developed Rational Emotive Behavior Therapy (REBT). In the context of behavioral activation, the ABC model helps individuals examine the relationships between events, thoughts, and consequences.
Here's a breakdown of the ABC model:
A: Activating Event:
The "A" represents the activating event, which is an external situation or occurrence that triggers emotional or behavioral responses. Activating events can be diverse and include a range of experiences, such as interactions with others, work-related situations, or environmental changes.
B: Beliefs/Thoughts:
The "B" stands for beliefs or thoughts that individuals have about the activating event. These beliefs are shaped by personal interpretations, cognitive patterns, and underlying assumptions. Beliefs can be rational (adaptive) or irrational (maladaptive).
C: Consequences:
The "C" represents the emotional and behavioral consequences that follow the individual's beliefs about the activating event. Emotional consequences include feelings such as sadness, anxiety, anger, or happiness. Behavioral consequences encompass the actions or behaviors that result from these emotional responses.
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