How Does Behavioral Activation For Depression Work?

Medically reviewed by April Justice
Updated February 28, 2024by BetterHelp Editorial Team

You have options for addressing a mood disorder

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?

Behavioral activation targets the cycles of maladaptive behaviors and negative feelings that depression can produce and focuses on replacing them with cycles that may be healthier and more productive.

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. 

Getty/Vadym Pastukh
You have options for addressing a mood disorder

Takeaway

Depressive disorders present a common conundrum: while certain activities can alleviate feelings of depression, the condition’s symptoms make it harder to be active. Behavioral activation is one way of addressing this challenge, helping participants implement beneficial activities into their lives and reduce symptoms of depression. If you'd like to learn how utilize behavioral activation techniques in your life, consider connecting with a therapist online. With the right support, you can manage depression and take the next step on your mental health journey.
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