The Hidden Weapon Against Depression (How To Do Behavioral Activation)

Dr. Tracey Marks, psychiatrist, explains:

A cycle of action

Depression is:

1. not fun
2. self-reinforcing in nature

That is to say: depression disrupts thoughts, feelings, behaviors, and by extension, physical wellbeing. The resultant withdrawal from activities further removes psychological rewards, and worsens depression in a spiralling feedback loop.

Behavioral activation (BA) is an underused but effective intervention that encourages re-engaging in meaningful activities (no matter how little you feel like doing them) to break the cycle of depression.

This is very different from CBT, because instead of changing thoughts directly, it modifies behavior to indirectly improve thinking and self-perception. That said, there’s no reason you can’t do both if you want to, but let’s be reasonable; a person in the throes of depression is usually not leaping at every opportunity with full enthusiasm, so maybe one thing at a time is sufficient.

How it works: even small constructive activities provide positive reinforcement, and can start a healthier loop. Additionally, if applicable (and it’s best if it is), exercise also helps by boosting brain-derived neurotrophic factor (BDNF).

Step-by-step:

1. Monitor activity: keep track for a week, noting morning/afternoon/evening activities and mood ratings (e.g. 1–10, or if you use a bullet-journalling app*, then whatever scale it uses is fine), focusing on intentional activities rather than basic bodily functions
2. Review activity: identify what boosted or lowered mood, which activities increased connection, and which gave a sense of accomplishment
3. Reflect on values: reconnect with core values that give meaning; use assessments or workbooks if needed
4. Plan activities: list items from the tracker, your values, essential daily living tasks, and an activity menu for new ideas
5. Schedule and commit: use the tracker to plan; expect gradual progress, with motivation and energy increasing over time

*This writer—who has found BA immensely useful personally for getting out of depressive episodes—uses Daylio, which has a customizable 1–5 scale (as well as customizable activities** to track). Personally I modified “3” on the scale to be able to mark two different kinds of “middling” days moodwise; I draw a distinction between days that are middling because they were emotionally flat, and days that were middling because they had a mixture of highs and lows that, for bullet-journalling purposes, cancels out to “middling”. That way, I still get my overall mood chart in the graph, but I can also scroll through my days and see if, for example, I have been emotionally flat for a time (big warning sign of depression) rather than “my day was mixed in nature” (perfectly normal healthy part of the human experience).

**As with Dr. Marks’ advice, I do mostly track intentional activities (e.g. gardening, exercise, wash hair, meditation, see sunrise, see friends, etc), though I also track my sleep (e.g. good sleep, bad sleep, medium sleep, wake early), and some physiological things such as crying, and cramps (because if I track crying for several days and then cramps, I can probably attribute it at least in part to hormones), because these things have bearing on how I then interpret the data—which is part of how the “monitor” and “review” parts of BA work.

One of the great things about BA is that you can do it by yourself, but you also can enlist help, e.g. from a partner, friends, family, etc. When experiencing depression, it’s easy to imagine that either everyone hates you or, at best, nobody cares—but usually there will be people who will be glad to help if given the opportunity.

For more on all of this, enjoy:

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Want to learn more?

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Behavioral Activation Against Depression & Anxiety

Take care!