Behavioral activation

What Is Behavioral activation?

Behavioral activation is a cognitive behavior therapy that was developed specifically for depression. It acts as a natural antidepressant by assisting you in identifying everyday activities that are meaningful to you but that you have lost, and helps you to actively reingage with them. Depression often makes you feel exhausted and experience low energy, and these moments of low mood can take a toll on your life, as they can extend for a long period of time, making you lose the connection to actively doing things that can bring you positive experiences and improve your mood. It is those lost connections that Behavioral activation aims to reinstate in your life – helping you find meaning and purpose in your everyday life.

The link between what you do and how you feel

This search for meaningful actions is very important. One key principle in CBT is that your behavior strongly influences how you feel. What you do matters. Doing something that you appreciate or feel strongly about versus not doing just that (and maybe just watching TV instead), these everyday differences impact your life. This has to do with the very close link between inactivity and feelings of emptiness and low mood.

To understand further the very close link between behavior and emotions we need to understand the cycle of depression, which is one of the most common mental disorders worldwide. Research consistently shows that a large proportion of people will experience some depressive symptoms at some point in their lives. For some, these symptoms can create a cycle where they begin to avoid positive and rewarding activities, leading to lower energy and more avoidance, which worsens the low mood. This connection between reduced positive experiences and lower mood is often obvious to the non-depressed person but is often lost to the one experiencing depression, who often has many jugemental thoughts, interpreting his depression as “laziness” or other non helpful attributions.

Behavioral activation is about working on this connection between what you do and how you feel. Your therapist will help you introduce activities that you identify as meaningful to you, and over time you will feel more and more in contact with and in control over your life, making you more active and engaged.

Overview of the therapy

First, your therapist will help you observe your everyday life in a new way, including and most importantly, what you’re doing (staying too much at home, scrolling endlessly) or not doing (not going out of the house, not meeting up with friends or doing things that matters to you with your family), and how it is making you feel. This will intuitively help you see the close link we talked about earlier between your actions and your feelings. This ‘inspection’ of your everyday life will also give clues to patterns in your life that may have lead you to feel depressed in the first place.

Next, your therapist will help you identify areas of activities that you used to do before that were meaningful to you and that you’re no longer engaging in, along with setting new goals and introducing such activities that you yourself judge as purposeful and meaningful (close to your values).

Moving on, your therapist will help you plan how you can introduce these activities throughout the week, making an an “activity schedule” that will your major tool between sessions to support you, keeping on track with what you value in life, and helping you act in accordance with your goals, and not just in reaction to the low mood you feel in the moment. During this phase of pursuing meaningful goals, your therapist will tell you to pay attention to your feelings and notice how engaging in these activities impact your mood.