How changing activity levels and the activities you carry out boosts your mood
When people become depressed, many of their activities function as avoidance and escape from aversive thoughts, feelings or external situations. (Ferster, 1973) When your life consists of a very narrow selection of activities that are passive in nature and allow for avoidance of emotions or situations, not only can it lead to depression and anxiety but also maintains it. People with depression often lose enthusiasm and interest in activities that in the past they enjoyed which often results in a reduction in their engagement levels in activities that are pleasant and enjoyable.
Behavioural activation (Martell, Addis & Jacobson, 2001), recommended by NICE for mild to moderate depression, seeks to redress the balance by identifying how you spend your time. It looks at the activities that you are doing which are beneficial to helping you lift depression, those which are pleasant and enjoyable, those which you might have been avoiding, those which are unhelpful coping strategies (including avoidance behaviours), as well as times where you spend ruminating.
For one week, monitor how you spend your time each day, making a note of what activities you do. Once you have that information, you can see more clearly what you spend your time doing. Think about what the immediate effect was of doing each of the activities. Perhaps some of them had an unintended effect. Were they in keeping with your goals and valued directions in life? Did they make you feel more comfortable? Did they stop you feeling or thinking something painful? Did they make you feel more hopeless, tired or depressed?
Look at the following types of activities and ask yourself how much of your time was spent doing these during the week you monitored:
Activities that are pleasant and satisfying
Activities that you feel are beneficial to helping you lift depression, for example, exercise, socialising, self-care, etc.
Activities that you feel are unhelpful coping strategies such as drinking alcohol, avoidance behaviours, comfort eating, spending excessive time in bed, etc.
Time when you are just sat doing nothing, such as sitting around the house
Time spent ruminating and generally thinking negatively
Also look at what isn’t featured in your week - are there activities that you are not doing that you have been avoiding that you really do need to be doing.
Looking at it overall, are you content with the amount and types of activities that you did? Do you feel there was enough variety?
Now that you have a clearer idea of how you spend your time, you can start to make adjustments. What alternative activities could you choose to do instead of or as well as the activities you’re already doing that are in keeping with your goals and valued directions? You might choose to add in more pleasant activities and those which help to lift your mood. You might add in some of the activities you’ve been avoiding (as avoidance typically makes anxiety and depression worse). And you might find healthier and more helpful coping strategies to support you instead of the unhelpful ones as well as rumination.
Obviously, you’re not going to change everything at once. It is best to make gradual changes which are manageable. When you commit to making changes to your day to day activity, always act according to your plan, not according to how you feel at the time. Once you’ve started to add in these extra or alternative activities, think about what effect that carrying out the activity had on you.
Whilst generally behavioural activation is used with people who have depression, research has also shown that it can be beneficial for those suffering from anxiety disorders. (Hopko, Robertson & Lejuez, 2006) I also think that everyone could benefit from carrying this out to some degree as even if we do not experience depression or anxiety, we might avoid things, not do much of the things that support our mental health, or spend time unproductively. It’s an interesting exercise to do and I would highly recommend you give it a go.
References:
Ferster, C. B. (1973) A functional analysis of depression. American Psychologist, 28, 857–870.
Hopko, D.R.; Robertson, S.M.C. & Lejuez, C.W. (2006). Behavioral Activation for Anxiety Disorders. The Behavior Analyst Today, 7(2), 212–224
Martell, C. R., Addis, M. E. & Jacobson, N. S. (2001) Depression in Context: Strategies for Guided Action. Norton.
Veale, D. (2008) Behavioural activation for depression. Advances in Psychiatric Treatment, Volume 14, Issue 1, pp. 29-36