One Method For Depression
An Introduction to Behavioral Activation
The Issue With Depression
Depression is a major issue globally. We know the rates of depression have risen and will probably continue to rise. We know depression is linked to decreased productivity, increased risk of suicide, and increased risk of other health complications.
It's fair to say depression is an issue we need to tackle more proactively. The causes of depression are multifaceted, stemming from both environmental factors and our biological predispositions.
However, what we do know a bit more clearly is the symptoms of depression and the cycles of it.
Depression is categorized by the following characteristics in the DSM:
Persistent sad, anxious, or “empty” mood
Feelings of hopelessness or pessimism
Feelings of irritability, frustration, or restlessness
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Decreased energy, fatigue, or feeling slowed down
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, waking early in the morning, or oversleeping
Changes in appetite or unplanned weight changes
Physical aches or pains, headaches, cramps, or digestive problems that do not have a clear physical cause and do not go away with treatment
Thoughts of death or suicide or suicide attempts
We also know that those with depression often have negative ruminating thoughts, lack motivation, have problems with sleep and appetite regulation, and engage in avoidance behaviors.
What are some ways we have to deal with depression?
Keep in mind these are evidence-informed practices based on the best available research we have on the subject.
One way we can help individuals deal with depression is through anti-depressant medications. These can include a classification of medication called selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and others.
Another effective way depression is treated is through psychotherapy. This includes seeing a qualified mental health professional to give you the tools to help cope with your depression. One of the most effective forms of psychotherapy for depression is cognitive behavioral therapy (CBT).
But I am here to propose an even more straightforward intervention than what Aaron Beck (the creator of CBT) had in mind. I am here to propose an emphasis on behavioral activation (BA).
In this article, I want to cover what BA is, some of its core tenets, the evidence of its efficacy, and how we can implement what it teaches us to ourselves.
What is Behavioral Activation?
To preface, much of the information I am conveying comes from Behavioral Activation for Depression: A Clinician’s Guide by Christopher R. Martell, Sona Dimidjian, and Ruth Herman-Dunn.
Behavioral activation (BA) is a form of brief psychotherapy used to treat depression. The core concept of BA lies in behaviorism from psychologist B.F. Skinner, but has evolved over time as a form of treatment.
The core tenets of BA include activation, scheduling activities, and problem-solving.
Unlike, cognitive behavioral therapy (CBT), which focuses on thoughts and feelings along with behaviors, BA just focuses on behavior.
The theoretical assumption from BA is that depression is an interaction between behaviors and environment which leads to the reinforcement of negative or avoidant behaviors.
The goal of BA is to increase positive reinforcement in a person’s life with more proactive beneficial behaviors.
Activation (or doing) is thought to be important for getting a person out of depression because the idea is behavior changes mood and gets a person out of the depressive cycle. The point of doing BA is to get people to participate in beneficial positive behaviors.
BA in theory is simple, replace negative behaviors with positive ones, but in practice, it is a bit tricky.
The Trick
So, how can we implement BA to rid ourselves of depression?
The trick is to stop thinking about the method we administer to ourselves that will solve a multifaceted issue such as depression. A method like BA should be used under the influence of a clinician trained to deliver such a method.
However, we can gain insights from certain techniques from this approach.
First, we need to understand the first core principle of BA.
The key to changing how people feel is helping them change what they do.
This means we cannot depend on our mood to get us to change our actions but to change our actions in order to change our mood.
BA is highly structured and has us test our behaviors like a scientist who tests hypotheses.
The clinician doing this treatment should pinpoint negative behaviors that reinforce depressive symptoms and replace them with positive behaviors that can break the cycle of depression.
Depression is cyclical, BA can acknowledge that our thoughts thoughts, and feelings impact our behaviors but by targeting the behavior itself we can hopefully break the cycle.
Final Thoughts
Depression is extremely complex, and there is no agreed-upon cause.
But we do have treatments that are just as effective as medication, such as BA.
BA allows us to work out of the cycle of depression by changing the behaviors we are acting upon to reinforce that depression.
Those who are depressed tend to withdraw and avoid uncomfortable situations that induce stress.
By completing tasks that compel us to act despite how we feel, our mood can improve.
Nevertheless, we need the direction of a competent mental health professional who specializes in BA to guide us through these actions.
We have the schedule activities and act upon them, this is hard for a depressed person to do alone. Depression requires support and constant practice in the form of skills.
Here is a great resource for depression (tap/click here).