If you have depression, sometimes you might not feel like doing things you used to enjoy. And the less you do, the more depressed you could get. A treatment called behavioral activation (BA) aims to stop the downward spiral and help you feel better.
BA is a type of talk therapy for depression and other mood disorders. A therapist helps you choose, schedule, and keep up with activities that you might find fun, useful, or meaningful. As you gradually add more activities to your schedule, you might find your mood and energy improving.
Research suggests that behavioral activation may be as effective as antidepressants, even for people with severe depression.
BA stems from another type of talk therapy: cognitive behavioral therapy (CBT). CBT teaches you how to take charge of negative thoughts, while BA focuses on changing your actions. One study suggests that they’re equally effective for depression and that behavioral activation is more cost-effective.
How Does Behavioral Activation Work?
You might need anywhere from eight to 24 weekly therapy sessions. The exact number depends on things like how severe your depression is and how much progress the treatment helps you make.
After you first meet your therapist and talk with them about your depression, they’ll ask you to keep a daily log of your activities. For each hour of the day, you simply write down what you’re doing and how you’re feeling. Your therapist may ask you to rate how you’re feeling on a scale of 0 to 10, with 0 being the worst and 10 being the best.
The activity log helps you and your therapist spot activities and situations that make you feel good and those that don’t. It can also reveal clues that you might be avoiding certain things that could be good for you, like finding a more fulfilling job, paying bills, or connecting with friends.
Your therapist then uses this information to make a plan just for you. They’ll help you:
- Choose and schedule mood-boosting activities.
- Set goals that motivate you to complete them.
- Learn new skills that could boost your odds of success, like relaxation techniques or communication tips.
- Break bigger activities into smaller, doable parts.
- Spot habits that could sink your mood.
As you gradually start doing more activities, you’ll keep track of how they make you feel. Your therapist may again ask you to rate your moods on a scale of 0 to 10.
What Activities Can Help?
Everyone’s different. Your therapist will make suggestions tailored for you. You’ll choose from activities that fall under some or all of these groups:
Healthy habits. These are lifestyle changes that boost your physical and mental health. Some examples are:
- Exercising more
- Eating healthier
- Getting enough sleep
Pleasant experiences. These are hobbies or interests that make you happy. They could include things like:
- Arts and crafts
- Getting out in nature
- Dancing
- Cooking
- Martial arts
Social activities. These involve spending quality time with people you care about, or building new connections. Some examples are:
- Phone call or video chat with a loved one
- Emailing a friend
- Game night with your family
- Helping someone who needs a hand
Mastery activities. These help you feel productive, build skills, or give you a sense of accomplishment. They could include:
- Completing work or school assignments
- Tackling home improvement projects
- Reading a new book
- Improving personal hygiene
What Happens After BA Therapy?
By the time you complete all your sessions, the idea is for you to have a routine of feel-good activities and healthy habits that can help you continue to take charge of your depression and accomplish other goals in your life. Your therapist will give you an action plan that describes what to do in case you have trouble keeping up with your activities and your depression comes back.
After you finish BA, it’s common to have occasional slip-ups where you skip or forget to do an activity. No one’s perfect -- the key is to get back on track as soon as possible.
Your therapist should offer you follow-up sessions after your treatment ends. These are chances for you to discuss how things are going and to work on any challenges or problems you’ve had.