Why is behavioral activation important?
Have you ever dealt with depression? Many people express that it is an extremely dark place to be. Some describe it as feeling cold where the only warm place you can find is in bed, so you stay in bed for long hours. Feeling physically weighed down, like you’ve been in a car accident so that you are exhausted by every movement you make. Other people describe it like your body is in grief and loss and working through the heartache of losing someone or something.
When you or a loved one finds themselves in this horrible place, it can be very difficult to come out of. Living the life you once had can feel next to impossible. The immensely difficult thing is the toll this takes on your perception of what is possible. You may start thinking that once you get the right job things will fall into place; or that once you feel better you will start doing more. Unfortunately, that could take years and “landing a job” isn’t just going to happen on its own. Also, the days that go by unemployed can cause you to sink into worse thoughts about yourself.
Luckily, this is not the end or a place you need to stay stuck in. While it’s best to move forward with the help of a therapist if you are severely experiencing depression (say to the point of self-harm, suicidal thoughts, or if you absolutely don’t have a support network) there is a lot of great improvements you can make with slowly and consciously adding more activity into your life. When I say activity I mean anything. Literally anything counts.
The goal is to get started
When there's so much doing to get done, how do I know what doing to do??
Remember that the point of adding more activity is just to get started. In the beginning that is it. That is the goal. Living our life demands so much of us but we are not going to get there until we take the first steps. It can even be going from eating one meal a day to adding an apple in the morning before that one meal. It can be to brush our teeth a couple times a week or simply gathering the hygiene products we’ll need.
Break things down to the smallest most doable steps either mentally or on a piece of paper. It can be adding a block to walking your dog (it may be easier to do things for our furry friends or others than it is to do things for ourselves).
The goal is to relearn things about us and life
Remember when I mentioned it may feel like you’ve been hit by a car? No doctor would expect you to recover from a broken hip in a couple of weeks! So why do we expect our loved ones or ourselves to “turn things around” in such a short period of time? Depression can damage the way we think about who we are, our neural pathways, and our capabilities. It takes time to heal. We cannot discover we have a wound one day and expect ourselves to heal by the next. So, another point to adding activity to our lives is - relearning.
Depression says “Don’t do that, what's the point, you don’t matter”. It is a challenge to just simply do anything when you have that voice under your skin. Your loved one suffering with depression is now tasked to relearn how to live on less “feel good” chemicals in their brain and with a crushing sense that they are not good enough or nothing matters. They are re-learning how to live.
Getting experimenting and engaging in the doing!
I started alluding to this negative voice many people with depression experience. This is not really another voice but a representation of their own feelings of worthlessness. It is the “voice” we have to challenge with behavioral activation. Here is the hard part: that voice is BOTH real AND it is made up. Depressed people really believe they cannot do something and find they often can but only with great (really great) effort.
So often it's that emotional effort that doesn't seem worth it to use up. But, it is going to take doing that thing to learn you can do it. For example, depression will pick apart any “good” suggestion by giving you mostly just the negative sides of doing anything. But really you don’t know that those hypothetical things are going to happen. Also the reality is that doing anything in life can have drawbacks. Starting with small steps gives you the opportunity to start improving your life. That opportunity is worth fighting for.
Remember behavior activation is just an experiment. You are just trying to see what activity you can add to your life and if it makes you feel better or gets you a fraction closer to your goals - Great! If it doesn't it just means that that activity isn’t the experiment to try right now and you can come back to it later only if you want to.
Recognizing that the voice that says you are not worth the effort is depression talking can be helpful for getting some distance from that emotional pain.
Mantras:
“I want to do something about this."
"It is ok to start one step at a time."
"I will be ok”