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Behavioral Activation Can Help with Depression

     

Depression is one of the most common mental health conditions and a major cause of disability. Medication and cognitive behavioral therapy (CBT) are the most common and effective treatments, yet many people with depression do not get treatment. Behavioral activation is a brief therapy that can be used by itself or along with cognitive behavioral therapy to address depression.

friends-cooking.jpgBehavioral activation helps to break the negative cycle of depression. A stressful life event or a trigger from the past can lead to negative emotions and distress that make one want to withdraw, leading to avoiding people and activities and general isolation. The avoidance and isolation cause a negative cycle of more negative events and depressed feelings.

The basic concept behind behavioral activation is that for people with depression, becoming active doing things that are personally meaningful 

and enjoyable can help improve the depression. Engaging in activities can help in the short term. For example, exercising can boost your mood. In addition, participating in activities can lead to positive experiences, which then reinforce and motivate further participation. 

Among the steps in behavioral activation therapy are monitoring daily activities, identifying goals and values, purposefully scheduling meaningful and enjoyable activities and working to address obstacles to getting active.

Tracking one’s daily activities and feelings helps to identify what contributes to feeling better and what contributes to feeling worse. In behavioral activation, the focus is not just on any activity or even pleasurable activity, it is on valued and meaningful activities. So, part of the process involves identifying what is most meaningful to the individual and activities, such as work or sports, that involve developing skills and offer a sense of accomplishment. The next step

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 is identifying and pursuing specific activities related to those areas. A University of Michigan Health System guide on behavioral activation describes it this way:

“In behavioral activation we ask people to work from the outside-in, acting according to a plan rather than waiting to feel ready. We can jump-start our mood by starting with an action and letting our mood follow. This is hard at first, but over time, most people recognize that their actions can actually have an impact on their mood, so they feel less at the mercy of their depression.”

There is substantial research supporting the effectiveness of behavioral activation. One recent study looked at a group of people with depressive symptoms treated with behavioral activation compared to a group receiving standard treatment. Following up over two years they found that the depressive symptoms were alleviated in the intervention group and they showed greater improvement in functional ability than the control group. The authors note that behavioral activation offers the advantage of being relatively brief and not requiring extensive training for providers.

Another study looked at the effectiveness of a short, five-week behavioral activation intervention among late adolescents with depressive symptoms. At the one-year follow-up, the participants who had been through the program had significantly lower depression scores than the control group.

Behavioral activation offers one more approach to consider, either alone or in conjunction with other treatment, for those facing depression.

References

  • Luoto, KE, et al. Behavioral activation versus treatment as usual in naturalistic sample of psychiatric patients with depressive symptoms: a benchmark-controlled trial. BMC Psychiatry. 2018, 18:238.
  • Takagaki, , et al. Enduring effects of 5-week behavioral activation program for subthreshold depression among late adolescents: an exploratory randomized controlled trial. Neuropsyhcaitr Dis Treat. 2018, 9;(14):2633-2641.

     

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