Putting the Behavior in Cognitive Behavioral Therapy
Since the inception of cognitive behavioral therapy, psychologists have known that your behavior is vital in treating depression successfully. And, if you've ever been depressed, you know that a hallmark symptom of depression is having no motivation or desire to do anything--even things you previously enjoyed. You just can't imagine feeling any sense of satisfaction or enjoyment, and the problem is, you're partially correct! Anhedonia (lack of ability to experience pleasure) and amotivation (lack of motivation) are two of the most debilitating symptoms of depression because they keep you from doing the things that would make you feel better.
Behavioral Activation for Depression and Loss of Motivation
A critical component of cognitive behavioral therapy is the behavior portion. When you're depressed, you lose motivation because everything requires too much effort. It's as if nothing was ever fun - it all feels so foreign and distant. The idea that you might enjoy something again seems impossible because that's what depression does, it makes you feel hopeless about ever experiencing pleasure or joy again.
This is where behavioral activation comes into play! Why and how does behavioral activation work? First, the "Why?" Let me preface by saying there's nothing simple about depression; it's a complex and debilitating disease. But, research shows that doing the things you would do if you weren't depressed helps alleviate depression by creating positive reinforcement feedback loops. Conversely, a negative feedback loop occurs when you do nothing, or worse, do things that temporarily make you feel better but hurt in the long run. Also, "doing" forces you to focus "outward" rather than "inward" on your pain. For more, check out "Behavioral Activation for Depression" by Martell, et al.
Doing Things You Used To Enjoy Relieves Depression
Now for the "How:" Do stuff. Do what you used to enjoy. Do what your friends or family invite you to do. Complete a work project. Attend a meetup. Go for a walk. Volunteer. Shower and get dressed every day. Trust me, you are not going to feel better the first time you push yourself to do something, so don't expect it. But you must keep pushing yourself, because, eventually, you will feel better. It's difficult to motivate yourself when you're in the throes of depression. It's hard to even think of something to do. A good therapist can help you create a plan, but there's a lot you can do on your own.
If you need inspiration, subscribe to www.dailyshoring.com, which sends a prompt for one positive activity each day - nothing overwhelming, but something concrete that will help you create that positive feedback loop.
If you have activities or routines that help you when depression strikes, please share!
This blog was written by:
Deann Ware, Ph.D., is the author of www.dailyshoring.com, a blog for emotional well-being. She's a psychologist in private practice in Dallas, TX, and has over 15 years of experience helping people with depression, anxiety, OCD, panic, ADHD, and other emotional challenges
To be a guest author on the Your Mental Health Blog, go here.
Author, G. (2014, February 18). Putting the Behavior in Cognitive Behavioral Therapy, HealthyPlace. Retrieved on 2021, December 7 from https://www.healthyplace.com/blogs/yourmentalhealth/2014/02/putting-the-behavioral-in-cognitive-behavioral-therapy
Author: Guest Author
To Pogo,Say that you refer a depressed ptaient for CBT--she may have feelings of sadness which have resulted from a thought, "Nothing in my life is going right, therapy can't help, nothing can. I'm only going to get worse and worse." In CBT, the therapist might ask, "What is going through your mind right now?" In this way, the client learns to focus on these thoughts and the thoughts are typically responsible for the feelings of sadness. Each person has an internal communication system oriented to themselves, a kind of network that provides ongoing observations of themselves and others. CBT teaches people to modify these beliefs to change their behavior. For example, for the depressed woman, she would challenge the belief that "nothing can help" or that she is getting "worse and worse." In this way, she can teach herself to change or reduce the thought that she is hopeless, etc. and therefore reduce her depression.
i have lost my will to live i am 30 years old and am just so broke down i don't know where to turn i am going crazy and don't know where to turn i'm crying as i write this and even now i just want to end it, it all started when my son was taken from me and my fiancee since then i have been down and hurt so bad that i don't care about my life anymore i can't go on much more i loved life so much at one time but now i have no one.
My name is Natasha and I write another blog on this site.
I understand wanting to kill yourself. You don't know me, but if you read my work you'll see, I've battled depression and suicidality for years.
So what I can tell you is this: it gets better. It always does. Life is not stagnant - not anyone's. Things will change and there will be a day when it won't hurt as much.
In saying that, you may need help to find that better day. You can start by calling a helpline. The people there can guide you to resources you can use. You do not have to be in pain alone.
- Natasha Tracy
Thanks, Anne, for pointing out to me that the heading says, “Doing Things You Enjoy”—it should read, “Do What You Used to Enjoy!” I think that must have been an editing error—the “used to enjoy” qualifier is key! Depression is debilitating exactly because of the lack of enjoyment, motivation, and energy, coupled with loss of hope. If you’re at a point where you can activate yourself to do some of the things you used to enjoy, it will eventually help. Behavioral activation can also inoculate against depression to some degree. But as Judy points out, behavioral activation is extremely difficult at the lowest point of depression. Daily support and a good therapist can help you move through the worst of it.
Do what you enjoy??? With my depression I do not enjoy anything. "Complete a work project. Attend a meetup. Go for a walk. Volunteer. Shower and get dressed every day. ". That's the problem. I'm not sure you understand. Most of those things are very difficult if not impossible. You mean get over it?
I agree with Margaret. CBT is difficult to utilize at the lowest point of depression, or even hypomania/mania. When there is a certain amount of stabilization, then it is more of a realistic possibiliy.
I don't think this psychologist understands depression. Perhaps situational depression could be alleviated by 'just getting going'. Clinical depression is a whole other thing - if it were possible to do something it would not be depression. I liken this to telling a quadrapalegic to just take a step.
Thanks, Kelly! Hope it was helpful!
This is great. Thank you for the article.