Behavioral Activation (BA) is an effective psychotherapy for the treatment of depression. Sometimes depression can become a vicious cycle where people stop doing things or being social because of their depressive symptoms, which in turn, worsens the depression because people become may become isolated and miss out on fun opportunities. BA is based on the idea that doing certain kinds of activities can break this cycle of depression. It helps to break down the sometimes overwhelming problem of depression into manageable chunks in order to build upward spirals of wellness instead of the downward spirals of depression. In BA treatment, psychotherapists function as a supportive “coach” to identify activities that have the potential to change how people feel and think. In fact, the right kinds of activities can even change the very biology of the body. But not just any activity will help to build (or rebuild) a life that is rich and rewarding, which is why it is sometimes helpful to have the support and guidance of a professional.
How does BA work? The basic idea in BA is that depression is caused and maintained by difficulties in responding to challenging life situations. As difficulties pile up, life becomes less rewarding. In response to a less rewarding life, it is natural to feel depressed or less interested. When people begin to feel more depressed it is very common to start pulling away from others and engaging in fewer and fewer activities. In BA, this is called the “downward spiral” of depression where low mood and increased withdrawal behavior combine to keep people stuck in depression.
BA helps people become active and engaged in their lives in ways that will help improve mood and address life problems. A number of basic core strategies are use in BA, including increasing activities that provide a sense of accomplishment or pleasure, decreasing avoidance of stressors, identifying and working towards important life goals even in the face of feeling depressed or worried, and solving problems.
What does BA look like in action? After learning how BA therapists think about depression, clients begin the process by monitoring daily events and activities as well as the effects that these activities have on mood. This information helps to identify do-able steps for participating in activities that are enjoyable, feeling more productive and solving specific life problems. Each therapy session concludes with specific actions people can practice between sessions. Often, BA therapists will focus first on the activities of pulling away that contribute to the downward spiral of depression. Getting active again can help people to feel less tired, stop dwelling on difficult parts of the past or worrisome parts of the future, and feel more motivation. BA is based on the idea that the more people do, the more people feel like doing. Over time, as people became more active and re-engaged in regular routines, the focus shifts to tackling some of the bigger problems in life that may be adding stress to life or getting in the way of feeling and noticing the good things in life.