Theraverse . January 3, 2025

During exams in school, I vividly remember my friends and peers hoping and praying that the teachers our papers would go to, are in a good mood while evaluating. It was quite funny at the time because regardless of how poorly we wrote, we would still heavily rely on the teacher’s mood, to hope for better marks.

If we look past the silliness, there is a logical explanation to this when we think about the relationship between mood and behaviour. Positive moods increase dopamine activity in the brain’s reward pathways, enhancing motivation to pursue rewarding or goal-directed behaviors. Negative moods often reduce dopamine levels, leading to withdrawal, passivity, or avoidance.

We have all had our moments in which the way we feel has had a direct impact on what we do. For instance, looping a sad playlist the minute we start feeling low, adding cinematic value to crying in the shower! Sometimes the vice versa also happens where the way we act, shifts our emotional state. Like unwillingly showing up at the gym on a Monday but feeling a sense of accomplishment after the workout. And Behavioural Activation capitalises on this very concept. It sprouts from the essence of doing something even when we don’t want to or finding it difficult to do, because it can influence how we feel in the long-run.

What is it?

Behavioral activation (BA) is an evidence-based, time-limited, and structured psychotherapy that engages individuals in rewarding activities of their own choosing as a way to counter the negative feelings and withdrawal that are typical of depression. A core symptom of depression is the loss of interest in previously pleasurable activities pushing people into a demotivated, inactive state of being. This also inevitably contributes to the low mood and increase in avoidance and withdrawal.

How it works?

BA encourages individuals to re-engage with activities that are pleasurable, meaningful, or aligned with their values. This increases opportunities for positive reinforcement, creating a feedback loop where, engaging in rewarding activities uplifts mood, produces dopamine (pleasure and reward) and motivates further action. It also breaks the cycle of avoidance by replacing it with active engagement, exposing individuals to situations that can generate positive outcomes.

While changing the way we think, and views about self are important in terms of cognition, the treatment is more effective when we instigate change on a behavioural level as well. So cognitive-behavioural therapy (CBT) is one of the most effective treatments for depression. And BA has proved effective enough to also function as a standalone treatment at times.

Here are a few strategies from BA that can be employed for someone going through depression.

Activity monitoring

• Identify how current activities (or inactivity) affect mood.
• Track daily activities and rate mood during or after them between 0-10. Eg. Sleeping (4)
• Recognize patterns of withdrawal, inactivity, or avoidance.

Identifying values and goals

• Figure out what you value the most and rank these values from most to least
• List out all the goals that have been overwhelming you lately in order of priority

Customise plan

• Based on the assessment of the activities that have scored high in mood and the values that you prioritise the most, customise a plan that incorporates these, to create more pleasurable and meaningful activities.
• If talking to a friend as an activity scored 8 and the highest ranked value is maintaining relationships, you can customise an activity such as ‘chai with family’ every evening at 6PM.
• Break down goals into smaller, realistic and achievable parts. And schedule how and when we can celebrate small wins like reaching half way. Make the effort to acknowledge when you have completed something, without rushing on to the next target.

Anticipate obstacles

• When depressed, naturally the motivation to follow through on the plan would not be present, so to avoid falling into a spiral of inactivity, we need to anticipate potential contingencies and brainstorm
• If we have scheduled morning walks at 8AM, one of the obstacles could be rainy weather. And in that case the alternative plan could using the treadmill at the gym or any indoor workout options.

Sustainable over satisfying

• Despite laying a strong foundation for the behavioural activation, it takes a lot of commitment to stick to and follow through on the plan.
• It may feel more satisfying to just lay in bed but it is far more sustainable in the long run to get up and carry out the tasks. So, it is important to constantly have a check in with yourself, taking the time to remember why you are doing this in the first place.

Why this might help?

1. The reason there is so much emphasis on values is because the plan/activity/schedule needs to be something that you want for yourself, instead of something that has been imposed on you. This will allow you to feel the positive feedback from engaging in these behaviours. And by making the plan about you, it throws out the ‘one size fits all’ treatment options and helps identify what could work best for you.
2. The level of difficulty for activities and goals can be beyond the depression level but it still has to be realistic. So, we can remove the overwhelm from the tasks and not set unachievably high standards for the self which sometimes is the reason people feel paralysed.
3. Waiting for a cognitive shift in motivation can make you feel powerless and also perpetuate a cycle of passivity. By carrying out the behaviours even when we don’t want to and doing it consistently, allows for a more active role in creating the change.

A quick reminder that this is not a substitute to getting care by a mental health professional, just an aid that might make the journey towards healing, a little shorter!

By,

Jensita Grace

In-house Psychologist, Talk therapy clinic

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Resources:

https://www.medicalnewstoday.com/articles/behavioral-activation#limitations

https://www.therapistaid.com/therapy-guide/behavioral-activation-guide

https://www.psychologytools.com/self-help/behavioral-activation

https://www.healthline.com/health/behavioral-activation-therapy

https://www.sciencedirect.com/topics/psychology/behavioral-activation