Depression is a complex
mental health condition that can affect multiple
aspects of your life, including your thoughts,
feelings, behaviors, and physical wellbeing. When you're depressed, you tend to disengage
from your usual routines and withdraw from your environment. When you do this, you don't
get the psychological reward from pleasurable activities, and this creates a feedback loop that perpetuates more depression. A very effective intervention
that is often underutilized is behavioral activation. That's what I'm talking about today. I'm Dr. Tracey Marks, a psychiatrist, and I make mental health education videos. First, let me explain a little more about the cycle of depression and how it leads to the inactivity that makes your depression worse. A single depressive episode can be triggered by
many different factors: loss, trauma, prolonged stress, or a genetic predisposition
and no identifiable trigger. Once depression sets in, you can experience
persistent negative thoughts, like, "I'm worthless,"
"No one cares about me," and feelings of sadness, hopelessness, and a lack of pleasure in things that you previously enjoyed. Also, another thing that can
happen when you get depressed is even the smallest
things feel really hard and you have no motivation to exert the energy that you don't have to do these hard things. Then because of these negative
thoughts and feelings, you withdraw from social situations, avoid responsibilities, and
neglect hobbies and interests. This leads to less
involvement in activities that once brought joy or
a sense of accomplishment. As things progress, you become more and more
inactive mentally and physically. You may sleep more or stay in bed more even
if you're not asleep. You can feel sluggish all the time and even feel mentally foggy and slowed. Feeling like this makes you
continue to not do very much because you don't feel well, and then the loop just
keeps circling on itself and you feel more and
more lonely and hopeless. You may even blame yourself
for being inadequate. Research shows that participating in constructive activities,
even in minor amounts, can have a positive reinforcement effect. And we're not talking about exercise here, although exercise also improves depression because it increases brain
derived neurotropic factor, called BDNF. BDNF is a brain chemical
that promotes nerve growth. I talk more about the science of how exercise impacts your
mood and rewires your brain in another video that you
can watch after this one. The activities of behavioral activation can be anything that you normally do that you're now not doing much of. You're reengaging with these activities, even if you don't feel like it, and over time, repeated
exposure to these activities produces a sense of
accomplishment and productivity that is positively reinforcing and offsets the negative thoughts you have about yourself and the
world when you're depressed. Behavioral activation is a form of cognitive behavioral therapy and it is purely behavioral. You're looking into
modify what you're doing instead of what you're thinking, but what you do affects how
you think about yourself and your environment, so we're indirectly addressing
your negative thoughts by changing your behavior. How do you do it? The first thing you want to
do is monitor your activity. It's easy when you're depressed to slip into this low activity state and not be aware of just how
much you're no longer doing. You may know that you're not doing a lot, but you've lost perspective and can't appreciate the change as much. Keep track of your activities for a week. Break down each day into
morning, afternoon, and evening. For each segment of the day, write down what you did
and how you felt about it on a scale from 1 to 10 with 10 being awesome and 1 being awful. You don't have to write
down every single thing, like "I brushed my teeth
and used the bathroom." In fact, you can probably eliminate going to the bathroom from the list because that's not really an activity. That's a body function
that's going to happen whether you're lying in bed or not. The activities on this
tracker are intentional things that you do that you
don't have to do to live. To help you identify these things, you can answer the W questions. What were you doing? Who were you with? Where were you? You want to make sure
you write down things soon after you do them. It's much harder to
remember things hours later. I have a handy activity tracker
that you can use for this, or you can keep track on your phone. But you want to keep the
tracker or your phone nearby so you can immediately
write down what you did. You're only tracking for a week, and you want to record activities even if they seem trivial
like doing laundry. After you've monitored your
activities for the week, next thing you want to do
is review your activities and how you felt with
each of these activities. What were you doing
when you felt your best? What were you doing when
your mood was the lowest? Also, think about these questions. What activities made you feel
the most connected to people? What activities made you
feel the most accomplished? Can you see a relationship between your mood and activity level? In general, we get more
satisfaction out of life when we are doing things that
align with our core values, or doing things that are important to us. When we get depressed, we tend
to lose sight of our values and things that are meaningful, so step three would be to
reflect on your core values. There are different ways
to think about your values. You can find articles online about common values that people have. You can also use this values assessment that is part of this Life in
Action workbook that I created. Look at the chart and circle the values that
most resonate with you. The next step is to plan your activities. You're going to create
a list of activities from a few sources: your activity monitoring
sheet, your values assessment, and you'll need to include essential activities of daily living like preparing meals,
laundry, paying bills. I mentioned earlier you don't have to list every single thing like brushing your teeth. You could group all of your grooming as just a grooming activity because you don't want
the list to be too long you can't fit it in the space. Then you can also use the activity menu that's included in the workbook to help brainstorm some other activities. The last step is to schedule
and plan the activities. You can use the same activity tracker that you used from the activity monitoring in the first step. You are going to need to be
patient with this process. Getting active won't make
you feel better immediately. It takes time. But the more you do
it, the easier it gets. You become more motivated
and more energized and feel better about yourself. If you really struggle to do this, you can ask a friend or a family member to help you brainstorm
some activity ideas, help you realize your values, or hold you accountable for sticking to the
things that you scheduled. Connecting with people you
care about in and of itself is extremely valuable and can
be one of your activities. If you don't have much support, a therapist can also help you create a behavioral activation plan. To get started with this, you can download the activity tracker free from my new Mental Wellness Store. Or if you're on my email
list, it was sent to you, and you can get the Complete
Life Action Workbook from the Mental Wellness Space Store. It includes the activity
tracker, values assessment, activity menu, and activity planner. If you are part of my Mental
Wellness Space community, the workbook is included
in your membership. Watch this video for more on how exercise helps rewire your brain. Thanks for watching. See you next time.
