Guide
When our mood drops, we do less: we go out less, see fewer people, put things off. It is understandable, but it reduces the opportunities for pleasure and achievement, and leaves more room for rumination. Mood drops even further.
Behavioural activation
This approach, very well evaluated for depression, suggests gradually putting activities back into your life, following a plan rather than your mood. The key idea: motivation often comes after action, not before.
Behavioural activation suggests reversing the usual order: not waiting for your mood to lift before acting, but acting a little so that your mood has a chance to lift.
How to do it
- Observing the link between what you do and your mood.
- Choosing small activities that bring pleasure, achievement and connection.
- Planning them and doing them, even if you don’t feel like it.
- Spotting and reducing the idle moments that encourage rumination.
A little theory · Behavioural activation is simple, but well proven: a meta-analysis found it as effective as “full” CBT for depression (Ekers et al., 2014), and a large British trial showed equivalent results at a lower cost (Richards et al., 2016).
A little theory · A distinction is made between pleasure activities and achievement activities (a sense of having accomplished something). Both count: a day with only obligations, or only leisure, feeds mood less than a mix (Martell et al., 2010).
When to ask for help
If sadness, loss of interest or tiredness last more than two weeks, or there are thoughts of death, see a professional. In an emergency: 112, 3114 (France) or your local emergency number.
Worksheets to practise
- 71 · My activity and mood log · Seeing the link between what I do and how I feel
- 23 · Filling my week again · Planning activities that matter (behavioural activation)
- 05 · My compass · Choosing an action guided by your values, despite anxiety
- 67 · Stopping putting things off · Getting started with a 5-minute first step
- 22 · Talking to myself as I would to a friend · The self-compassion break for anxiety
Sources
Martell, C. R., Dimidjian, S. & Herman-Dunn, R. (2010). Behavioral Activation for Depression: A Clinician’s Guide. Guilford.
Beck, J. S. (2020). Cognitive Behavior Therapy: Basics and Beyond (3rd ed.). Guilford.
Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D. & Gilbody, S. (2014). Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis. PLoS ONE, 9(6), e100100.
Richards, D. A., Ekers, D., McMillan, D., Taylor, R. S., Byford, S., Warren, F. C. et al. (2016). Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): A randomised, controlled, non-inferiority trial. The Lancet, 388(10047), 871-880.
These worksheets do not replace therapy. If you are in distress or having suicidal thoughts, call your local emergency number (112 in Europe; 3114 in France, free, 24/7).
