5 Steps for CBT Behavioural Activation for Depression
Updated: Oct 1, 2024As winter sets in, many people start feeling low. This can be seasonal depression or a general depressive episode. Sometimes it’s the result of changes in our behaviour as the weather gets colder. For example, if you usually spend a lot of time outdoors but now find yourself stuck inside, it can take a toll on your mood.
What is Depression?
Depression is more than just feeling sad. It’s a heavy, lingering sense of sadness or emptiness. It impacts how you think, feel, and function day to day. It’s common, and you're not alone in this struggle.
Depression is a significant mental health concern in Canada and North America. It impacts millions of people. According to recent statistics, approximately 1 in 5 Canadians will experience a mental health issue. Depression is one of the most common conditions, impacting around 10% of the population at any given time.
Certain populations may be more prone to depression due to various factors. For example:
Women. Research shows that women are more likely to experience depression than men. Usually, this is due to hormonal changes, societal pressures, and higher rates of trauma exposure.
Teens and Young Adults. Adolescents and young adults are particularly vulnerable to depression. Often because they tend to have more stressors. For example, they have to deal with academic pressure, social media influence, and identity struggles.
Indigenous Peoples. Indigenous communities in Canada and the U.S. face higher rates of depression. This is because of historical trauma, cultural disconnection, and socioeconomic challenges.
LGBTQ+ Individuals. Members of the LGBTQ+ community may experience elevated rates of depression. This stems from discrimination, stigma, and lack of acceptance.
Individuals with Chronic Illnesses. Those living with chronic physical health conditions may also be more prone to depression. The impact of ongoing illness can affect a person's mental well-being.
Low-Income Populations. Economic hardship and lack of access to mental health resources can increase the risk of depression.
Signs and Symptoms of Depression
Depression can present differently from person to person. Some common signs and symptoms include:
Feeling tired all the time
Losing interest in things you usually enjoy
Withdrawing from friends and family
Feeling worthless or guilty
Changes in sleep and appetite
Thoughts of suicide or self-harm (or that you would be better off dead)
If these symptoms persist, it could be worth talking to a therapist. If you are an Ontario resident, book a free consultation with our clinic. We have a variety of expert therapists to choose from. Learn more about our social workers, clinical psychologists, and registered psychotherapists. Learn about our fees.
What Can Cause Depression?
Many factors can contribute to feeling low or depressed. Often, it’s a combination of different things. These can include:
Biological: Your genetics, brain chemistry, or even a lack of sunlight and vitamin D in the winter can contribute.
Physiological: Not moving enough—when we're less active, it can affect our mood.
Societal: The pressure to stay busy all year, especially when the cold makes it harder to keep up.
Emotional: Stress from finances, holidays, or feeling isolated.
Treatment Options for Depression
Treatment can vary, but common options include therapy (like CBT), medication, and lifestyle changes. Each person’s path to feeling better looks different, and it's okay to take small steps.
Here are some of the most common approaches:
1. Cognitive Behavioural Therapy (CBT)
CBT is a widely recognized and effective form of therapy for depression. It focuses on helping people identify and challenge negative thought patterns. CBT also helps to change behaviours through behavioural activation. Through guided sessions with a trained therapist, clients learn to:
Recognize Unhelpful Thinking. Understand how negative thoughts can distort reality and influence mood.
Develop Coping Strategies. Learn practical skills to manage stress and emotional challenges. CBT will teach problem-solving techniques and relaxation exercises.
Set Realistic Goals. Break tasks into manageable steps, promoting a sense of achievement and motivation.
CBT involves regular sessions over a set period. Most people will respond to CBT after 8-20 weekly therapy sessions. The improvements are often long-lasting.
2. Medication for Depression
Medication can be an essential component of depression treatment for some individuals. Antidepressants work by balancing chemicals in the brain that affect mood and emotions. Here’s what to consider when considering medication:
Types of Antidepressants. There are several classes of antidepressants, including SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin-norepinephrine reuptake inhibitors), and atypical antidepressants. Each works differently, so finding the right one may need some trial and error.
Consultation with a Healthcare Provider. It's important to discuss options with a healthcare professional who can provide personalized recommendations. You may want to meet with your family doctor or ask for a referral to see a psychiatrist.
Monitoring and Adjustment. Regular follow-ups are important to assess the effectiveness of the medication. Making adjustments as needed to ensure the best outcomes with minimal side effects.
3. Lifestyle Changes
Incorporating lifestyle changes can significantly impact mood and overall well-being. While these changes are not substitutes for professional treatment, they can enhance the effectiveness of therapy and medication. Key lifestyle changes to consider include:
Regular Exercise. Engaging in physical activity releases endorphins, which can improve mood. Aim for at least 30 minutes of moderate exercise most days of the week.
Healthy Diet. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins supports brain health. Certain nutrients, such as omega-3 fatty acids and vitamin D, are particularly beneficial for mood regulation.
Adequate Sleep. Establishing a consistent sleep routine can help improve energy levels and mood stability. Aim for 7-9 hours of quality sleep each night.
Social Connections. Maintaining relationships and social interactions can provide emotional support. It can also help reduce feelings of isolation. Consider joining support groups or engaging in community activities.
Mindfulness and Stress Management. Practices like meditation, yoga, and deep-breathing exercises can reduce stress. It can also promote relaxation, helping to manage symptoms of depression.
What is Behavioural Activation?
Behavioural activation is a key part of treating low mood. It’s something I find very helpful. It’s about finding balance in your day and adding activities that bring meaning and joy, even when you're not feeling up for it.
When we feel down, our days can fall out of balance. We tend to overdo it on downtime (too much TV, scrolling on our phones), or neglect things that lift us (self-care, creativity). The idea behind behavioural activation is to bring in more balance, so you're getting a bit of everything—work, play, rest, and connection.
One way to get started is by tracking your activities and mood. For example, you might jot down that from 4:00-5:00 PM you watched TV and felt sad (40% sad). You might notice that the longer you watch, the worse you feel. From there, you can tweak your day to include more productive or enjoyable tasks, even for just a little bit of time.
The important thing to remember is that motivation follows action. It’s not always easy to start, but doing a small activity, even for a few minutes, can help shift your mood. This is where having a therapist for support can be a game-changer.
The Connection Between Behaviour and Mood
Our behaviour and mood feed off each other. Think about:
How do you feel when you learn something new?
What about when you accomplish a task you’ve been putting off?
How do you feel after a shower or doing something creative?
What about spending time with loved ones?
These activities can directly influence how we feel, and noticing those patterns is part of behavioural activation.
5 Steps to Try CBT Behavioural Activation
It's best to do this with a therapist, but you can get started on your own.
Track Your Day's Activities. Use an activity monitoring worksheet to write down what you do each hour and rate your mood (e.g., sad, 40%).
Review the Data. What activities are tied to higher moods? What about lower moods? Look for patterns.
Identify Feel-Good Activities. Make a list of things that lifted your mood and those that didn’t.
Reflect on Your Values. What’s important to you? Maybe you want to spend more time with family, pick up a new hobby, or get back into exercise.
Create a Balanced Schedule. Use your values and feel-good activities to build a schedule that feels manageable. It’s not about doing everything perfectly, just making sure there's a mix of productivity, self-care, and fun.
It’s okay if you don’t feel motivated at first. These things take time, and that’s normal. Even small steps—like 15 minutes of a new activity—are worth celebrating.
