Treating depression: BEHAVIORAL ACTIVATION
This approach is effective with adolescents and adults who are depressed, especially those with a vegetative depression (e.g., oversleeping, lethargic, self-isolating, low activity level).
The basic concept behind this strategy is that “depressed” behaviors are reinforced (by sympathy and avoidance) and create “depressed” body chemistry, both of which lead to more depressed behavior, continuing to spiral down into increasingly depressed states. “Nondepressed” behavior brings you in contact with more positive consequences and changes body chemistry to a more elevated mood, which makes it easier to engage in more “nondepressed” behavior, and so on in an upwards spiral. The strategy is to behave in ways that people who are not depressed do (AKA “nondepressed” behavior).
Because when you are depressed, it is hard to get motivated to do “nondepressed behavior,” it is important have motivation strategies. Two of the most effective strategies are
1)self-monitoring, which is recording on a checklist which “nondepressed” behaviors you do each day and set daily goals to continue increasing the number of them that you do.
2)have a “coach” to hold you accountable for making progress. Let that person know your daily goals and ask them to check with you on a regular basis to see how you are progressing. Choose someone who is dependable and positive.
Regulate Sleep: Sleep the correct amount for your age at night and do not nap during the day. Inadequate sleep results in irritability, memory problems, lack of focus, and lethargy. REM sleep, which refreshes the brain, is primarily in the last 2-3 hours of sleep, so if sleep is cut short, the body gets refreshed (deep body sleep is primarily in the first 3-4 hours of sleep), but the brain does not. Napping interferes with sleep at night and can make you groggy and without energy afterward.
Regulate Eating: Eat 3 meals per day, even if you don’t feel like it. Failure to eat lowers blood sugar, which leads to increased depression. Do not snack in between meals, because overeating leads to feeling bloated and weight gain, which can worsen an already negative self-image. Don’t have alcohol or caffeine in the evening, as these interfere with sleep.
Routines: Keep a regular schedule, including waking up on time, bathing, brushing teeth, getting dressed, eating meals, doing chores, and going to bed on time.
Socialize: Have conversations with people every day. Make sure that most of the conversations are about positive things. If you can’t think of anything to talk about except your problems, make a list of topics to talk about and/or research new topics on the internet, newspapers, or magazines.
Control negativity: It is difficult to stop negative perseveration, so when you find yourself dwelling on your problems, start a conversation about something else. It’s hard to continue thinking negative thoughts while talking about more positive topics. It is a myth that “venting” to friends about problems is helpful. In fact, too much negativity can drive even the most caring friends away, leaving you feeling abandoned.
Activity Level: Stay busy. Do things that you used to like or try new things that you have never done before but think you might like.
Be Productive: Completing projects gives a sense of accomplishment, even if the project was not particularly fun (e.g., chores). Do chores, learn new skills, inform yourself about current events by reading the newspaper, do volunteer work, go to work, etc.
Exercise: Many research studies have proven the positive effects of exercise on energy, mood, sleep and overall brain function. It is hard to get motivated to exercise when you are depressed, so start small but do it regularly. As the exercise starts to improve your energy and mood, you will be able to increase the amount of exercise.