Behavioral Activation Explained: How It Can Help You Overcome Depression

In this video, Jürgen Hoyer explores behavioral activation, a therapy concept for treating depression. Behavioral activation is based on the idea that depressed individuals engage in too few rewarding activities, and increasing their activity level can boost their mood.

Identifying purposeful actions that align with your values

Nick: Perhaps we should take time to touch on behavioral activation, what that exactly means. So maybe Jürgen, would you like to touch on that? Because I think you have a strong history with that, a long history.

Jürgen: Yeah, I'm a psychotherapist and I'm concentrating in research and in treatment on anxiety disorders and affective disorders, most importantly, depression. The treatment concepts for depression, many of them are coming from behavior therapy; and one of them, the easiest principle, is called behavioral activation, and that's been developed in the United States by a group around Peter Lewinsohn and others, also a famous depression theorist, Aaron Beck, integrated behavioral activation in his concept, which had dominated depression treatment for decades.

But behavioral activation was not attractive. The basic idea behind behavioral activation is depressed people suffer from doing too little rewarding activities, so what would help them is increase their activation rate. Really, really simple thinking, but guess how depressed people find that? I mean, it's a little bit ironic even, because that's exactly what they can't do, engage in things.

And so behavioral activation got a reformulation in the 90s and beginning 2000 years, that rethinking of behavioral activation integrated value work. So what your values in your life that you are really committed to. And so there was a shift in the conceptualization of behavioral activation from just doing more pleasurable things toward finding committed action for yourself that serve your values.

Because you cannot do the whole day pleasurable things, and definitely not as long as you're depressed. But if you want to get back into life, it's very helpful to do simple tasks. After having done them, you will feel better than before, and that's really a life principle grounded on wisdom. I mean, do your thing as small it might be, it gives you better feelings than not doing it. That's the motivational motor within behavioral activation.

But how do you find the right action? That's quite different. And I don't think that this is different from ikigai, and I don't think that there are such strategic ways within ikigai like they are in behavioral activation, and that is called Activity Monitoring and Scheduling; it's a form of an inductive method.

So you're just monitoring your daily activities, and in your activity, in new protocol, you evaluate how your mood was during and after an activity. And doing this avoids what we call recall biased. Because if you ask a depressed person after a week if there had been any enjoyable activities, a depressed person, the mindset is so negative that the person will answer no.

But if you look at activities when they occur, you find out that not all activities are giving you bad mood, some give you euphoric or wonderful or happy mood, but make make you feel okay. And step by step, these kinds of activities over other activities, especially depressogenic, as we say, activities like withdrawal, like staying in bed, engaging in negative thinking, paying attention to your own feelings of insufficience and things like that.

So any activity, even on really small matters, are beneficial compared to just staying in a depressed mood and and remaining passive. So that's the idea behind behavioral activation. It's a well tested method, it's as beneficial as the best behavioral methods and treatments, but it's simpler, because that's the basic idea.

And yeah, we have empirical data enough to say that's helping people out of depression, not all of them, of course, but in many cases, even severe cases, that has been shown that behavioral activation really works in treatment. And to say the last sentence, what I'm thinking is ikigai can be a close neighbor of behavioral activation in the field of preventing to ever fall into the depressive hole.

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