Chronic PainDepressionMindmind & social well-being

Behavioural Activation for Depression | Behavioural Activation in 7 Simple Steps

By June 29, 2018 May 9th, 2019 No Comments

Behavioural Activation for depression

It is sad but true – chronic pain & depression often go hand in hand.

Depression is a natural response to constant pain, unpredictable symptoms & fatigue.

Even for the most resilient person – chronic pain can affect your mental health.

Pain & depression can have a dramatic impact on your life, routines & behaviour.

People with chronic pain & depression often neglect themselves & their responsibilities. Many people become less active & leave decision making to others.

Maybe you have neglected to pay the bills? Or the dishes are stacking up by the sink?

Although self neglect is understandable when pain & depression steal your energy & motivation…

Being less active can make depression & pain worse

If you have stopped doing the things you love – your depression may get worse.

Similarly, if you put off necessary tasks – they can quickly mount up & become overwhelming.

The result could leave you feeling guilty, ineffective or even a failure.

You may fall into a vicious cycle of pain & depression.

The more depressed you feel – the more pain you feel.

If you worry about your pain & distress, you might like to check out this article on 7 Surprising Signs of Depression.

Behavioural Activation for DepressionBehavioural Activation for depressionWhat is behavioural activation for depression?

Behavioural activation is a very simple & effective method for treating depression.

It simply involves increasing your activity levels, especially those things you enjoy doing.

Behavioural activation for depression also includes tackling that ever-growing ‘to do list’.

Now I can imagine you saying…

“But it is not that easy when you are in constant pain, have zero energy & even less motivation”

You’re right – its not easy but it is possible!

The trick is to build up your activity levels in a realistic & achievable way. This way you set yourself up to succeed.

Does behavioural activation for depression work?

Behavioural activation is not rocket science but its simplicity is its strength.

Simple strategies are easier to learn & quicker to start. As a result, they are more likely to be completed than complex treatments.

A recent study from the UK found that behavioural activation was as effective at treating depression than more complex psychological treatments & even medication.

Please bear in mind there is no ‘silver bullet’ for mental health & chronic pain.

Behavioural activation has helped many people with depression but it might not work for everyone.

If you (or a loved one) worry about your mental health please reach out!

Speak to friends, family & your doctor.

You are not alone!

You can always join our free, welcoming & supportive Facebook community here.

Advantages of behavioural activation for depression

Depression is not just feeling sad. Depression can come with a range of other feelings like hopelessness, guilt & despair.

Behavioural activation can help with depression & a range of other emotions too.

8 advantages to behavioural activation

  1. Distraction – At the very least, when you start an activity, it will give you something else to think about. Shifting your focus away from pain & painful emotions will help to relieve depression.
  2. A sense of achievement – Even brushing your teeth can give you a sense of achievement when you haven’t manage it for a while. Focus on what you CAN do not what you can’t.
  3. Pleasure from the activity – You may even enjoy your activity. If you haven’t seen friends for a while, you may be surprised to find pleasure in the activity.
  4. Increased energy – Usually when you are tired you need rest – however when you are depressed the opposite is true. Sleeping more & sitting around doing nothing can actually zap your energy & make you feel more lethargic & tired. Doing nothing also leaves you time to dwell on painful thoughts & feelings.
  5. Relieves pain – Serotonin is the body’s natural painkiller & happy hormone. Serotonin is 60% more effective than opioid medication. How do we make more serotonin? Physical activity can help. Any amount of physical activity (no matter how small) will help your body to produce serotonin.
  6. Clear the brain fog – Once you get started your mental focus will shift to the activity you are doing. This can help to clear your mind from churning painful thoughts & feelings over & over.
  7. Sense of purpose – Tick something off your ‘to do list’. This will help to give you a sense of purpose. No matter how small – celebrate all of your achievements.
  8. Regain a sense of control – Living with pain or depression can leave you feeling out of control. By planning & completing small achievable activities – you will start to feel more on top of things.

Behavioural Activation for depressionHow to ‘do’ behavioural activation for depression

1) Start with the ‘doing’ not the motivation

The biggest thing to remember is the first step in behavioural activation is DOING, not motivation.

The evidence tells us that by starting the activity you should soon start feeling better.

2) Start small

When you start behavioural activation for depression – start small.

Nobody could start their running career with a marathon. They must train for months starting with short walks or jogs & building up to the marathon.

People who start with a jam-packed schedule often feel overwhelmed.

A natural symptom of depression is the domination of negative thoughts.

“It’s too hard”            “I won’t enjoy it”                    “I will probably fail anyway”

Feeling overwhelmed along with these negative thoughts might mean you never get started.

Not starting can lead to more feelings of sadness, guilt or hopelessness – so the vicious cycle continues.

It is vital to start by taking baby steps.

When depressed & in pain, it is not reasonable to expect to clean the entire house before meeting a friend for lunch.

Start by segmenting tasks. For example, rather than cleaning the whole house – plan to make the bed or clean the dishes.

If the thought of meeting a friend for lunch in the city is too daunting – make plans for a coffee in your local area.

3) Be kind to yourself

Whatever your current level of activity is – plan things that you can achieve.

Be kind to yourself, don’t set yourself up to fail. Focus on what you CAN do – not what you can’t do.

4) Pace yourself

When you’re in pain it is natural to have a fear of injury or more damage.

A very effective way to increase your activity levels confidently & safely is through activity pacing.

Activity pacing involves taking a very scientific approach to increasing your activity levels.

If you would like more information you might like our hand out ‘3 Common Mistakes People with Chronic Pain Make when Exercising’.

The same pacing strategy is effective in behavioural activation.  You want to get active without creating stress for yourself.

Another useful strategy to try is setting time periods.

It might be easier to aim to read a book for 5 minutes than a whole chapter.

Or to weed the garden for 20 mins rather than aim for the whole backyard.

Again it’s important to set your timed activities at a level that is appropriate for you right now.

The activity itself can be anything that might be fun or give you a sense of achievement.

5) Find a balance in your activities

The activity itself is not as important as how it makes you feel afterwards.

Everyone has both responsibilities & activities they enjoy.

Getting on top of tasks you have neglected, may not be fun but they offer an emotional reward.

It is important to balance fun activities with responsibilities.

10 Suggested Activities for Behavioural Activation for Depression

  1. Walking
  2. Listening to music
  3. Gardening
  4. Art, drawing, doodling
  5. Paying bills
  6. Meeting friends
  7. Reading to your children (grandchildren)
  8. Watching sport
  9. Writing in a journal
  10. Going to the hairdresser

This list of 10 is only a suggestion. Identify things that are special to you & might be fun or create a sense of achievement.

The trick is to make your goals achievable & just start ☺

6) Get Scientific

The prescription is simple – try to do something fun or satisfying.

However, if you’re feeling depressed right now – you might not get the same level of enjoyment as usual.

Try not to compare – you need to be objective

On a scale of 1-10, measure how you feel before & after the activity.

Keep going & you will hopefully see your overall mood lift.

You can get a handy worksheet for planning & recording behavioural activity here.

7) Reward your progress

By being scientific you will be able to track your progress.

Recognise your accomplishments & reward yourself for your progress.

The rewards may help to increase your motivation & keep you moving forward.

One step at a time you can use behavioural activation to bring more meaning & fulfilment to your life.


Behavioural activation is a really simple & effective way to treat depression.

By starting with the DOING, not the motivation, you may be surprised to find an overall lift in your mood.

Remember it is important to start small & set achievable goals.

Be kind to yourself & focus on what you can do – not what you can’t.

Pace yourself to avoid overwhelm, further injury & unnecessary stress.

By being objective & tracking your results you might be pleased to find an overall lift in your mood.

What activities would you like to try for behavioural activation for depression?

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