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Anxiety and depression can be debilitating. Both cause distress, impair your daily functioning, make it difficult for you to work towards your goals, and interfere with your sleep and appetite. Furthermore, both prevent you from doing the activities you used to enjoy. Depression can make people too tired, sad, and hopeless to initiate previously rewarding activities, while anxiety renders individuals too fearful. Unfortunately, with so much overlap between the two ailments, is it all too common for people to suffer from both simultaneously.
Luckily, there is an upside to this fact: Due to the similarities between depression and anxiety, it is also possible to treat them concurrently. Often, clients of mine express the belief that they need to become happier or calmer before they are once again able to delight in former pastimes or new passions. Happily, research indicates that it can be done the other way around. Studies show that people are primarily successful in alleviating anxiety and depression by merely engaging in rewarding activities – be they past hobbies or new pastimes. Psychologists call this straightforward technique behavioral activation. One study of individuals hospitalized with depression and anxiety disorders showed that participants who utilized this simple strategy reduced their depression scores by over 45 percent in just two weeks while the members of the control group saw only a 19 percent improvement (Hopko et al., 2003). Another study concluded that behavioral activation was as effective as antidepressant medication and more efficient than cognitive therapy in treating severe depression (Dimidjian, 2006).
Due to its simplicity and effectiveness, there are many different variations of the behavioral activation technique. One method to write down a list of enjoyable activities in order from easiest to most difficult to initiate and then to progress through the hierarchy in this order. For example:
- Play with the dog
- Make the bed
- Talk to a family member on the phone
- Take a shower
- Call a close friend
- Go for a walk
- Wave to a neighbor
- Cook a meal
- Read a book
- Exercise at the gym or yoga studio
- Go to lunch with a friend
- Meditate or pray
- Write in a journal
- Go to dinner with a group of people
- Participate in a Spanish conversation group
- Paint a picture
- Join a volunteer group
- Go hiking and camping
- Attend the office holiday party
- Go on a date
- Take a salsa dancing class
- Take a trip out of the country
This particular style of behavioral activation is my favorite because accomplishing the least intimidating tasks on the list provides a sense of self-efficacy that makes it a whole lot easier to attempt the more daunting activities. I also like it because it very closely resembles an extremely effective treatment technique for overcoming social anxiety – systematic desensitization via progressing through a hierarchy of social activities beginning with the easiest, like grabbing lunch with a close and trusted friend, and ending with the most anxiety-provoking, such as speaking in front of a large group of people.
Although part of the beauty of behavioral activation is its simplicity, it is still a journey that can be daunting and confusing at times. To optimize your experience with this technique – and your success – partner with a counselor. Before you know it, you might be smiling ear-to-ear as you rediscover a former hobby or delight in a new passion – all while bidding farewell to the dark cloud of depression and anxiety. If you are in Austin and find yourself in need of anxiety counseling or depression counseling, you can contact use to make a counseling appointment so we can help you to break free.
If you liked this blog post, also read “Minimize Anxiety & Depression By Living In The Now” or “A Holistic View On Health.”
For a more detailed look at behavioral activation, check out this manual:
Hopko, D.R.; Lejuez, C.W.; Lepage, J.P.; Hopko, S.D. & McNeil, D.W. (2004). “A Brief Behavioral Activation Treatment for Depression.” Behavior Modification 27 (4): 458–469.doi:10.1177/0145445503255489
Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., & Jacobson, N. S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of consulting and clinical psychology, 74(4), 658.
Hopko, D. R., Lejuez, C. W., Lepage, J. P., Hopko, S. D., & McNeil, D. W. (2003). A Brief Behavioral Activation Treatment for Depression A Randomized Pilot Trial within an Inpatient Psychiatric Hospital. Behavior modification, 27(4), 458-469.
Hopko, D. R., Lejuez, C. W., & Robertson, S. M. (2006). Behavioral activation for anxiety disorders. Behavior Analyst Today, 7(2), 212-233.