When you’re feeling down, you may feel too tired or listless to do things that might lift your mood. How can you break out of the inactivity trap that is at the heart of depression?
When you’re feeling good, you do things that make you feel good. You do enjoyable things with other people; you pursue your hobbies and interests; you keep active; you’re more likely to seek out opportunities and adventures and take on new challenges. It’s a virtuous circle, because these positive choices beget more positive feelings. Feelings of pleasure, of mastery, of confidence – in short, you feel better about yourself.
In contrast, depression is characterised by a vicious circle. Understandable but unhelpful behaviours – avoidance, withdrawal, inactivity – result in fewer chances to feel pleasure, achievement, connectedness. You start off feeling bad, you end up feeling even worse.
In this column, I often talk about correcting the unhelpful thinking patterns that characterise depression. Changing your thinking is great, but the quickest way of breaking out of this vicious cycle is by changing your behaviours. CBT emphasises the importance of behavioural activation – that is, by increasing your level of activity and doing things that will make you feel better about yourself.
An obvious stumbling block here is the question of motivation. When you’re down, you may feel lethargic, even exhausted. You may think, “I just can’t summon up the motivation to do anything”.
However, remember that you don’t have to feel motivated to get things done. When I wake up in the morning, zombie-like, I often don’t feel like getting up or going for a walk, but my mood and energy levels pick up when I do get up and about.
As CBT researcher Dr Robert Leahy often points out, it’s important not to wait for the motivation to show up. To quote Dr Leahy, motivation is not a bus that you get onto. You are the driver of your own motivation.
Try to remember this simple line: action first, motivation afterwards. Action leads to motivation. Aim to act against your low mood and choose a more active behaviour – even if you don’t feel like it at the time.
This is advice that applies to everyone – after all, everyone goes through difficult periods, everyone knows what it’s like to be feeling low.
If you suffer from clinical depression, however, it can be more difficult to summon up the energy. While it’s important to be as active as you can, don’t overdo it or beat yourself up if you can’t do as much as you would like. Lecturing a depressed person and unsympathetically doling out the Nike line (“just do it”) is unhelpful, to say the least.
SMALL STEPS
Effective behavioural activation is different to the “just do it” philosophy. What sets it apart, notes psychologist Dr Nick Wignall, is the concept of incrementalism. If you’re not getting as much done as you would like, including engaging in activities you ordinarily find rewarding, then aim to break things down into smaller steps.
For example, says Dr Wignall, say you can’t seem to meet a friend for dinner and drinks – it just seems too much for you. Well, how about meeting him for lunch? If that’s too hard, what about meeting up for a coffee? If that’s still too much, maybe invite your friend over to watch some sport on TV. Still too much? Send him a text after the game about something that happened in it.
Once you’ve found a small enough increment, do it until you notice a small uptick in energy and motivation. Then, go for the next most achievable thing on the list, and so on.
Dr Wignall refers to a colleague who used to say he never met someone so depressed that they couldn’t go to the bathroom. His point was that if you can find the energy to get to the bathroom, that’s a start; it's something you can build on.
It’s worth repeating that you don’t need to be motivated to start on this path. Inactivity maintains and worsens low mood, so remember: action first, motivation later. Start small, reward yourself for your efforts, and keep going.
(First published in Southern Star on 06/01/2022)