17 MarHow Behavioral Activation Can Help You Overcome Negative Emotions by Dr. Brian Amorello, PhD Negative emotions are a part of the human experience. Whether it’s feeling sad, angry, or anxious, everyone has experienced negative emotions at some point in their lives. While these emotions are a natural part of being human, they can also become overwhelming and interfere with our daily lives. Behavioral activation is a therapeutic approach that has been shown to help individuals overcome negative emotions. This approach focuses on helping individuals identify and engage in activities that bring them joy and a sense of accomplishment.Understanding Behavioral Activation- Behavioral Activation (BA) is the notion that as we stimulate ourselves with activities that we find pleasurable, our mood increases. In other words, when we do things that we love, we tend to be happier individuals, and negative emotions such as depression, anxiety, and anger begin to decrease. When people are depressed, they often isolate, avoid, and restrict themselves from engaging in activities that they enjoy. This results in the person staying home, many times alone with nothing to do, which ends up reinforcing those negative emotions mentioned earlier. It also results in the person having poor sleeping and eating habits, two areas that are essential to our psychological well-being. If we are eating and sleeping too much or too little, we cannot possibly expect our mental health to be optimal. BA is a critical component to a person successfully combating their depression or anxiety, and it allows a person to distract themselves from whatever is causing the negative emotion. How Behavioral Activation works? BA works in a number of ways. Put in its simplest form, BA gives us the opportunity to do stuff that we love, while also decreasing depression and anxiety. When we “behaviorally activate,” neurons in our brains fire that support happiness, joy, and other positive emotions. For example, going to a friend’s party should biologically make us happy. This is because we chose to put ourselves in a happy environment (the party), which then impacts positively how we psychologically feel. When we isolate and avoid activities like parties, we have less to distract ourselves from what causes emotions like depression and anxiety. For example, laying in bed with no stimulation allows us to think about what is depressing us, and therefore the emotion of depression increases. What is the Relationship between Behavior and Mood? There is a strong and significant link between behavior and our mood. In other words, how we feel (mood) impacts how we behave, and vice versa. One of the common misconceptions however is that feelings more so impact how we behave, meaning people often think that once they “feel better” they will then more so behaviorally activate. This is not usually the case, and is more of the opposite. For example, my patients will often say to me, “When I feel happier, I will return to the gym.” Unfortunately, this is not how it works. Patients would benefit more from BA if they say, “I know if I go to the gym, I will feel happier.”. Doing activities we love, as difficult as that is when we are severely depressed or anxious, will have a positive impact on our mood, and decrease depression and anxiety. How to Implement Behavioral Activation in Your Life Implementing BA into one’s life is no easy task, and again very difficult when suffering from negative emotions like depression and anxiety. BA needs to be structured, and goal-orientated, meaning you should begin by setting weekly goals for yourself (i.e., I want to go to the gym 2 times this week). These goals also need to be reasonable and within real expectations. It’s highly unlikely that a severely depressed person will begin reaching their goals if they choose to go to the gym 6 times per week. It is more reasonable to start off with the expectation of possibly going once or twice, and gradually increasing as time goes on. Moreover, choose creative ways to hold yourself accountable. For example, plan to go to the gym with a friend. You can hold yourself more accountable because this friend will likely hold you to it! Also, putting your goals on a dry erase board in your home or in the calendar app on your phone helps remind you of what you need to do. After all, we’ve been doing this with children forever with chore charts in their room that remind them of what their parents expect of them! Next, they need to notice the moments when their depression is impacting them in ways that cause them to not want to reach those goals, and ask themselves in that moment what they need to make that achievement. “What will help me get to the gym right now?” Tips for making Behavioral Activation a part of your daily routine One of the things I often discuss with patients is setting daily goals. This can be done in advance (set your goals for the week each Sunday night) or day to day (when you wake up, ask yourself “what do I hope to accomplish today?”). BA will then become routine when you do this on an increasing basis, and therefore new healthy habits are formed! Incorporating Behavioral Activation into your therapy or self-help regimen Setting BA goals with your therapist plays an essential role for success. My patients have “homework” (i.e. going to the gym twice before our next session) each and every week that they need to implement into their lives, and they know that my first question for the next session will be whether or not they complete it. This alone often holds patients accountable, because they want to avoid feelings like embarrassment if they have to tell me they did not complete their homework assignments. Effectiveness of Behavioral Activation in various settings and populations- We know that BA helps all populations (i.e. children, adolescents, and adults across racial and ethnic backgrounds), and there is no research or evidence to support that BA can be harmful to anyone. BA is a phenomenon that really can help anyone at anytime, especially people who suffer from mood disorders such as major depression or generalized anxiety. Engaging in positive behaviors that we love allows us to think better of ourselves, which then increases our mood and allows us to promote our own mental health and well-being. There’s very little to support the fact that BA can hurt a person in any way. Recognizing how (even if sometimes your depression tells you not to) being in the gym or out with friends socializing can benefit your mood is critical to the work I do with my patients. People often cannot make sense of how staying at home with avoidance and isolation can positively impact their mood, so it’s frequently an easy concept to follow. Having a therapist that could help guide your BA and tailor it to your own needs is key to mental health and well-being! Frequently Asked Questions People Also Ask What is behavioral activation and why is it used in the treatment of depression? I think I covered the first part, however it is often used in the treatment of depression because there is evidence to support that it works to decrease those feelings of sadness. If followed correctly, the person puts themselves in a much better place to achieve optimal mental health. Can behavioural activation be used for anxiety? Yes! It is used in almost the same manner for anxiety, however the one difference is some of those behaviors might be more in a soothing sense. For example, one of the behaviors a therapist might work with a patient on is in-the-moment deep breathing, which activates our parasympathetic nervous system, which calms us and decreases nervous or anxious feelings. On-Page Questions What Activities Can Help? Anything you love! Each person needs to use BA activities that they love to achieve success. Depressed people often cannot verbalize much that they love, however they can speak to loved ones or their therapist on BA activities that are tailored for them and provide the right stimulation! Does behavioral activation have limitations? BA has no limitations, as there is not much to support the notion that BA can be harmful to a person in any way. The key is setting reasonable and attainable goals. What conditions can it help with? Many! Most commonly depression, anxiety or any other mental health conditions that have a mood component, which essentially is most of them. There is also evidence that BA helps with other conditions such as Bipolar Disorder and PTSD.