What does depression look like, and what can I do about it?

October is Depression Awareness Month. According to the American Psychiatric Association (APA), depression causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home. Symptoms last at least two weeks and other causes must be ruled out (e.g., underactive thyroid, vitamin deficiency).

Common symptoms include:

• Little interest or pleasure in doing normally enjoyable things
• Feeling down, irritable, and/or hopeless
• Trouble falling asleep, or sleeping too much
• Feeling tired or low energy
• Poor appetite or overeating
• Feeling bad about yourself—or that you’re a failure
• Trouble concentrating
• Moving or speaking slowly, or being fidgety and restless

1 in 15 adults experience depression in a given year. 1 in 6 adults will experience it in a given lifetime. Women are more prone to depression: up to 30% report having it at some point. It can be hereditary: there’s a 40% increased risk for it with a first degree relative.

Thankfully, treatment is helpful in 80-90% of cases.
Behavioral Activation (BA) is one such treatment. Depression is often accompanied by a lack of engagement in pleasurable or meaningful activities, which can exacerbate and perpetuate depressive symptoms; BA aims to help individuals overcome this by encouraging them to increase their involvement in positive, rewarding, and goal-oriented activities.

Some key components and principles of BA for depression:

1. Activity Monitoring: The therapy begins with the client monitoring their daily activities and moods. This helps in identifying patterns and understanding which activities might be contributing to their depression and which ones might be beneficial.
2. Activity Scheduling: After identifying problematic activity patterns, the therapist and client work together to create a structured daily or weekly schedule. This schedule includes a balance of essential life activities (e.g., work, chores) and enjoyable, rewarding activities (e.g., hobbies, social interactions).
3. Graded Task Assignment: Clients are encouraged to set achievable goals, starting with small, manageable tasks. As they experience success and a sense of accomplishment, they gradually work their way up to more challenging activities.
4. Avoidance Reduction: Behavioral activation helps clients confront and gradually reduce avoidance behaviors that are common in depression. This might involve facing situations or activities that have been avoided due to anxiety or low motivation.
5. Behavioral Analysis: The therapist and client analyze the relationship between activities, thoughts, and emotions. This helps in recognizing negative thought patterns and understanding how certain activities can influence mood.
6. Problem Solving: Clients learn problem-solving skills to address obstacles that might hinder them from engaging in planned activities. This can include developing strategies to manage stressors or negative thoughts.
7. Self-Monitoring and Relapse Prevention: Clients are taught to continue monitoring their activities and mood, which enables them to identify signs of relapse and take proactive steps to prevent a return of depressive symptoms.
8. Positive Reinforcement: Encouraging clients to notice and savor the positive experiences and emotions resulting from engaging in meaningful activities is a crucial aspect of behavioral activation. This reinforces the idea that engaging in activities can improve mood.
9. Collaboration and Support: The therapist and client work collaboratively to set goals and track progress. Social support and involving friends and family in the process can also be beneficial.

BA is typically a time-limited therapy, often delivered in 12-16 weekly sessions. It can be used as a standalone treatment or in combination with other therapeutic approaches, such as Cognitive Behavioral Therapy (CBT). Research has shown that BA is effective in reducing depressive symptoms and improving overall well-being, making it a valuable option for individuals dealing with depression.

In honor of Depression Awareness Month, we’re opening up the waitlist for our long-awaited depression and burnout programs—co-designed with our research partners at Thomas Jefferson University.