Self-Help CBT for depressed mood
Cognitive behavioural therapy (CBT) is an effective evidence-based treatment of depression. Its principles revolve around changing thoughts and behaviours that lead to low mood.
This approach can be pretty helpful in depression because depression can impact both our thinking and our behaviours. For example, people with depression may have negative thoughts such as “I’m worthless” and “there’s nothing I can do to feel better”. As you can imagine, these thoughts also lead to behaviours that maintain depressed mood, such as staying in bed and withdrawing from activities and people we enjoy and give us meaning.
There are plenty of techniques in CBT that are commonly used in therapy. These techniques can also be applied in a self-help fashion. In depression specifically, there are a few specific CBT strategies that I use with patients with the intention of improving mood.
Below I provide a list of four CBT strategies you can experiment with to try in improving your mood.
#1. Activity scheduling and positive reinforcement
Activity scheduling is a CBT technique that involves including activities in a person’s life to increase a sense of pleasure and mastery (also called behavioural activation). It is based off the idea that depression pulls for people to stop doing things they enjoy, which reduces positive reinforcement in their lives and maintains low mood. People with depression follow their feeling – and unfortunately, feeling depressed unsurprisingly leads to a lot of behaviours that don’t really help.
Activity scheduling is a way to slowly add small activities into your life that are personally enjoyable and meaningful. Start small and make your way up. Even one small activity a day (e.g., grabbing a cup of coffee or doing a few minutes of journaling at night) can be great ways to slowly add back positive reinforcement into your life in a way that is manageable. Make a list of different activities that you think would provide you pleasure or mastery (make you feel competent) and start by picking just one or two that you feel is do-able and enjoyable (i.e., whatever gives you the best bang for your buck). You can even enter them into a calendar to remind yourself to do that little thing for yourself! It’s important to remember that depression will try to keep you depressed. Your depression brain may say things like “there’s no point”, and “it’s not going to do anything”. Keep an open mind and stay curious to see if engaging in these behaviours are actually helpful. This article can be a helpful way to guide activity scheduling using your own values.
#2. Thought records for negative thoughts
Thought records are a great way to target our negative thoughts that keep us depressed. It’s a strategy that one can use to properly evaluate whether our negative thoughts are true. For example, we might think to ourselves “I can’t do anything today, I’m too tired”. To challenge this thought, you might consider times where you have been able to engage in an activity despite feeling worse for wear. A balanced thought might be: “Although it’s much tougher for me to complete today’s tasks, I can definitely act despite not feeling like it. For example, I pulled myself from my bed yesterday to take my dog for a walk and make lunch”.
The replacement of a negative distortion with a more helpful, balanced thought can improve mood and give us the needed momentum to engage in activities that are helpful in breaking the cycle.
Here’s a guide to using thought records if you are interested in reading more about developing thought records!
#3. Journaling to process mood
Journaling is a helpful CBT strategy that can be done for just a few minutes in the morning or at night. Journaling can be a great way to understand how you feel, going through the situation, thoughts associated with the situation, and why you felt that way. This is also known as the ABC model. You can write down the A (antecedent – what was the situation), B (belief – what were your thoughts), and C (consequences – what happened because of these thoughts?) This allows you to understand the process behind the feeling and its consequences, which can be very helpful to gain insight about yourself.
For example, you might notice times when you are being extra critical to yourself in negative situations and use this knowledge to give yourself some compassion. The ‘best-friend’ technique can be a great strategy to reduce self-criticism and validate your thoughts and feelings.
#4. Behavioural experiments to assess mood changes
Behavioural experiments are a tool for you to become a curious scientist and assess whether your negative thoughts are true in a more behavioural way than thought records. For example, you might have the thought or prediction that “I’ll feel too tired to take a walk and be exhausted after”. You could then go for the walk and test that prediction (I will be more exhausted) and rate your energy levels before and after.
Behavioural experiments are therefore helpful to carefully examine whether our negative predictions are true. Here’s a guide for behavioural experiments if you would like to learn more on designing more experiments for yourself!
Please feel free to experiment with one or more of these strategies to see how they help with your mood. You can even combine these strategies together, such as using activity scheduling and behavioural experiments to include more activities in your life and assessing how they impact how you feel!
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