Acting before you feel like it

The low-mood cycle

Low days happen to everyone and usually pass within days or weeks. When low mood settles in, though, it is common to drop the things that used to help: going out, seeing people, exercising, keeping up with chores. Avoiding them brings instant relief, but the day becomes emptier, tasks pile up and mood tends to sink further.

Behavioural activation starts from a simple idea: instead of waiting for motivation to return before acting, act a little at a time so that mood has a chance to lift. NICE describes the approach as work that links activities to mood, reduces avoidance and plans practical changes, without trying to change thoughts directly.

What research shows

Behavioural activation is among the psychological treatments for depression listed by the World Health Organization, alongside cognitive behavioural therapy, interpersonal therapy and problem-solving therapy.

A 2020 Cochrane review brought together 53 trials with more than five thousand participants. Behavioural activation did about as well as cognitive behavioural therapy and appeared better than usual care, although the certainty of that evidence is moderate. An earlier meta-analysis, from 2014, also concluded that the approach is effective for depression, even though many studies were of limited quality.

For less severe depression, NICE guidance is to start with the least intensive option, such as guided self-help using structured behavioural activation or cognitive behavioural therapy materials, with support from a practitioner.

How to start

Watch a day or two: what you did and how your mood was at each point. Your check-ins in the app are made for this. Often some activities turn out to help a little and others make things worse.

Choose small activities of two kinds: ones that bring some pleasure, however slight, and ones that give a sense of achievement or connect with what matters to you. A ten-minute walk, replying to a message, washing up, calling someone.

Set a day and a time. A planned activity does not depend on how you feel in the moment; it depends on the agreement you made with yourself. Start with something so small it feels almost too easy.

Afterwards, note how it went and how your mood was. It does not have to have gone well. The aim is to notice, over time, what moves your mood, even slightly.

If it does not go to plan

There will be days when nothing happens. That is part of it. Instead of giving up, make the step smaller: if the ten-minute walk did not happen, try five, or just stepping outside the door. The World Health Organization also suggests staying in touch with people you trust, moving your body, keeping regular times for meals and sleep, and cutting down on alcohol and other drugs.

When to seek help

If low mood has lasted two weeks or more, if you are struggling to cope with daily life or if self-help is not working, see a health professional. If thoughts of death or of hurting yourself appear, get help now: emergency contacts are at the bottom of every screen in the app.