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Depression

Activity Scheduling for Bipolar Depression

Combat bipolar depression with activity scheduling.

Key points

  • Many people find it hard to do their usual activities when depressed.
  • Behavioral activation is a program focused on building enjoyable and important activities into your daily life.
  • Mood tracking can help you recognize the relationship between specific activities and changes in your mood.
MabelAmber/Pixabay
Source: MabelAmber/Pixabay

During episodes of depression, many people find it harder to engage with activities that they usually find enjoyable. This is because the symptoms of depression (feeling down, feeling tired and without energy, and having less interest in typical activities), can lead people to withdraw from the world. As a result, people experiencing depression may spend more time in periods of inactivity, which makes it more likely that their depression will stick around.

There are a few reasons why inactivity can contribute to ongoing depression. First, inactivity means missed opportunities to participate in activities that may reliably improve mood. Second, time spent in inactivity can cause people to repeatedly focus their attention on negative thoughts and emotions, which in turn makes it even harder for people to have the motivation to get started with positive activities that may reduce depressed mood.

One treatment for depressed mood, known as behavioral activation, focuses on building up activities that are enjoyable and/or that bring a sense of accomplishment or capability. Research has shown that scheduling and completing such activities can increase positive mood, and decrease symptoms of depression.

Following are some suggested steps for trying out a behavioral activation program for decreasing depression:

1. Use a calendar to monitor daily activities. For one week, keep track of what you are doing hourly, each day. This means noting everything, such as times that you are sleeping and times that you are not doing anything at all. Monitoring your daily schedule as a regular habit is helpful for a couple of reasons. As a first step, monitoring can help you figure out when to add in activities (see #2 below). Once you start adding in activities, continuing to regularly monitor your schedule can help you keep track of your activity levels and their relationship to your mood (see #4 below).

2. Use the calendar to schedule daily activities. Insert planned activities at specific times of the day. For people with bipolar disorder, keeping a regular schedule is important for mood stability, and scheduling activities is one way to ensure that you are carving out time for planned activities at specific, appropriate points in the day. For instance, avoid scheduling activities that interfere with your regularly chosen bedtime. For people with bipolar disorder, it is also important that your schedule stays manageable and within a healthy range. Be careful not to add too many activities to your schedule, and be thoughtful about keeping a good balance of “active” activities (such as exercise) and activities that allow you to decompress and unwind (such as meditating or listening to music).

3. Choose a balanced mix of enjoyable and important activities. Think about healthy activities that you have historically found to be enjoyable and that contribute to pleasant feelings. It is possible that, when you are feeling depressed, it will take many repetitions of these activities for you to feel the same positive effect on your mood. You may find that, in the short term, completing these activities can instill even a bit of positive emotion into your day. You may also find it helpful to think of a new pleasant activity that you could try, such as playing a sport, completing a hobby, spending time with friends, going out to eat, or playing a game.

Important activities are things that need to get done that are harder to complete when depressed. These activities could include paying bills, completing a chore, finishing an assignment at school, or finishing a task at your job. Completing these activities can contribute to feelings of mastery, or the sense of achievement that we feel when we complete something important, and improve positive feelings that we have about ourselves. This latter point is important, as when people are depressed they often find that they tend to be more self-critical.

4. Keep activities small and manageable. Sometimes, completing a whole task or activity can feel overwhelming when people are experiencing depression. In these instances, try to break up activities into smaller pieces. For instance, if you need to complete a chore in the house, complete half of the chore today and half tomorrow. If picking up your old hobby of painting feels overwhelming, think about how you can break down the steps for this hobby: Maybe one day, you think about what you would like to paint; the next day, you prepare the materials that you will need to paint; and the following day, you start painting.

5. Use mood tracking to note changes in your mood. Mood tracking is a great way to recognize the relationship between your activities and their effect on your mood. Record your mood before and after completing a specific activity. Seeing how activities reliably boost your mood can help you feel motivated to keep staying active, and can help you prioritize scheduling in those activities that most consistently keep your mood feeling balanced.

This blog contains the opinions and ideas of the author. It is solely for educational and informational purposes and should not be regarded as a substitute for professional treatment. The author shall not be liable or responsible for any loss or damage allegedly arising from any information or suggestions in this blog.

References

Cuijpers, P., van Straten, A., & Warmerdam, L. Behavioral activation treatments of depression: A meta-analysis. Clinical Psychology Review 2007;27(3):318-326.

Greenberger, D. & Padesky, C.A. (2016). Mind over mood, second edition: Change how you feel by changing the way you think. Guilford Press.

Lejuez, C. W., Hopko, D. R., Acierno, R., Daughters, S. B., & Pagoto, S. L. (2011). Ten year revision of the brief behavioral activation treatment for depression: revised treatment manual. Behavior modification, 35(2), 111-161.

Otto, M., Reilly-Harrington, N. Kogan, J.N. Henin, A., Knauz, R.O., & Sachs, G.S. (2008). Managing bipolar disorder: a cognitive behavior treatment program. Oxford University Press.

Weinstock, L.M., Melvin, C., Monroe, M.K., & Miller, I.W. (2016). Adjunctive behavioral activation for the treatment of bipolar depression: A proof of concept trial. Journal of Psychiatric Practice 22(2):149-158.

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