As I wrote in part 1 BA is a common-sense approach to mental health. The problem is when you are in the depths of depression and anxiety the logical common-sense part of your brain is inhibited. You also struggle to hold on to the positive experiences in this state. In fact, at times your brain actively seems to resist them. Professor Richard Davidson elucidated this in his brilliant book ‘The Emotional Life of your Brain’. Davidson describes that in comparison studies, depressed patients report the same level of positive emotion in response to pleasant stimuli. The difference is in the half life of these positive emotions. In the control group these positive emotions increased as the subjects reflected and savoured the experience, whereas, in the depressed individuals the positive emotions dropped away sharply. This was reflected in the brain region related to reward and pleasure, the nucleus accumbens. The ‘notes’ of pleasure in the brains of depressed patients were trailing off far quicker than in healthy controls. I think anyone who has experienced depression will relate to this, there are moments of happiness and pleasure, but these are often followed by even deeper lows as you lament for what slipped through your fingers. Sometimes these highs are so subtle that they even go unregistered, so the depressed person is tricked into believing there is only the darkness.
There is also the lack of motivation or the paralysis of fear to deal with. You literally can’t get yourself to think, move or act in a positive way. You might even know what will help you but your body doesn’t seem to move or your overwhelming thoughts convince you that nothing will help or you don’t deserve recovery.
Many theorists posit that depression has an evolved function. In the days of our ancestors this mood state would induce you to go back to the cave to rest and avoid danger. Or it might mean that you kept a lower status in the group so that the dominant members of the tribe would not attack you. Is it perhaps a mechanism that in smaller dose’s can be beneficial, but is not designed for our modern world? Is depression triggered by an overactive physiological response to the everyday stresses of modern life? These theories make sense to me. Perhaps we can use them to help us be kind with our harsh inner critics and cut ourselves some slack. After all, it is not our fault that we have tricky brains.
So, what can you do when you are depressed and want to utilise BA? As MBCT states ‘In depression, we have to do something before we are able to want to do it’. Over the next series of blogs, I’m going to describe 10 tools that have helped me. Needless to say, it will always be most effective to do BA under the guidance of a trained professional.
- Divide and conquer – The science of procrastination has a lot of transferable tools here (see Prof Timothy Psychl brilliant book for more details). Divide every task up into smaller and smaller chunks, until it seems possible. At the extreme end of the scale, getting out of bed and going downstairs for breakfast could be divided into multiple steps, each one being focused on in turn. Start small in terms of changes, with one or two new items added to your schedule a day (or week). Start with the simpler tasks and build up to anything more challenging.
- Put it down on paper – As discussed in the first article, BA is typically recorded hour by hour on paper. It really helps to write the plan down and focus on each hour rather than the potentially overwhelming full day or week. Generate and write down your list of pleasure and mastery activities that reflect your values and goals.
These first two points work in partnership. Putting our plans down on paper helps us to divide and conquer. But what happens when your thoughts and feelings resist this process? We will take a look at tools to work with our tricky minds in the next article.