Harvard Mental Health Letter

In Brief: Act, don't think, to relieve depression

In Brief

Act, don't think, to relieve depression

That's the conclusion of a study comparing standard cognitive behavioral therapy with an expanded version of behavioral therapy called behavioral activation therapy.

Cognitive therapy targets persistent self-defeating thoughts. Cognitive behavioral therapy, a version that includes behavioral training and homework, has become one of the most widely used treatments for depression. But some researchers have questioned how much work the cognitive part of the therapy really does.

Behavioral activation therapy, the alternative used in the study, is based on the idea that depressed people withdraw from the routine activities and demands of daily life to avoid emotional pain. As a result, they receive fewer rewards and become more depressed. For example, a depressed person in the midst of a conflict with a coworker stays home for several days. Withdrawing from feeling as well as action, she avoids immediate conflict but deprives herself of the satisfying knowledge that she is completing tasks and earning money, while doing nothing to address the original problem. What would help her in the long run is temporarily difficult and unpleasant. As depression progresses and deepens, that may come to include getting out of bed in the morning.

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