Treating depression with behavioural activation

Everyone goes through phases of low moods, sadness or despair. These phases are part of life and usually pass after a while. It is different for people who have depression. People who have depression plunge into a low emotional state over several weeks and months and often can’t see a way out. Negative feelings and thoughts impact their thinking and behaviour, even if this is not triggered by a specific event or a clear reason.

If the depression takes the form of a single occurrence, it is called a depressive episode. This can develop into a recurring depressive disorder or even chronic depression. Symptoms range from persistent sadness and dejection, lack of interest, lack of motivation and loss of appetite to sleep disorders, anxiety about the future and suicidal thoughts.

The Harding Center for Risk Literacy at the University of Potsdam has summarised the benefits and risks of behavioural activation as a short-term psychotherapeutic treatment for moderate to severe depression compared to general medical treatment by a general practitioner without psychiatric treatment or psychotherapy.

Did the symptoms improve?

For around 53 in 100 people who did not receive psychiatric treatment or psychotherapy but were looked after by a general practitioner using a general medical approach instead, their symptoms of depression decreased significantly within twelve weeks. Among those treated with behavioural activation, symptoms of depression decreased significantly within twelve weeks for 75 in 100 people. This means that 22 in 100 people benefited more from behavioural activation than from general medical care without psychiatric treatment or psychotherapy. Those treated with behavioural activation also had fewer worries and anxieties.

How often did adverse events occur?

Psychotherapeutic treatment in the form of behavioural activation has so far resulted in 11 out of 100 people experiencing adverse effects, such as hospitalisation or suicidal thoughts and attempted suicides. Without psychiatric or psychotherapeutic treatment, this figure was 8 out of 100 people.

Behavioural activation can help reduce symptoms of depression and improve worries and anxieties. However, for people with severe, chronic depression, this approach can be very challenging and only effective in the short term. The reason for this is that the method focuses on current problems and not on treating the causes.

Whether behavioural activation treatment is worthwhile depends on the goals of the person in question and the severity of their depression. A doctor can help with choosing the right treatment. We hope you now have a clearer overview of this complex issue.