David Veale - Manage Your Mood--How to Use Behavioural Activation Techniques to Overcome Depression

Published by Robinson

ISBN: 978-1-47213-770-8

Copyright 2007 David Veale and Rob Willson

The moral right of the author has been asserted.

Your Fitness Personality Profile () copyright 2005, James Gavin PhD and taken from Lifestyle Fitness Coaching, Human Kinetics Europe Ltd, 2005.

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D AVID V EALE , FRCPsych, MD, BSc, MPhil, Dip CACP is a consultant psychiatrist in Cognitive Behavior Therapy at the South London and Maudsley NHS Foundation Trust and the Priory Hospital, North London. He is an Honorary Senior Lecturer at the Institute of Psychiatry, Kings College London. He is an accredited cognitive behavior therapist and President of the British Association of Behavioural and Cognitive Psychotherapies 20068. He has about 50 publications to his name, accessible through his website www.veale.co.uk. He has been helping people with depression and anxiety disorders for more than 15 years.

R OB W ILLSON , BSc, MSc, Dip SBHS is a cognitive behavior therapist in private practice. He also works as a tutor at Goldsmiths College, University of London. He holds an honours degree in Psychology, an MSc in Rational Emotive Behaviour Therapy, and a Postgraduate Diploma in Social and Behavioural Health Studies. He has been involved in treating people with depression and anxiety for the past 12 years.

David Veale and Rob Willson are authors of Overcoming Obsessive Compulsive Disorder, also published by Robinson.

3-part self-help courses

Overcoming Anxiety Self-Help Course

Overcoming Bulimia Nervosa and Binge-Eating Self-Help Course

Overcoming Low Self-Esteem Self-Help Course

Overcoming Panic and Agoraphobia Self-Help Course

Overcoming Social Anxiety and Shyness Self-Help Course

Single-volume books

Overcoming Anger and Irritability

Overcoming Anorexia Nervosa

Overcoming Anxiety

Bulimia Nervosa and Binge-Eating

Overcoming Childhood Trauma

Overcoming Chronic Fatigue

Overcoming Chronic Pain

Overcoming Compulsive Gambling

Overcoming Depression

Overcoming Insomnia and Sleep Problems

Overcoming Low Self-Esteem

Overcoming Mood Swings

Overcoming Obsessive Compulsive Disorder

Overcoming Panic

Overcoming Paranoid and Suspicious Thoughts

Overcoming Problem Drinking

Overcoming Relationship Problems

Overcoming Sexual Problems

Overcoming Social Anxiety and Shyness

Overcoming Traumatic Stress

Overcoming Weight Problems

Overcoming Your Childs Fears and Worries

Overcoming Your Smoking Habit

If you are using this book with your client you should be aware that it is based on Behavioral Activation (BA) which is part of the family of Behavioral and Cognitive Psychotherapies and derived from the treatment manual, Depression in Context: Strategies for Guided Action by Martell et al (2001) (see .) There are differences between the standard activity scheduling of cognitive behavior therapy (CBT) and that of BA. BA is rooted in a contextual functional analysis of activities that are being avoided, or that have the function of avoidance (e.g. ruminating). This information then guides the choices in the activity scheduling. The aim is to help people develop a pattern of approach behaviors rather than avoidance. We have added elements of Acceptance and Commitment Therapy (ACT) by also encouraging activities that are in keeping with ones valued directions in life. The distinctive feature of BA, ACT and newer approaches in CBT is the process of thinking (e.g. rumination, worry, self-attacking) rather than trying to change the content of a persons thoughts. Thought records and identifying schemas and assumptions are therefore not used unless, for example, it is to identify and determine the helpfulness of ones assumptions about ruminating or self-attacking. This book can be used in guided self-help for stepped care for mild to moderate depression, which in the future we hope to evaluate.

David Veale and Rob Willson

Depression is a very common problem in the world today and the number of reported cases is rising. It is estimated that 1 in 4 women and 1 in 7 men will have an episode of depression at some point in their lives, with many episodes beginning in early childhood and adolescence. Research has shown that in some communities, particularly the impoverished, depression can be even more widespread.

One of the difficulties with understanding depression is that it can vary depending upon the individual. Some people experience high levels of anxiety and a sense of dread; others experience elevated anger, frustration and irritability. Some eat more while others eat less. Most people suffering from depression have difficulty sleeping, but again, this can vary enormously from case to case. Despite these variations there are commonalities. For many, depression is seen as a state of exhaustion you can feel physically, mentally and socially exhausted. This exhaustion can drain away positive feelings and interest in others and your environment. The combination of feelings of dread and fatigue, plus a negative outlook can make you want to hide away.

Over the centuries there have been many treatments for depression. More recent treatments include medications and specific psychological interventions. It is well known that depressed peoples negative thinking and predictions about others and their environment make them more likely to give up and thus spiral downwards into depression. Research was conducted to explore whether helping people directly to change their thinking, behavior and level of activities could be helpful. The answer was it definitely could. For instance, regular exercise can really help to combat depression. By gradually increasing your level of activity, focusing on small but important steps, you can start to reduce the effects of depression.

David Veale and Rob Willson have written Manage Your Mood to share with you some of the ways you can understand your thinking style and reorganize your daily routines and activities to help overcome your depression. By doing this you can start to take control of your life rather than battling on as before, simply keeping going, or just putting on a brave face.

Many of the ideas outlined in Manage Your Mood are derived from what are called behavioral approaches to problems. This works on the basic idea that in order for us to learn new tasks or overcome difficulties and anxieties skilful action is required, for example, if we are anxious about learning to drive, the best way to develop our skill and confidence is to get in a car and practise with an instructor. Think of how many difficulties you have overcome in life by actually going out and tackling your problem even when anxious!

When it comes to depression, skilful action means:

1. Recognizing what was happening in your life that triggered depression. Sometimes it can be a life event such as the break-up of a relationship, or a combination of difficulties that just seemed to happen simultaneously. Some degree of depression may be a natural way we deal with things when we feel over loaded.