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Behavioural activation
Activity monitoring: how to keep an activity diary
Activity monitoring means writing down what you do each hour and how you feel. It's the first step of behavioural activation. You do it before you change anything, so you can see where your day goes.
What to write down
For each hour of the day you're awake, write two entries:
- What you did. A few words is enough: "couch, TV" or "walked to the shops".
- Your mood, from 0 to 10. 0 is the lowest you feel, 10 is the best.
Some psychologists also ask for three more scores from 0 to 10: how much you got done, how close you felt to other people, and how much you enjoyed it. These are the same ratings as in activity scheduling, the step that comes next.
An example day
This example shows a diary for a made-up weekday.
| Time | What I did | Mood (0 to 10) |
|---|---|---|
| 8 am | Woke up, stayed in bed on my phone | 2 |
| 9 am | Shower, breakfast | 3 |
| 10 am | Work emails | 3 |
| 12 pm | Lunch at my desk | 3 |
| 1 pm | Walked to the shops | 5 |
| 3 pm | Work, put off a call | 2 |
| 5 pm | Couch, TV | 2 |
| 7 pm | Cooked dinner with my flatmate | 6 |
| 9 pm | Phone in bed | 3 |
In this day, mood went up during the walk and while cooking with someone, and down in the late afternoon on the couch.
How to keep it going
- Keep it for a few days, and include a weekend day if you can.
- Fill it in two or three times a day, while the last few hours are fresh.
- Rough is fine. A missed hour doesn't spoil the diary.
- Don't try to change your day yet. That comes after.
What to look for
After a few days, read the diary back and ask yourself:
- When is my mood lowest, and what am I usually doing then?
- Which activities have higher mood numbers next to them?
- Which parts of life are missing? For example, time with people, something you enjoy, or moving your body.
- Where are the long stretches of the same activity?
A diary like this can show patterns you might miss from day to day.
What comes next
Use what you found to plan small activities for set times, starting with the times your mood is lowest. That's activity scheduling, and the free worksheet fits a week of it on one page. For every step in order, see behavioural activation step by step. For ideas, see the 142 activities.
Where it comes from
Recording what you do and how you feel goes back to early behavioural research on depression by Peter Lewinsohn and colleagues in the 1970s and 1980s, including the Pleasant Events Schedule. The revised treatment manual for brief behavioural activation still includes a daily monitoring form.
Behavioural activation is a recommended psychological approach for depression (RANZCP 2020; NICE NG222).
The trials of behavioural activation, such as those in a 2020 Cochrane review and a large UK trial, tested it with a therapist or trained mental health worker. They didn't test Bloom, and Bloom isn't therapy.
For more, see what behavioural activation is.
When to get more help
Has it lasted more than two weeks? Is it getting in the way of work, study or the people around you? Then talk to your GP. In Australia, your GP can refer you to a psychologist under a Mental Health Treatment Plan.
Beyond Blue is on 1300 22 4636 in Australia. If you're not safe, call 000 in Australia or 988 in the US, or Lifeline on 13 11 14.
Bloom does this with you
Bloom asks how you feel after each activity, so you can look back on which ones left you feeling better.
Sources
- Lejuez CW and others (2011). Ten year revision of the brief behavioral activation treatment for depression: revised treatment manual. Behavior Modification 35: 111–161. doi.org/10.1177/0145445510390929
- Kanter JW and others (2010). What is behavioral activation? Clinical Psychology Review 30: 608–620. doi.org/10.1016/j.cpr.2010.04.001
- Lewinsohn PM, Libet J (1972). Pleasant events, activity schedules, and depressions. Journal of Abnormal Psychology 79: 291–295. doi.org/10.1037/h0033207
- MacPhillamy DJ, Lewinsohn PM (1982). The pleasant events schedule: studies on reliability, validity, and scale intercorrelation. Journal of Consulting and Clinical Psychology 50: 363–380. doi.org/10.1037/0022-006X.50.3.363
- Get Self Help. ACE log: achievement, closeness and enjoyment. www.getselfhelp.co.uk/media/jotpwjfr/acelog.pdf
- Uphoff E and others (2020). Behavioural activation therapy for depression in adults. Cochrane Database of Systematic Reviews. doi.org/10.1002/14651858.CD013305.pub2
- Richards DA and others (2016). Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA). The Lancet 388: 871–880. doi.org/10.1016/S0140-6736(16)31140-0
- NICE (2022). Depression in adults: treatment and management (NG222). www.nice.org.uk/guidance/ng222
- Malhi GS and others (2021). The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian and New Zealand Journal of Psychiatry 55: 7–117. www.ranzcp.org/getmedia/a8c79505-c0b5-46b4-9f27-67f79e047674/RANZCP-mood-disorders-clinical-practice-guideline-2020.pdf