If you're thinking about ending your life, or you're not safe right now, call 000 in Australia or 911 in the US. You can also call Lifeline on 13 11 14 in Australia, or call or text 988 in the US, any time. Anywhere else, findahelpline.com lists free local lines.

What to do when you're depressed

When you're depressed, even small jobs can feel impossible. The trick is to make the first step smaller than it feels worth doing. Behavioural activation starts there: do something small, before you feel like it.

Start smaller than you think

Depression can make big plans feel pointless, so skip the big plan. Pick one activity you could do in five minutes, even on a bad day.

• Open the curtains or blinds BodyOpen the curtains or blinds and let the daylight in
• Have a glass of water right now BodyPour a glass of water now and drink it
• Make your bed AchievementStraighten the sheets and pillows
• Step outside for fresh air BodyStand on the porch or walk to the letterbox
• Send a voice message to someone ConnectionRecord a short voice message to say hello

Five steps for a bad day

1. Lower the bar. One small activity is a good day.
2. Mix it up. Over a week, try something from each part of life: getting something done, time with people, something you enjoy, your body, and rest.
3. Do it before you feel like it. The idea is that you start first, and motivation can follow.
4. Notice how you feel afterwards. Worse, the same, or a bit better. Writing it down can show you patterns over time.
5. Do it again tomorrow. Behavioural activation is built on small steps, repeated day after day.

If you're at home

You don't need to go anywhere. Each of these takes ten minutes or less.

• Do a load of laundry AchievementRun one load through the wash and hang it out
• Pay a bill or admin task AchievementClear the one that's been sitting on the list
• Stretch for 10 minutes BodyStretch slowly and hold each stretch for a few breaths
• Dance to one song BodyPut on a track and let your body move
• Make a nice cup of tea or coffee EnjoymentTake your time making a drink you like
• Light a candle EnjoymentLight a candle and watch the flame for a minute
• Put your phone in another room before bed RestLeave your phone to charge in another room overnight
• Hold something warm RestWrap your hands around a warm mug or a heat pack

If you're on your own

Contact with people still counts, even from the couch.

• Text someone you've been meaning to reach out to ConnectionSend that message you've been putting off
• Send a voice message to someone ConnectionRecord a short voice message to say hello
• Message a friend a funny meme ConnectionShare something light and playful
• Reply to a message you've been putting off ConnectionAnswer one message that's been waiting for a reply
• Join an online community ConnectionFind your people in a forum, group, or server

There are 142 small activities in the full list, grouped by how long they take.

The idea behind it

This is behavioural activation, and it describes a loop. Low mood takes away energy and interest, so you do less. Doing less leaves fewer good moments in your day, and that can make the next start harder. Small activities work on that loop from the doing end.

A 2020 Cochrane review brought together 53 studies of behavioural activation for depression in adults, with about 5,500 people. Five of those studies, with 601 people, compared it with CBT. The review found no clear difference between the two in the short term, up to six months after treatment, and rated that evidence as moderate certainty.

Behavioural activation is a recommended psychological approach for depression (RANZCP 2020; NICE NG222).

These studies tested behavioural activation with a therapist or trained mental health worker. They didn't test Bloom, and Bloom isn't therapy.

What is behavioural activation? covers the research in more detail.

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 911 in the US. Lifeline is on 13 11 14, and in the US you can call or text 988. Anywhere else, see findahelpline.com.

Tools that help

• The activity list, with a button that picks one for you
• A free worksheet to plan a week and rate how each activity went
• How activity scheduling works, with an example week

Sources

1. Uphoff E and others (2020). Behavioural activation therapy for depression in adults. Cochrane Database of Systematic Reviews. doi.org/10.1002/14651858.CD013305.pub2
2. Kanter JW and others (2010). What is behavioral activation? Clinical Psychology Review 30: 608–620. doi.org/10.1016/j.cpr.2010.04.001
3. Lewinsohn PM, Libet J (1972). Pleasant events, activity schedules, and depressions. Journal of Abnormal Psychology 79: 291–295. doi.org/10.1037/h0033207
4. NICE (2022). Depression in adults: treatment and management (NG222). www.nice.org.uk/guidance/ng222
5. 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