How To Activate Yourself

The problem;

Depression is a vicious circle. It slows you down, mentally and physically. Everything becomes an effort, and you tire easily. You do less, and then blame yourself for doing less. You come to believe that you can do nothing and that you will never get over your depression. Then you feel even more depressed. It becomes even more difficult to do anything. And so it goes on.

Overcoming the problem: activity scheduling;

Becoming more active is one way of breaking the vicious circle. It has a number of advantages.

Activity makes you feel better. At the very least, it takes your mind off your painful feelings. It can give you the sense that you are taking control of your life again, and achieving something worthwhile. You may even find that there are things you enjoy, once you try them.

Activity makes you feel less tired. Normally, when you are tired, you need more rest. When you are depressed the opposite is true. You need to do more. Doing nothing will only leave you feeling more lethargic and exhausted. And doing nothing leaves your mind unoccupied, so you are more likely to brood on your difficulties, and to feel even more depressed.

Activity motivates you to do more. In depression, motivation works backwards. The more you do, the more you feel like doing.

Activity improves your ability to think. Once you get started, problems which you thought you could do nothing about come into perspective.

In spite of these advantages, getting active again is not easy. This is because the gloomy, pessimistic thoughts which are typical of depression stand in your way. When you are depressed, you may think that you are doing nothing, achieving nothing, and enjoying nothing.

It may be difficult to organize your time productively, or to involve yourself in things you normally enjoy. When you are faced with something you want to do, you may find yourself thinking : ‘I won’t enjoy it’, ‘I’ll only make a mess of it’, or ‘It’s too difficult’. Thoughts like these stop you from taking action and help to keep you in the vicious circle.

Later on in therapy, you will learn how to work directly on depressing thoughts which stop you from getting down to what you want to do. Your goal will be notice and challenge the thoughts, so that they no longer stand in your way. First of all, though, you need to get a detailed idea of what you are doing, and how much pleasure and satisfaction you get from what you do.

What you discover will help you to plan your time so as to get the most out of each day’s activities. This is called ‘activity scheduling’, and you will find details on how to do it below. There are two steps involved: self-monitoring and planning ahead.

Step I: Self-monitoring:

‘Self-monitoring’ simply means observing your pattern of activities. It involves keeping a detailed record of what you do hour by hour. You can do this in a notebook or diary, or your therapist will give you a special record sheet.

Your record will show you in black and white how you are spending your time, and will make you aware of how much satisfaction you get from what you do. This will allow you to test thoughts such as ‘I’m not doing anything’ or ‘I don’t enjoy what I do’, and to see if they hold water when compared to the facts.

You may well find that you are more active and competent than you assumed, and that you are enjoying yourself more than you thought. Even if this is not the case, you will have a factual record to help you find out more about what is getting in your way, and to form a basis for changing how you spend your time.

How to do it

For the next few days, in your diary or your record-sheet, write down:

1.   Your activities. Record exactly what you do, hour by hour.

2.   Pleasure and mastery. Give each activity a rating between 0 and 10 for pleasure (P) and for mastery (M). ‘P’ refers to how much you enjoyed what you did. So ‘P10’ would mean you had enjoyed something very much. ‘P0’ would mean that you had not enjoyed it at all.

You could use any number between 0 and 10 to show how much you enjoyed a particular activity. ‘M’ refers to how much mastery you experienced in what you did. How much of an achievement was it, given how you felt? ‘M10’ would mean that what you did was a real achievement. ‘M0’ would mean that it was not an achievement at all. Again, you could use any number between 0 and 10 to show how much mastery was involved in a particular activity.

Common problems in self-monitoring

Thinking you are doing nothing. Sitting in a chair in front of the television is an activity. So are going to bed, and staring out of the window brooding. You are never doing ‘nothing’. But some activities might be less helpful to you than others. It will help to identify these if you specify on your record-sheet what they are, rather than simply writing ‘nothing’.

Underestimating your achievements. ‘M’ should be rated for how difficult an activity is for you now, not how difficult it was for you before you got depressed, or how difficult another person might find it. When you are depressed, things which would normally be very easy become difficult. Even getting out of bed, or making a slice of toast, can be a major achievement, given how you feel. Beware of thoughts like ‘But I should be able to do this better’ or ‘So what? Any fool could do this’. This will only keep you trapped in depression’s vicious circle. Take a stand against them by making sure that you give yourself credit for what you do.

Delaying your ratings. It is important to rate your activities for P and M at the time. If you wait until later, your depression will colour how you see your day, and may well cause you to ignore or devalue good things you have done. When people are depressed, bad things that happen are easily noticed and remembered. In contrast, good things are often blotted out or discounted. If you make your ratings at the time, this bias in how you see things is less likely.

Immediate ratings will also help you to become sensitive to even small degrees of mastery and pleasure, which might otherwise go unnoticed.

Step II: Planning ahead

Now that you can see how you are spending your time, the next step is to plan each day in advance, making sure that you include activities which will give you a sense of pleasure and mastery.

Planning ahead will allow you to feel that you are taking control of your life, and will give you a sense of purpose. The framework you give yourself will prevent you from sinking into a swamp of minor decisions (‘What shall I do next?’), and will help you to keep going even when you feel bad. Once the day’s activities are laid out in writing, they will seem less overwhelming. You will have broken the day into a series of manageable chunks, rather than a long shapeless stretch of time which you must somehow fill.

How to do it.

1.   Plan your activities. Every evening, or first thing in the morning , set aside some time to plan the day ahead. Find out which time suits you best to do this, remembering that you are likely to be able to plan most realistically and constructively when you are feeling relatively well and clear-headed. If you find it difficult to remember to make time to plan ahead, give yourself reminder cues. Put up signs around the house, for example, or ask someone to remind you that 7.30 is your time for planning tomorrow. As far as possible, try to ensure that your planning time is not interrupted, and that there are no other pressing demands to distract you. Turn off the television and take the phone off the hook.

Aim for a balance between pleasure and mastery in your day. If you fill your time with duties and chores, and allow no time for enjoyment or relaxation, you may find yourself feeling tired, resentful, and depressed at the end of the day. On the other hand, if you completely ignore things you have to do, you may find your pleasure soured by a sense that nothing has been achieved, and your list of necessary tasks will mount up. You may find it helpful to aim for the pattern of activities you found most rewarding in the past. There is a fair chance that, once you get going, you will find this pattern works for you again.

Encourage yourself by starting the day with an activity which will give you a sense of mastery or pleasure, and which you will have a good chance of completing successfully. This is particularly important if you have trouble getting going in the morning. And plan to reward yourself with a pleasurable or relaxing activity when you tackle something difficult. You might, for example, set aside time to have a cup of coffee and listen to your favourite radio programme when you have spent an hour doing housework. Avoid beds. Beds are for sleeping in, not for retreating to during the day. If you need rest or relaxation, plan to achieve it in some other way.

To begin with you may find that trying to plan a whole day at a time is too much for you. If so, break the day down into smaller chunks, and deal with them one at a time.

2.   Record what you actually do. Put your plan into practice. Write down how you in fact spend your time on your record sheet, just as you did at the self-monitoring stage. Rate each activity out of 10 for mastery and pleasure.

3.   Review what you have done. At the end of each day, review what you have done. Take the time to sit down and examine how you spent your day, how much pleasure and mastery you got from what you did, and how far you managed to carry out the activities you had planned. This will help you to see clearly how you are spending your time, what room there is for improvement, and what changes you might like to make in the pattern of your day.

If you have managed overall to stick to your plan, and have found what you did reasonably satisfying, this gives you something positive to build on. If on the other hand you did not stick to your plan, or you got little satisfaction from what you did, this will give you valuable information about the kind of things that are preventing you from making the most of your time. What exactly was the problem?

Did you over-estimate what you could do in the time available? Did you feel too tired to carry out everything you had planned? Did you aim too high, forgetting to take into account how you feel at the moment? Did you spend your day doing things that you felt you ought to do, rather than things that would give you pleasure and help you to relax? Were your best efforts blocked by pessimistic thoughts? If you can find out what went wrong, you can learn from these experiences. Use what you have found out to help you plan in future.

Coping with practical tasks

Depression often leads people to put off practical tasks they need to carry out. The pile mounts, and in the end they feel completely overwhelmed. You can help yourself to get started on things you need to do by following these steps;

1.   Make a list of all the things you have been putting off, in whatever order they occur to you.

2.   Number the tasks in order of priority. Which needs to be done first? If you cannot decide, or it genuinely does not matter, number them in alphabetical order. The important thing at this stage is to do something.

3.   Take the first task and break it down into small steps. What exactly do you have to do in order to complete it?

4.   Rehearse the task mentally, step by step. Write down any practical difficulties you may encounter, and work out what to do about them.

5.   Write down any negative thoughts that come to you about doing the task, and answer them if you can (see ‘How to deal with negative thoughts’ section). If you cannot find answers, simply note the thoughts down (recognising them for what they are), put them to one side for later discussion with your therapist, and concentrate on what you are doing.

6.   Take the task step by step, dealing with difficulties and negative thoughts as they occur, just as you did in your mental rehearsal.

7.   Write down what you have done on your activity schedule, and rate it out of 10 for P and M, as soon as you have completed the task.

8.   Focus on what you have achieved, not on all the other things you still have to do. Watch out for negative thoughts that will make you devalue or discount what you have done. Write these thoughts down, and answer them if you can. If not, note them and put them to one side for later discussion with your therapist.

9.   Take the next task and tackle it in the same way.

Common problems with planning ahead

Not being able to get going. If you have difficulty getting down to a particular activity, tell your body in detail what to do. ‘Get on with it’ is too vague. ‘Legs, walk. Hand, pick up pen. Now write’, will give you the impetus to begin. As soon as you have told yourself what to do, do it. Do not allow any pause for doubts to creep in.

Being too rigid. Your plan is a guide, not a god. It is not carved on stone tablets. It is there to help you, not to rule your life. So, for example, something unexpectedly happens to throw you off schedule. A friend drops in unexpectedly, or the washing-machine breaks down.

At this point you may feel that your efforts to plan your day have been wasted: unless you can stick to what you have planned, you might just as well not bother. There are a number of things you can do to cope with the unexpected:

Accept the disruption. Accept that things have not worked out the way you thought they would, and continue with your original plan when you can. Your friend leaves at 4 o’clock. What did you have scheduled for that time?

Think of alternatives. Some of the activities you have planned may depend on factors beyond your control, such as the weather or other people’s health. Supposing, for example, you plan a picnic, have something up your sleeve in case it rains. Or supposing you had planned to spend the weekend with an old friend and at the last minute she comes down with flu, look for an alternative that you will enjoy, rather than giving up and doing nothing in particular.

Do not try to make up things you have missed. If for some reason you cannot do what you had planned at a particular time (you wanted to clean the bedroom and ended up talking to your son about his holiday plans), do not go back and try to do it later. Move onto the next activity on your plan, and re-schedule what you missed for the next day.

Similarly, if you find that you finish an activity sooner than you had planned, leave your next activity until the time you had scheduled. Fill the gap with something you enjoy. You may find it useful to have a list of pleasurable activities handy so that you have something to choose from.

Being too specific or too general. You need not write down what you intend to do in nit-picking detail. Listing every piece of furniture and ornament you have to dust is too specific. Equally, do not be too general. ‘Housework’, for example, is too general for you to feel clear about what it is that you are aiming to do. So you will not know when you have achieved your goal. Schedule your activities roughly by the hour or half-hour. Experience will tell you how long each activity is likely to take.

Planning for quality, not quantity. Write down the amount of time you are going to spend on a particular activity, not how much you are going to do in that time. When the time is up, stop. How much you do in a given period may depend on factors outside your control (e.g. interruptions, machines breaking down), or on other problems (e.g. concentration difficulties, fatigue). If you tell yourself you must weed the whole garden this afternoon and you do not do it, you will probably think of yourself as a failure and give yourself no credit for what you have done.

If on the other hand, you set yourself to weed for an hour, then how much you do is neither here nor there. Reward the effort, not the outcome.

Expecting miracles. Your immediate goal is to carry out what you have planned as best you can, not to get over your depression. You will probably feel less depressed when you are doing some things than when you are doing others. And if you work steadily at becoming more active, you will eventually feel better. But no single thing you do is likely to produce a miracle cure. Don’t expect to be over your depression after an hour’s television, or cleaning out the cupboard under the stairs. If you do, you will only disappoint yourself.

Stopping when the going gets tough. Quit an activity when you are winning, not when you have exhausted yourself, or when things are going badly. This will leave you feeling good about what you have achieved, and ready to carry on.

Thoughts that stop you activating yourself

We have already discussed how pessimistic, gloomy thinking can get in the way of your attempts to activate yourself, and trap you in the vicious circle of depression. The most powerful way to overcome your depression is to identify your depressing thoughts when they occur, and challenge them.

You will learn how to do this later in therapy. In the meantime, monitoring what you do and planning ahead will give you a good opportunity to start becoming more aware of depressing thoughts that block progress and get in your way.

In the last section of this handout, you will find some examples of the kind of thoughts that may be preventing you from becoming more active, together with some possible answers to them. These are not the right answers, nor the only answers. They are just some suggestions. The answers which work for you personally may be quite different. With practice you will learn to find effective answers, which will change how you feel and help you tackle your difficulties constructively, for yourself.

Automatic Thoughts	Possible Answers
I can’t do anything – there are too many practical difficulties	There are always practical difficulties involved in doing anything – it’s part of life. What would I do about them if I wasn’t depressed? Is there anyone who could give me advice with things I don’t know how to handle?
I can’t keep a schedule – I’ve never been a record-keeper	Keeping written records is a skill that I can learn. I may not have done this before, but that doesn’t meant to say I can’t do it. After all, I’ve used lists before, for shopping and to remember what to take on holiday. I could start by listing all the things I have to do.
There’s too much to do – I won’t be able to cope	Believing that is all part of depression. It may not be true. If I write down what I need to do, it won’t seem so overwhelming. I don’t have to do it all at once. I can take things one at a time.
It’s too difficult	It only seems difficult because I’m depressed. I’ve done more difficult things than this in the past.
I won’t know how to go about it	The idea is to have a go, not to produce a perfect performance. It’s better to try and find out how I do than not to do anything at all.
I don’t want to	That’s true. But whether I want to or not, what is in my best interests? Which will make me feel better and more in control of things? Doing it? Or not doing it?
I’m not up to it just now, I’ll wait until I’m feeling better	I won’t know if I’m up to it until I try. If I wait until I’m feeling better, I’ll never do it. Doing it will make me feel better.
It’s too late, I should have done it before	Maybe it would have been better if I’d done it before. But the fact is I didn’t. Feeling guilty is not going to help me. Better late than never – do it now instead of wasting time in regrets.
I can’t decide what to do first	It really doesn’t matter. The important thing at this stage is to do something. Take the thing that comes first in the alphabet. Once you get going it will probably be clearer what to do next. If not, just go on down the alphabet.
There’s no point in trying. I’ll only make a mess of it and feel worse	I don’t know that until I try. Nobody’s asking for a five-star performance. Even if I do make a mess of it, it’s not the end of the world – I can learn from my mistakes if I don’t take them too seriously.
I won’t enjoy it	How do I know? I’m not a fortune-teller. I might enjoy it more than I think, once I get involved in what I’m doing. That has happened before.
I won’t be able to do everything I’ve planned	No-one does everything they’ve planned all the time, so there’s no need to feel badly about it. Before I got depressed, if I didn’t get everything done, I just put it forward to the next day. Do what you can, and forget what you can’t. The world won’t end because I don’t clean out the attic today.
I’m not doing anything	Am I sure of that? Or is it that I’m not giving myself credit for what I do? Why not keep a record for a few days, and see. Maybe I just think I’m not doing anything.
I don’t do anything worthwhile	I didn’t see it that way before I got depressed. I was doing much the same then as I am now, but I could see that it was worthwhile, even though none of it was very dramatic or exciting. If I discount everything I do, I will only get discouraged.
I don’t deserve to enjoy myself. I should get on with all the things I’ve got to do	Doing things I enjoy will help me to feel better. That’s what I want. Also, if I’m more relaxed and feeling better, I’m more likely to do what I’ve got to do more efficiently, instead of getting in a muddle and dashing from one thing to another. I know that from experience; I get more done when I give myself breaks than when I plough on non-stop.
So I cleaned the car. So what?	Normally, cleaning the car would be nothing very special. But given the way I feel, it is in fact very difficult. So doing it is an achievement. I deserve to give myself credit for that. M10.