Behaviours
So it’s not rocket science, but one thing CBT has taught me is that if you can work out what you are not doing when you feel down, and then start to do it, it will help you feel better.
At first I wasn’t sure that was possible – there seemed so many good reasons (like being pregnant) for not doing all the things I wasn’t doing I didn’t think I could change things. Thankfully, being off work not only gave me some time and some energy back to deal with my physical health but it removed some of my excuses for dealing with my mood too.
The ‘not doings’ in depression can be typically divided into 3 categories: routine, pleasure and necessary. I’ll give an example for how I’m tackling one of each.
Routine: these are ordinary everyday things we do, like cleaning our teeth or cooking a meal. My example is washing up, which I’ve never enjoyed but is a considerable part of my normal daily life. Due to the pain and dizziness I really struggled to do it, and thankfully my husband /friends/ lodger helped me out a lot during the first 6 months of pregnancy.
Since being off work I’ve learnt to take my time. I don’t rush to stand after eating, and when I do it I take breaks in between loads. If I need to lie down I do and if it takes all day I don’t worry about it. Consequently I’ve been able to get the washing up done at least once a day.
Pleasurable: This category includes anything we do, or used to do, which gave us enjoyment. So many times I meet mums who are great at doing everything routine and everything necessary, but who have nothing in their life purely for pleasure. I’ve found being pregnant, in pain, and tired in the evenings has cut out most of my pleasure activities, like exercise and seeing friends.
Seeing my friends is huge for me. Since stopping work I’ve found I have time to plan in coffee during the days, either with my girls or even (gasp!) on my own. It takes planning but being able to see the people I love and who I can be honest with, who love and support me, who I can laugh and really talk with, has been a wonderful joy.
Necessary: all the jobs that just have to get done- bills and food shops and mending the car and Christmas planning etc. Mine was writing Christmas cards (always traditionally my job). I achieved this by the means of breaking it down into manageable chunks.
- Buy stamps
- Get up to date addresses
- Print out card labels
- Write bare minimum in cards whilst watching tele.
- Post overseas cards
- Post hand delivered cards to neighbours
- Post all other cards
This turned my insurmountable task into achievable goals which I could do over a period of time.
So by not being at work; reassessing my priorities; working around my health; breaking big tasks down and planning in pleasant things I started doing the things I had stopped doing during my pregnancy. This interrupted the negative cycles I had got caught in, and I started enjoying life a whole lot more.
This method of Behavioural Activation has been adapted from an evidence-based CBT strategy for treating depression. You can find the whole strategy in this simple workbook from the NHS: Getting active
Clarie-fication 