This document discusses depression and behavioral activation therapy as a treatment approach. It defines depression as a "brain state" with physical, emotional, and thinking changes that is different from normal sadness. Behavioral activation therapy acts as "jumper cables" for the depressed brain by having patients engage in three types of activities on a daily schedule - connection with supportive people, accomplishment of small tasks, and enjoyable activities. Engaging in these prescribed activities can help combat depression symptoms faster than antidepressant medication alone by getting the depressed brain active again. The final section provides a "TLC recipe" with lifestyle recommendations to support treatment.

1. Quick-Start Skills
ACTIVATING BEHAVIOR TO BATTLE DEPRESSION

2. Depression
• How is it different from sadness?
• Sadness is in response to a situation, it comes in like a wave, gets
intense and then passes
• Depression is a shut down response in the body, a response to
hopelessness
• Depression is a “brain state” with physical, emotional and thinking
changes, it is a treatable condition, not a permanent illness
• This “brain state” has a natural protective function, like anxiety

3. A Bunny Tale:

4. Depression Symptoms:
1. Loss of interest in doing things you normally like to do
2. Feeling down, or hopeless
3. Changes in sleep: too much or too little
4. Tired, low energy
5. Changes in appetite: too much or too little
6. Feeling like a failure, that you have let others down
7. Trouble concentrating
8. Physical slowness or agitation
9. Thoughts that you would be better off dead

5. Why depression is a disease of civilization:
• Video Stephen Llardi
• https://www.youtube.com/watch?v=drv3BP0Fdi8

6. So What do we do?
• Behavioral Activation Therapy:
-acts as a set of “jumper cables” to the depressed
brain
• Helps us live effectively: defined as reacting to how
the situation is, and not how we wish it was
• Depression reverses the motivation process, normal
we can wait until we feel like doing something
before we do it… no so in depression.

7. Depression and Fatigue:
• Tiredness and fatigue of depression can be misleading
• When we are not depressed, tiredness means we need to rest
• When depressed, resting can increase tiredness
• “The fatigue of depression is not normal tiredness, it calls
for increased activity instead of rest, even if only for a
short while”

8. • “We've had a lot of trouble with Western mental health workers…They would
do this bizarre thing. They didn't take people out in the sunshine, where you
begin to feel better…They didn't involve the whole community…Instead what
they did was they took people one at a time into dingy little rooms and had
them talk for an hour about bad things that had happened to them.”
• Rwandan man (Solomon, 2010)

9. Three Magical Activities and a Calendar:
•Three magical activities to combat
depression:
• Connection: with people who make us feel
good
• Accomplishment: break it down, if you can’t
get started, the first step is too big
• Enjoyment: do something that gives you fun,
enjoyment or pleasure

10. Three lists
• Make three lists of connection, accomplishment and enjoyment activities,
include:
1. Things you used to do and have stopped doing
2. Things you would like to try
Pick things from category #1 to start with, it’s easier to add things back in than
create new activities

11. Schedule?
• Yes, schedule. Pick a planning time for the next day,
elicit a support person to help you brainstorm
• The depressed brain is not good at “thinking on the fly”
• Take a “dose” of prescribed activity daily
• It will feel like work at first, and then will get easier
• Often works faster than anti-depressant meds

12. Final Thoughts: TLC Recipe
• Catch and interrupt Rumination, choose acceptance and action instead
• Schedule the three magical activities daily
• 7-8 hours of sleep (stay up later if you keep waking up, take your mind on an
image adventure if it won’t settle, to the mall, grocery store, neighborhood etc)
• Some physical activity x3 per week, 30-40 mins per session
• 30 minutes of bright light per day
• Omega 3 Fatty acids 1000 mg EPA
Website: Therapeutic Lifestyle Changes to battle depression:
http://tlc.ku.edu