Behavioral Activation Therapy in Milwaukee

When people come to see me in Milwaukee, and we talk about behavioral activation therapy, I usually start with a very simple idea. You do not have to wait until you feel better before you start doing things.

In fact, I often tell patients, “You can catalyze your recovery by starting the process.” If you wait until you feel less depressed before you take action, you can end up in a vicious cycle. Low mood, less activity, loss of purpose and pleasure, lower mood. Behavioral activation is about breaking that cycle.

What is Behavioral Activation Therapy?

Behavioral activation therapy is a core skill within cognitive behavioral therapy, and it can also be used as a standalone treatment. I commonly use behavioral activation for depression and anxiety, but it has applications in other areas.

At its heart, behavioral activation focuses on the relationship between your activity and your mood. It is what some people call an “outside in” approach. Instead of waiting to feel motivated, we start with action, and let the improved mood follow.

I often put it this way: “Action precedes motivation.” It is like physics. The hardest part is the start, but once you are going, it is easier to keep going. You are breaking that seal of inertia.

Behavioral Activation Therapy in Milwaukee: How I Approach It

When I work with patients on behavioral activation therapy in Milwaukee, I am not asking anyone to change their life overnight. In fact, I prefer the opposite.

I like to start small and build up. If we set only big goals, we run the risk of expecting too much of ourselves and then feeling disappointed. I would rather see “little victories that progressively get bigger.”

For example, instead of saying “I will run for 30 minutes every day,” we might say, “I will walk for 5 minutes and get my heart rate up a little.” You get out in the sun, you get a bit more vitamin D, and you feel better that you did something. Very often, patients come back and say, “I realized five minutes is good, but I can do another five minutes,” and suddenly it has been 15 minutes and the whole morning feels different.

Pleasure Activities Versus Mastery Activities

In behavioral activation, we talk about different types of activities.

1. Pleasure activities are straightforward. They are primarily for enjoyment.

For example:

• Going to a movie with a friend
• Having a nice meal out
• Watching a favorite show

I see these as “lower investment, lower return” activities. They feel good in the moment, which is valuable, but the benefit is mostly short-term. Dinner ends, and that is it.

2. Mastery activities are different. They may not feel good immediately, but they provide a sense of accomplishment and improve your skill set over time.

Examples include:

• Sending a difficult work email
• Doing the dishes
• Paying a bill
• Practicing a new skill
• Having a hard but important conversation

These activities pay your future self back. I sometimes say, “It is kind of like investments. You have to wait for the return to come, but it is a more sizable return. Something you will thank your current self for.”

The Five-Minute Rule of Behavioral Activation

A question I often hear is, “What is the five-minute rule of behavioral activation?” The five-minute rule is a practical way to make tasks feel less daunting. Instead of committing to a full workout, full cleaning session, or a long social event, you commit to just five minutes.

The goal is to make starting as easy as possible. You tell yourself, “I can do anything for five minutes.” Once you start, most people notice what I see all the time:

“That happens more often than not. People find that they can do more than five minutes. Maybe it is six minutes, maybe it is an hour, but a lot of people say, ‘It was not as bad as I thought it was going to be.’”

Over time, this teaches your brain that anticipation is often worse than reality. You begin to question that automatic “I cannot handle this” story.

How I Help People Get Started

Many patients tell me, “I do not feel like doing anything.” That is normal when you are depressed or anxious. My job is to help you find something you can do.

A session might involve:

• Brainstorming low-energy pleasure activities: Things you can do even when your energy is low, like sitting on the porch, listening to music, or texting a friend.
• Brainstorming mastery activities: Higher investment tasks, like sorting one drawer, sending one email, or getting up 5 minutes earlier.
• Creating a hierarchy: We list activities from “least daunting” to “most daunting.” Then we start at the very bottom.

Sometimes people say, “I cannot do any of these.” In that case, I break things down more. I often compare it to physical therapy for someone who has been immobilized. You do not start with running. You start with sitting up, then moving your legs, then standing, then walking on one foot.

The point is to find one doable thing and build from there.

Structure, Schedule, and Behavioral Activation for Depression

Structure is very important when I use behavioral activation for depression.

We might work on:

• A consistent wake time, even if it is initially quite late
• Gradually moving that wake time earlier
• Building a morning routine
• Scheduling specific activities into a calendar

For example, if someone is used to sleeping until 1:00 p.m., I might say, “I know you can set your alarm to 12:55. I know you can wake up at 12:55, and you will be okay.” We stick with 12:55 until it is consistent, then 12:50, and so on. The goal is to normalize the circadian rhythm and increase sunlight exposure. Once the routine is in place, we sprinkle in small activities that gradually build up.

We also look at behavior and mood across the day. Sometimes I use simple diary cards, where you might rate your mood from 0 to 10 and jot down what you were doing. You might notice that scrolling through social media is a 3 out of 10, but walking the dog is a 5 out of 10. That is useful information.

What Can Behavioral Activation Help With?

I most often use behavioral activation for depressive disorders, where it is very easy to fall into a rut of staying home, watching TV, and avoiding social contact. The longer that pattern continues, the harder it becomes to reach out to people again.

Behavioral activation is also very useful for:

• Anxiety disorders: Presenting at work, driving, or facing a feared situation often feels unbearable. Behavioral activation helps you do the thing anyway, gain mastery, and practice distress tolerance.
• Substance use and alcohol reduction: Gradual changes such as reducing the number of drinks per day, then per week, and tracking the pattern over time.
• Weight loss and medical goals: For example, someone with diabetes who wants to reach a healthier weight. Healthy, sustained weight loss is “painfully slow,” but it is a perfect illustration of “just keep going.”
• Eating disorders: Behavioral activation can be part of treatment for eating disorders, such as committing to sit through a planned meal, even when it feels uncomfortable, and riding out the wave of distress.
• Relationships and interpersonal patterns: Something as simple as sending a sibling a “Happy holidays” text, even if the relationship is strained, is a behavioral activation step. As I often say, “We do not have to be best friends, but we can offer a kind gesture.”

Common Barriers and How We Handle Setbacks

The hardest part of behavioral activation is often distress tolerance. When you start exercising again, your body feels tired and achy. When you face anxiety, the discomfort spikes. When you start changing eating patterns, you feel hungry or preoccupied with weight.

People sometimes want to master everything right away. When that does not happen, it is easy to think, “This is never going to work,” and give up. I try to remind people that meaningful change usually happens “super incrementally.”

Setbacks are expected. I often compare progress to the stock market. There will be bad days, bad weeks, or even bad months, but what matters is the overall trend. If you were having five drinks a day and now you are at three drinks a day, then three per week, you are still moving in the right direction, even if some days are rough.

One thing I tell patients is, “If you were not here, you would probably still be at the same starting point. So if you look at the cumulative effects, you have made progress.”

Homework and Real-Life Practice

Homework is a big part of behavioral activation therapy. “Homework is very valuable in behavioral activation. I highly encourage it.” That does not mean you need a mountain of tasks. It means that something from our sessions gets carried into your daily life consistently. Ninety-nine point nine percent of your life is outside a therapy session. That is where we want to see the change.

Any small, sustained behavior change counts as progress. Even if you fall off track, the fact that you get “back on the horse” is part of the work.

If you are in Milwaukee and wondering whether behavioural activation for depression or anxiety might help, the starting point is often very modest. One alarm set a little earlier, one five-minute walk, one text to a friend. Over time, those small steps can create a very different life.

Behavioral Activation Therapy Near You in Milwaukee

If you’re seeking support for depression, behavioral activation can help you regain motivation and reconnect with meaningful activities in your life. At New Frontiers, our compassionate team offers behavioral activation therapy in Milwaukee, Wisconsin, designed to guide you through practical, evidence-based strategies for overcoming low mood. Whether you’re interested in behavioral activation for depression or want to explore personalized approaches to improve your emotional well-being, we’re here to provide support every step of the way. Contact us today to schedule a session and take the first step toward a brighter, more engaged life.