As a psychiatrist, I like behavioral activation because it is practical and concrete. It is not about waiting until you magically feel better. Instead, it focuses on gently changing what you do, even when your mood is low, and trusting that your emotions will gradually follow your actions. It’s about small, intentional steps, things you can do rather than things you feel like doing.
“You do not have to wait until you feel like doing something before you start to do it.”
That one sentence captures the heart of behavioral activation.
What is a Behavioral Activity?
A behavioral activity is any intentional action that nudges you closer to your values, goals, or health, especially when you do not feel like doing it in the moment.
It might be:
- Physical:
- Going for a short walk
- Getting out of bed and showering
- Practical:
- Paying a bill
- Doing the dishes
- Social:
- Texting a friend you have not spoken to in months
- Health-related:
- Eating a planned meal
- Attending a medical appointment
- Interpersonal:
- Having a difficult, but necessary, conversation
The key is that it is chosen on purpose, not just driven by your momentary mood.
What is an Example of Behavioral Activation?
One classic example I often give involves depression and sleep schedule.
Imagine someone who is very depressed, sleeping until 1 p.m. every day, then feeling guilty for “sleeping the day away.” Instead of saying, “Just get up at 8 a.m.,” I might start like this:
“I know you can set your alarm to 12:55. I know you can wake up at 12:55, and you will be okay. So 12:55 it is.”
Once that is consistent, we gradually move the wake time earlier, in small, manageable steps. This might not feel dramatic, but over weeks it shifts:
- Sleep
- Sunlight exposure
- Sense of control
- Opportunities to be active and engaged
Another simple example is walking:
“A common one is exercise, and you do not have to run a marathon. It can be, ‘I am going to go for a walk and get my heart rate up for five minutes, and I am exposed to the sun.’”
That five-minute walk is a behavioral activity. It breaks the pattern of staying in bed, increases vitamin D exposure, and gives a small sense of accomplishment.
What Does Behavioral Activation Look Like Day to Day?
In real life, behavioral activation often looks like small decisions repeated over time, not giant heroic acts.
Some examples from my work:
- Getting out of bed, bathing, and putting on clothes that are not pajamas
- Sitting on the front porch for a few minutes each day
- Sending a “happy holidays” text to a sibling with whom you have a tension-filled relationship
- Doing the dishes for five minutes so future you has a clean kitchen
Patients often discover:
“I realize that five minutes is good, but I can do another five minutes.”
That is exactly what we want. You do something small, realize it was doable, and that creates momentum.
Which Disorders is Behavioral Activation Typically Used For?
Behavioral activation has a strong evidence base for depressive disorders, and that is where it is most commonly used. When someone is depressed, it is very easy to fall into a pattern of:
- Staying home
- Sleeping or watching television all day
- Avoiding social contact
- Losing a sense of purpose and pleasure
Behavioral activation helps break that cycle.
I also use it for:
- Anxiety Disorders
- For example, actually doing the work presentation you are afraid of, or driving on the freeway you have been avoiding.
- Eating Disorders and Weight-Related Issues
- Eating planned meals even when uncomfortable, or exercising for health rather than appearance alone.
- Substance Use
- Reducing drinking in small steps, substituting more helpful behaviors, and tolerating cravings.
- Interpersonal Difficulties
- Making small, proactive gestures to repair or maintain relationships, instead of withdrawing completely.
In short, if there is a gap between “what I know would help me” and “what I feel like doing,” behavioral activation probably has a role.
Ready to Take the Next Step
Behavioral activation is about taking small, intentional actions that move you toward your goals, values, and well-being, even when your mood is low. Over time, these consistent steps can help break patterns of avoidance, increase motivation, and improve overall mental health. If you are ready to start making meaningful changes, schedule an appointment today.
Author: Dr. Hong Yin
Hong Yin, MD, has been a practicing medical professional in the Milwaukee community since 2012. She understands that your health and wellness concerns extend beyond routine medical care. She’s a highly trained, board-certified psychiatrist who provides an array of comprehensive services and procedures to help people overcome mental health problems.