Week 2

Let’s Talk Low Mood

Week 2

• Feedback from last week and weekly tasks• Behavioural activation diary• Looking after yourself• Sleep, exercise and diet• Breathing exercise

Feedback from Weekly Tasks

• How did you find the first session?

• Any comments/questions?

• How was your weekly task setting SMART goals?

• Did you manage to fill in the CBT Hot Cross Bun?

VICIOUS CYCLE OF DEPRESSION

Depression

Hopelessness

Reduced activity

Nothing changes

SymptomsFatigue, ruminationPoor concentration,

lack of motivation, interest etc

More negative viewof self (I am useless,

I am lazy…..), the world & future

Loss of pleasure,achievement &

closeness

Reduced ability to cope with difficulties

It’s easier to….

….‘act ourselves out’ of depression than

‘think ourselves’ out of it

Why Behavioural Activation works

• When we’re depressed we -

– Feel physically unwell– Have depressed thoughts– Change the way we behave

• We behave differently by –

– often stopping doing the important life routines that make us comfortable in our surroundings

– withdrawing from doing pleasurable things that make us feel well such as talking to other people, walking etc

– avoiding important and necessary things such as paying bills.

Group Exercise

In small groups consider things you have stopped doing?

Eg: stopped seeing friends, doing hobbies, interests, exercise & music, going to the cinema etc..

Behavioural Activation Worksheet

• List some routine activities here: ie. Washing up, dusting, vacuuming

• List some pleasurable activities here: ie. Going out with friends/family

• List some necessary activities here: ie. Paying bills, dealing with difficult situations

Put your lists in order of difficulty, mixing up the different routine, pleasurable and necessary activities.

• The most difficult

• Medium difficulty

• The easiest

Behavioural Activation Hierarchy

Behavioural Activation Planning

• Sometimes when you are feeling down it is easy to forget to look after yourself.

• It is important to get a regular sleep pattern

• To eat regularly and healthily

• To keep alcohol consumption to a moderate level

• To exercise regularly

Looking after yourself

Diet• Eat enough carbohydrate to keep your energy levels up.

• Avoid ‘junk’ food and high-calorie, high-fat snacks.

• Eat plenty of vegetables, fruit and pulses.

• Choose low fat varieties of dairy products.

• Include plenty of protein rich food such as fish, chicken and lean meat.

• Drink plenty of water

Alcohol

Guide of how much we can drink without significant risk to health:

Men: 3-4 units per day or less Women: 2-3 units per day or less

One unit is equivalent to half a pint of beer, lager or cider, or a small glass of wine or a single pub measure of spirits

Exercise

Benefits of regular exercise

• Produces ‘feel-good’ chemicals, which helps to reduce anxiety and depression

• Increases confidence and self-esteem• Provides an outlet for tension and frustration• Helps us to relax and sleep better• Helps to prevent physical illness such as

heart disease and osteoporosis• It can provide an opportunity to socialise or

meet new people

Sleep problems are very common and effect people in different ways

There is no ‘right’ amount of sleep as this varies between people and across the life span

Sleep

Some common problems that can affect your sleep

• Worrying about not getting enough sleep

• Medical reasons• Loss and bereavement• Emotional state• Worry about other problems in your

life

Sleep

A few simple rules of how to improve your sleep

• Make sure your bedroom is conducive to sleep: No TV

• Do go to bed and get up at regular time

• Do have a bedtime routine and wind down before bedtime

• Do get up if you are worrying, or are not asleep after 30 min and do something relaxing

• Do exercise regularly, but not in the late evening

Sleep

Lifestyle Tips

• When you complete your behavioural activation sheet try to put in when you wake and go to sleep, when you eat and when you exercise.

• This will help you notice any patterns or where changes might need to be made.

• Square breathing• Breathe in through the nose • Breathe out through the mouth• Breathe from the diaphragm• Count as you breathe

Breathe in for 2 counts

Breathe out for 2 counts

Hold breath for 2 counts

Rest for 2 counts

Relaxation

•Behavioural activation diary

•Looking after yourself

•Sleep, exercise and diet

•Breathing exercise

•Any questions?

Week 2

• Review your SMART goals

• Start/continue working on your first goal

• Complete behavioural activation diary adding sleep, diet and exercise in to your schedule

• Read through your handouts

Weekly Tasks