Depression is one of the most common mental health concerns.


Clinical depression is defined by depressed mood, sadness, hopelessness, and despair.  Associated symptoms include change in appetite and sleep, social withdrawal, loss of pleasure in activities, and sometimes suicidal thoughts. Occasional blues or sadness for a few days is normal.  Severe symptoms for two weeks or more that interfere with daily functioning should be evaluated.

Cognitive Behavioral Therapy (CBT) has several therapies to help depression.


Behavioral activation (BA) is the first line treatment. Depression can be triggered by a challenging event in the sufferers’ life, such as loss of a job or relationship. To manage negative emotions, people withdraw from life activities. The decrease in activity strengthens the depressive state by removing experiences that produce positive emotions. The negative feedback cycle is reinforced.


Understanding our values


Interrupting the cycle is essential to heal from depression. BA counters isolation and withdrawal by scheduling activities that improves mood. Activities that are pleasurable and meaningful can break the depressive cycle. Start with activities that are valued or meaningful. Evaluate the elements in life you value. Here are common values:










Advocacy/working for change


Being of service to others

Steps to Take to Implement Behavioral Activation


  1. Rate each value on a scale from 0 (not important) to 10 (very important).  Next, pick the three values that are most important.  Jot down 2 – 3 activities that will provide an opportunity to experience this value.  Commit to one activity to be completed this week.  Have a back-up in case the first is outside of your control.
  2. Do necessary research to engage in the activity several days in advance.  Schedule the activity in your day planner and set a smart phone reminder.
  3. It’s normal to be hesitant before the planned activity.  Be your own coach to keep to your commitment. Remind yourself that scheduling meaningful activity reduces isolation to break the negative depression cycle.
  4. Rate the strength of your depression and hopelessness on a 0 (no depression) – 10 (very strong depression) scale before the activity.  Throw yourself into the activity with an open mind.
  5. After the activity, re-rate the strength of your depression and hopelessness.  A reduction in depression will occur over time with continued behavior activation.  Don’t be discouraged. Stay with it.  Be sure to incorporate pleasurable activities.

Contact Pacific CBT to schedule a consultation with one of the therapists specially trained in CBT.  We can help you with depression by using the strategies discussed in this blog.

John R. Montopoli, LMFT, LPCC is a licensed psychotherapist and certified by the Academy of Cognitive Therapy.  He is the founder of Pacific CBT.  John has many years of experience using CBT to help clients with depression, anxiety, work stress, relationship challenges, and life transition concerns.  You can reach him by emailing or (415) 689-4131.

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