Psychological support
4. Depression support
Depression removes motivation first and hope second. Behavioural activation puts action before motivation — and it works.
The downward spiral
Feeling low leads to doing less, doing less removes sources of pleasure and achievement, and that deepens the low mood. Illness accelerates this because fatigue and pain genuinely limit activity.
The way out runs backwards along the same path: schedule small activity first, and let mood follow.
Building your activity plan
- 1List activities in two columns: pleasure (enjoyable) and achievement (satisfying).
- 2Rate each for difficulty right now, 1–10.
- 3Pick two rated 3 or below. Not the ones you think you should manage.
- 4Schedule them at specific times this week.
- 5Rate mood before and after each, 1–10.
- 6Review at the end of the week. Add one slightly harder activity.
Handling the arguments your mind makes
- 'There's no point' — do it anyway and rate the result. Prediction versus evidence.
- 'I'll do it when I feel better' — in depression, that order never arrives.
- 'I used to do so much more' — compare to yesterday, not to your pre-illness self.
- 'I'm a burden' — ask the person directly. The answer is almost never the one depression predicts.
Get medical input too
Self-help works best alongside treatment. Ask about talking therapy and, where appropriate, medication — and ask for your physical drivers to be checked: pain, anaemia, thyroid function, vitamin D, sleep apnoea, and the mood effects of steroids and other drugs.
Where to go next
Afya Companion offers education and self-help support. It does not diagnose, treat or replace care from your doctor, nurse, psychologist or dietitian. If something in your health changes, speak to your care team.