1. Week 2 Let’s Talk Low Mood

2. Week 2 Feedback from last week and weekly tasks Behavioural activation diary Looking after yourself Sleep, exercise and diet Breathing exercise

3. 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?

4. VICIOUS CYCLE OF DEPRESSION Symptoms Fatigue, rumination Poor concentration, lack of motivation, interest etc More negative view of self (I am useless, I am lazy…..), the world & future Loss of pleasure, achievement & closeness Reduced ability to cope with difficulties

5. It’s easier to…. ….‘act ourselves out’ of depression than ‘think ourselves’ out of it

6. 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.

7. 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..

8. 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

9. 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

10. Behavioural Activation Planning

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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.

19. 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

20. Behavioural activation diary Looking after yourself Sleep, exercise and diet Breathing exercise Any questions? Week 2

21. 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