If you are depressed, stressed, or grieving, the term “pleasurable activities” may seem oxymoronic – no activity possibly could bring pleasure. Maybe you cannot even remember what gives you pleasure – or what once gave you pleasure no longer does.
You may also think that pleasure is simply petty. If you feel so bad that you think of suicide, or if you recently lost a loved one to suicide, then how could a bubble bath or a walk in the park possibly be relevant?
Perhaps, even, you might feel so down on yourself that you think you do not deserve to feel anything good.
Whatever it is you tell yourself, I hope you will hear me out. “Pleasurable activities” is the clinical term for things that are fun, feel good, or at least distract you from your pain. Two examples for adults are sex and food. Research shows that engaging in such activities actually inhibits stress responses in the brain.
Yet there is a vicious cycle when it comes to depression and pleasurable activities. Pleasurable activities may help someone to feel better, but a hallmark symptom of depression is a loss of interest in once pleasurable activities. So how do you rediscover pleasure in the face of depression?
Cognitive behavior therapy (CBT) uses a technique called behavioral activation. The overriding principle of behavioral activation is that a person need not wait until they feel better to start doing pleasurable things. Instead, the act of doing pleasurable things can help a person to feel better.
Behavioral activation involves monitoring daily activities and building up toward a specific goals in small steps. One example is exercise. Exercise is fun for many people, and it produces physiological effects that reduce stress and relieve depression. But to tell somebody with depression to exercise can be like telling someone with a broken leg to run around the block.
With behavioral activation, you would break down everything you need to do to exercise in small steps. These might include getting walking shoes out of the closet, getting the outfit together for walking around the block, putting everything on, going outside, and – here’s where the activation piece comes in – just walking for a few minutes. Then you can go back to the sofa or bed without guilt, because your goal was only to walk down the street and back. Gradually, a little bit more each day, you would work your way up to a 15-minute walk.
Healing Moment to Moment
Pleasurable activities, distractions, healthy escapes – whatever you want to call them, they are important components of cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT), two therapies that research has shown can help reduce suicide attempts in suicidal individuals.
It is true that sitting by a fire, petting a cat, working a crossword puzzle – whatever can give you pleasure or, at least, occupy your mind or distract you – cannot heal the tremendous pain or anxiety you experience. The momentary relief they bring cannot last a lifetime. But it can last a moment, and that is what healing involves – one moment after another, after another, and so on.
Ideas for What to Do
What can you do to keep yourself alive another moment, another hour, another day – long enough for this crisis to pass, or for you to get help, or for you to discover other ways to cope that do not require killing yourself?
If you have trouble coming up with ideas, answering these questions might give you some ideas:
What did you enjoy doing as a child? Could you do that now?
What would you enjoy doing if you did not have to worry about whether you are good at it, whether you are too old, whether others are watching, etc.?
What did you used to enjoy doing?
What have you always wanted to do?
What is something altogether new that you could try?
What is something simple that you could do for relief, such as take a nap, take a bath, or listen to your favorite music?
If you have trouble coming up with ideas, there are actually long lists of possibilities available online. I just looked up “pleasurable activities list” (in quotation marks) on Google, and 27,400 results came up. Here are a couple good ones among many:
© Copyright 2013 Stacey Freedenthal, PhD, LCSW, All rights Reserved. Written For: Speaking of Suicide
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