Beat Depression Using Graded Activities

Medical Reviewer

One person’s pathway to recovery from depression is another’s uphill struggle. Whether or not you subscribe to this view, most people find recovery incredibly difficult. A vicious cycle of low moods and depression is common, and it takes time and effort to find your way out of that cycle.

Graded activitiet isn’t possible to think your way out of depression, but it is possible to act your way out of it. "Graded activities" is about establishing a structure to your day and week and then sticking to the plan. The focus, therefore, isn’t about how you feel emotionally or physically -- it’s about doing.

Working in a graded way, at a pace that suits you, tackling the easier things first, is a feature of something called behavioral activation, or more simply, the outside-in method. Despite its simplicity there is good evidence that the technique is effective for mild and moderate-to-severe depression, even outperforming cognitive therapy.


  1. Your first step is to identify as many routine, necessary and previously enjoyable activities as you can.

  2. Next, make a hierarchy. That is, give each of the activities a rating based on how difficult you feel it might be to accomplish. Don’t worry too much about accuracy; the system is entirely flexible.

  1. Develop a record. The example I’ve provided below comes from the PsychologyTools  website, where you’ll find a variety of free downloadable resources.


Click to download your own activity sheet

Big tasks should be broken down into smaller steps. So if cooking a meal is important to you, break it into steps of preparation that can be done in advance.

Activities to action

Start small. You might be tempted to do more than you’ve planned. Resist that temptation. Just a couple of activities in your first week may be all you can reasonably achieve. Doing very little can make you feel as if you’ve achieved very little. But that's negative thinking: don’t allow it to hijack the process.

Always start with the less difficult activities first. Keep an eye on your list, however. If there are consequences for not doing something (e.g., paying bills), you should prioritize those activities.** Key points**

It’s important to remember that your mood may not change at first. This is not a quick fix, and neither is that the aim. The aim is simply to start doing things again and gradually building up to familiar routines. You will find that your mood begins to lift over time. It takes time to break out of the cycle of depression, so allow yourself that time.

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Dr. Jerry Kennard is a Chartered Psychologist and Associate Fellow of the British Psychological Society. Jerry's clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of