Navigating Depression and Anxiety with Acceptance and Commitment Therapy

Understanding ACT

Acceptance and Commitment Therapy (ACT) is a powerful, evidence-based approach designed to help individuals embrace their thoughts and feelings instead of fighting against them. Developed in the 1980s by psychologist Steven Hayes, ACT encourages psychological flexibility and acceptance, helping people live meaningful lives even in the face of difficulties like depression and anxiety. ACT is centered around six core processes, which we’ll explore below.

Six Core Processes of ACT

1. Acceptance - Acceptance is about allowing thoughts, feelings, and sensations to be present without attempting to change, avoid, or get rid of them. This can be particularly helpful when dealing with anxiety and depression, where avoidance often exacerbates symptoms.
2. Cognitive Defusion - Cognitive defusion involves changing the way we interact with our thoughts. Instead of being controlled by them, ACT helps us see thoughts as simply words or images. Techniques like labeling thoughts or saying them aloud in silly voices can help create distance and reduce their impact. Reminding oneself that they don't need to believe or hook themselves onto every thought that comes up can help too. We are more than are thoughts and feelings as these can change and pass like leaves on a stream or clouds in the sky. We ourselves get to choose which ones we want to hold on to and pursue -- not the other way around. Visualizing ourselves unhook or distance ourselves from our thoughts can also be helpful. 
3. Being Present - Mindfulness, or being present, is a core tenet of ACT. It involves focusing on the here and now, rather than being caught up in past regrets or future worries. This can be particularly grounding for those experiencing depression and anxiety. Using 5 senses activity, focus on deep breathing, focus on watching an object, or paying attention to body sensations through progressive relaxation, or walking or eating mindfully are just a few examples of mindfulness activities.  
4. Self-as-Context - ACT encourages seeing oneself as separate from thoughts and feelings. By recognizing that we are not our thoughts, we can reduce the power they hold over us. This can be achieved through exercises that promote self-observation and perspective-taking. Learning to observe thoughts without judgement and to unhook from stressful or negative thoughts can be helpful.  
5. Values Clarification - Identifying and clarifying values is essential in ACT. Values are the compass guiding us toward a meaningful life. For example, an oil-painting artist might place a high value on creativity, beauty, painted, colorful artistic expression, communicating ideas and feelings visually; whereas a teacher may place a higher value on education, mentoring youth, knowledge and transfer of knowledge; similarly, a dog trainer may place higher value on the canine-human bond, incorporating dogs in families, work, or other environments, valuing lives of all animals in general, etc. By understanding what truly matters as most valuable and important, individuals can make decisions and take actions that align with their core values - even with depression and/or anxiety.
6. Committed Action - Once values are clarified, committed action involves taking concrete steps toward living according to those values that are most meaningful and important. Despite feelings of depression or anxiety, individuals can take steps to do things to live a more meaningful, purposeful life, which can be motivating and bring hope. When their values and actions are in alignment, individuals often feel a little better as they are learning ways to follow a passion. This often means setting goals and making behavioral changes that reflect what is truly important, fostering a sense of purpose and direction.

Practical ACT Tools for Depression and Anxiety

• Mindful Breathing: Practice deep, mindful breaths to ground yourself in the present moment.
• Thought Labeling: When anxious or depressive thoughts arise, label them (e.g., “I’m having the thought that…”).
• Values Worksheet: Identify core values using a worksheet, and reflect on how to live in alignment with those values.
• Defusion Exercises: Use techniques like visualizing thoughts on leaves floating down a stream or clouds floating by in the sky to create distance from them.

Conclusion

ACT provides a comprehensive framework for addressing depression and anxiety by fostering acceptance, mindfulness, and committed action. By embracing thoughts and feelings rather than fighting them, individuals can build a more resilient, values-driven life.