DBT Skills for Depression

Depression looks like a lot of different things for a lot of different people. Sometimes it can look like staying in bed and not showering for a week.  Other times, depression manifests as constant and intense self-criticism.  And other times it looks like being incredibly irritable.  Sometimes it’s all of the above.  

Whatever form depression takes for you, having suicidal thoughts and urges should be a red flag to schedule an appointment with a therapist.  DBT, as a treatment, was designed to help people develop a life worth living in hopes of reducing suicidal behavior.  Below is a brief list of skills that may be useful for people who are experiencing feelings or symptoms of depression.  


The PLEASE skill helps people take care of their minds by taking care of their bodies.  One of the many acronyms in DBT, PLEASE stands for Physical illness, balance Eating, Avoid mood-altering substances, balance Sleep, and get Exercise.  Using Wisemind to address each of these areas will help increase emotional resources and allow you to manage depression symptoms.

deflated balloon

 Opposite Action

Opposite action is a very challenging and useful skill.  On a fundamental level, opposite action hacks into the body’s ability to alter emotions by Changing behaviors. So if you’re feeling sad, first identify the action urge associated with that feeling. often sadness directs us to withdraw and isolate ourselves, so the opposite of that will be to get active.  Doing some physical movements such as stretching or walking outside for 5 minutes changes your body’s chemistry and signals to your body to reduce the feeling of sadness.  

Mindfully Participate

Mindful participation directions to fully throw ourselves into the present experience. So if you’re washing dishes, wash dishes. If you’re crying, then cry.  If you’re reading or watching television, then put your whole being into those activities.  Often, depression can cause our minds to become stuck in other times and places such as thinking about what others think about us or dreading the next day.   When we mindfully participate in the present moment, we’re able to experience life fully and, by doing so, gain resources from pleasant activities and let go of worries about the past or future.

Accumulating Pleasant Emotions 

Because depression makes engaging in activities more difficult and less enjoyable, often people will stop participating in tasks they usually find fun and engaging.  When this happens, they lose the skills they need to engage in those activities. For example, if a person doesn’t play piano because they are feeling depressed, they will become less skilled at the piano over time.  A vicious cycle forms because they enjoy playing piano less because they’re not as skilled and then they become less skilled because they are not playing piano.  The way out of this vicious cycle is to engage in behaviors that you usually would find enjoyable and engaging, even if they do not immediately provide the same amount of satisfaction and pleasure as they usually would.  The thing that makes this skill so difficult and fulfilling is being mindful as you engage in these pleasant experiences and being unmindful of worries such 

as when the pleasant experience will end, whether you deserve the pleasant experience, and how “good” you are at whatever you’re doing.  

girl depressed

Mindfulness of Current Emotions

I have learned that mindfulness of current emotions is the keystone skill of DBT.  Essentially, this skill is what we’re all shooting for  as emotional people:  finding a way to relate to our emotions in a compassionate way. When a person is in t

he trenches of depression, it feels as if everything is darker, heavier, and more difficult.  To be mindful of these emotions, we need to avoid pushing away the emotions or become overwhelmed by them.  Become aware of the bodily sensations related to these emotions and remember that you are not your emotion.  When you are able to find  a respectful distance from these emotions, consider imagining them as a friend or loved one who is going through an extremely difficult time and could use some kind words.

This is a brief summary of a few skills that people might find helpful when wrestling with depression.  As a person who continues to practice the skills, I have found that I am constantly learning more about how to use them. If you think these skills would be helpful, consider scheduling an appointment with a CCDBT therapist to learn more about them.  

Samantha Mathews, PsyD (she/her) is a licensed psychologist who specializes in dialectical behavior therapy.  Samantha works with her clients to develop close relationships with themselves and others.  Samantha believes compassionately connecting with emotions is central to building a life worth living.  Click here to learn more about Samantha’s experience and therapeutic style.