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What is depression – and how to deal with it

Why people get depressed

Depression is a very human vulnerability. People can sink into a depressed mood when their innate physical or emotional needs are not being adequately met, perhaps because of some setback or traumatic event, and they begin to worry about what has happened, or what might happen, and how they will cope.

All depressed people worry. 'Why did I lose that job?' … ‘Why do people treat me like this?’ …  ‘What will I do if my partner leaves me?’ … ‘What is going to happen to me?’ … 'How am I going to pay my bills?’ … ‘Why don’t things work out for me?’ Feelings of frustration, anxiety, anger or guilt can become overwhelming but, instead of taking action to deal with the situation, which would bring the uncomfortable emotional arousal down, once we are in this situation we feel exhausted and powerless and worry even more – creating a mountain of negative expectations. The more we expect things to be bad, the more stressed we feel.

All strong emotions focus and lock our attention and, with depression, our attention stays focused on all the bad things that seem to be happening to us, whether real or illusory.

Every little thing we worry about and do not resolve in the day is translated into a bad dream the next night. So worrying increases the amount of dreaming that we do – the majority of depressed and anxious people dream far more intensely than non-depressed people. All the worries have to be worked through in extended and intense periods of dream activity, as the brain attempts to rebalance arousal levels. This upsets the balance between refreshing slow-wave, recuperative sleep and energy-burning dream sleep (known as REM sleep). When that happens, we soon start to wake up feeling tired and unmotivated. This makes us worry even more that ‘something is wrong with me’, and the cycle continues.

Why depressed people are always tired

Extended dreaming is exhausting, not just because it deprives us of restful and restorative slow-wave sleep, but also because it stimulates the 'orientation response'. This is a vital pathway in the brain which, during the day, alerts us to changes in our environment that might be relevant for us, drawing our attention, and, when necessary, generating motivation to act. But it can't do this as effectively if it has been over-used in dream-sleep the previous night. So, the next morning we awake feeling terrible because we haven't had refreshing sleep, and we find it much harder to motivate ourselves to get up and do anything because the brain mechanism that generates interest in life is exhausted as well. (See: Why do we dream?)

Exhaustion on waking and lack of motivation are features common to most depressed people. Because our normal sense that life is meaningful comes from the actions we take, life quickly comes to seem meaningless when our motivation levels are low. The natural delight we take in being alive and doing things drains away.

How does human givens therapy relieve depression?

Human givens therapists work with the fundamental understanding that people do not develop mental illness when their innate emotional needs are being met, healthily and in balance. Working with this powerful organising idea they employ therapeutic techniques long demonstrated as effective (interpersonal, cognitive behavioural, solution focused, imaginal) plus they make practical use of what you have just read above, putting emphasis on creating new expectations for the client that will 'kick-start' their interest in life again.

Because depression, like any strong emotion, fogs our thinking, the emotional arousal must be lowered before anything valuable can be achieved. Human givens therapists have a range of ways to guide the depressed person to begin to think more clearly about the situation that is causing them to worry. Once the client is calm, the therapist will be able to explain what depression is and how it is caused. This in itself is hugely therapeutic for most people, since they were probably imagining that there was something deeply wrong with them. The therapist may also carry out an informal emotional needs audit to find what emotional needs are not being met in a client's life, so that they can begin to address the circumstances that are causing the worrying that is, in turn, causing the problems.

Past achievements, skills and good qualities are actively looked for and given as much attention by the therapist as the troublesome history. If it emerges that there is trauma underlying the depression, this will be resolved using the HG version of the rewind technique.

The therapist will almost certainly use guided imagery to help a depressed person change their negative expectations into more positive, realistic and concrete ones, which, in turn, will help them re-connect with previously enjoyed activities. In guided imagery, they are guided to rehearse in their imagination keenly doing the things that will make their lives work again. This helps them become more confident about using their own resources to meet their emotional needs once more. Learning how to fulfil their innate needs resolves depression and provides the blueprint for quickly handling any relapses.

It is expected that significant progress will be made in the very first session. Some people only need one or two sessions in all, many just a handful, while others may need more. In all cases, the therapist will want to see clients only as many times as is necessary to make sure that progress is maintained and that they are continuing to take steps to change their expectations. Most cases of postnatal depression can be treated very effectively in exactly the same way.

Human givens (HG) therapy is effective on its own but can also be used alongside drug treatment. Read a case-study which shows how a human givens therapist dealt with depression.

Depression: some distortions of fact

To be deeply depressed is just about the most awful feeling we can experience, apart from sheer terror. It can disable anyone. But the topic is surrounded by false ideas: Depression, is not caused by a chemical imbalance in the brain, and this is increasingly recognised among professionals [1]. It is perfectly possible, if people receive the right help, to overcome depression without medication.

There can, however, be a physical element to common depression. It is becoming increasingly apparent that chronic inflammation in the body may contribut to depression. Chronic inflammation is caused by chronic stress, and stress is what we suffer when needs are not being adequately met or difficulties/setbacks (physical or mental) are not being addressed in ways that can put us back on track.

Note: Depressed or anxious people should be cautious if they are receiving counselling or psychotherapy that is making them feel worse, due to an excessive focus on the past or by encouraging excessive introspection or emotional arousal. As the above explains, this can deepen depression.

Self help

There are many things that you can do to help yourself, if you suffer from depression, or to help someone else who is suffering from depression. Useful information can be found in the best-selling book How to lift depression... fast, by Joe Griffin and Ivan Tyrrell.

You may also find the following audio MP3 downloads useful: Understanding and lifting depression without drugs and  Effective anger management.


Learn about depression, and gain essential skills and psychotherapeutic techniques with Human Givens College

How to Break the Cycle of Depression online course

How to Lift Depression – the practical skills you need  1-day workshop


1. Moncrieff, J, Cooper, R E, Stockmann, T et al (2022). The serotonin theory of depression: a systematic umbrella review of the evidence. Molecular Psychiatry, doi: 10.1038/s41380-022-01661-0
Last reviewed: January 2024

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