What is Depression – and how to deal with it
Why people get depressed
People sink into a depressed mood when their innate physical or emotional needs are not being met and, instead of dealing with this situation, they begin to worry about it — misusing their imagination. All depressed people worry. This increases the amount of dreaming they do, upsetting the balance between slow-wave, recuperative sleep and dream sleep. Consequently they start to develop an imbalance between energy burning dream sleep and refreshing slow-wave sleep. Soon they start to wake up feeling tired and unmotivated. (Depressed and anxious people dream far more intensely than non-depressed people.) This makes them worry even more as they feel that, "something is wrong with me".
Depression is a human vulnerability. Suppose we have a setback or suffer some traumatic event that interferes with getting our innate needs met. This arouses negative expectations in the autonomic nervous system — feelings of frustration, being 'stressed', anxious, angry, guilty etc. — but, instead of taking action to bring the arousal down, which is what the autonomic nervous system is designed to help us do, we start to worry even more, going over and over what's troubling us: 'Why did I lose that job?'…"Why do they treat me like this?"… 'What is going to happen to me?'… 'How am I going to pay my bills?' — on and on creating a mountain of negative expectations. This over-stimulates the autonomic arousal system which is why depression is such a strong emotion.
All strong emotions focus and lock attention and, with depression, 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. All these worries have to be worked through in extended and intense periods of dream activity in REM sleep as the brain attempts to rebalance your arousal levels. This upsets the relationship between slow wave sleep and REM sleep.
Why depressed people are always tired
Extended dreaming is exhausting, not just because it deprives us of restful and restorative slow-wave sleep (that should make up three-quarters of our sleep time), but also because it stimulates the orientation response. This is a vital pathway in the brain that alerts us to interesting things in the day, generating motivation to act, but it can't do this so well if it has been over-used in dream-sleep the previous night. So, the next morning we awake feeling terrible because we haven't really slept, and we find it much harder to get motivated to get up and do anything because the brain mechanism that generates that interest in life is exhausted as well. (See: Why do we dream?)
Exhaustion on waking and lack of motivation are features common to all depressed people. Because our normal sense that life is meaningful comes from the actions we take, when our motivation levels are low, life quickly comes to seem meaningless. 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 truth that people do not develop mental illness when their innate emotional needs are being met in balance. Working with this organising idea they employ techniques from various therapies that have proven effective (interpersonal, cognitive behavioural, solution focused) plus they add the new knowledge you have just read above that shows the importance of vividly creating new expectations in the mind of the patient to 'kick-start' them again.
Because depression, like any strong emotion, fogs our thinking, emotional arousal is reduced to start with. The therapist has a range of ways to do this so that the patient can begin to think more clearly about the situation that is causing them to worry. When the patient has calmed down the therapist will usually explain what depression is and how it is caused. This in itself is hugely therapeutic for most people since no one else is likely to have explained how and why the feelings arose and they were probably imagining that there was something wrong with them. Simultaneously the therapist will do an informal emotional needs audit to find what needs are not being met so they can begin to tackle the worrying that is causing the problems.
Whilst doing this the patient's past achievements, skills and good qualities are also looked for and given as much attention by the therapist as the troublesome history. If it emerges that there is trauma behind the depression, this will be resolved using the HG version of the rewind technique.
The therapist will almost certainly use guided imagery to help the depressed person change their negative expectations into more positive, realistic and concrete ones to help them re-connect with previously enjoyed activities and rehearse in their imagination doing the things they need to be doing. This helps them become more confident about using their own resources to pick up their life and get on with taking the actions that will help them start meeting their emotional needs once more. Learning how to fulfil these innate needs resolves depression and prevents relapses.
Usually much progress is made on the first session but the therapist will always want to see a person who has been deeply depressed a number of times to make sure that progress is maintained and that the patient is taking steps to change their expectations. Postnatal depression is treated very effectively in exactly the same way.
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, as experienced by the vast majority of sufferers for example, is not a biological illness; neither is it 'anger turned inward'; it is not a 'chemical imbalance in the brain' and it is not usefully divided into 'clinical depression', 'post-natal depression' and ordinary 'depression'; and is not, in most cases, hard to come out of.
The term 'endogenous depression' is used to describe a low mood that is purely the result of biological factors, such as a brain disorder or neurological dysfunction affecting serotonin, dopamine or other neurotransmitter. Such specific brain damage is very rare.
Note: Depressed or anxious people should not have forms of counselling or psychotherapy that concentrate on the past and encourage introspection or emotional arousal. Research shows this is often unintentionally harmful.
If you or someone you know suffers from depression, there are many things that people can do to help themselves. Useful information can be found in the best-selling book How to lift depression... fast, by Joe Griffin and Ivan Tyrrell. You can also try Effective anger management - and audiobook available in both CD and MP3 formats.
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