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 – 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 (which 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 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 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, 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 truth that people do not develop mental illness when their innate emotional needs are being met, healthily and 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' their interest in life again.
Because depression, like any strong emotion, fogs our thinking, the emotional arousal must be lowered before anything further can be achieved. The therapist has a range of ways to do this so that the depressed person can begin to think more clearly about the situation that is causing them to worry. When the person has calmed down 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 no one else is likely to have explained how and why the feelings arose and they were probably imagining that there was something deeply wrong with them. The therapist will also carry out an informal emotional needs audit to find what needs are not being met, so 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 the depressed person change their negative expectations into more positive, realistic and concrete ones, which will help them re-connect with previously enjoyed activities. In guided imagery, they get to rehearse in their imagination doing the things they need to be doing to make their lives work again. This helps them become more confident about using their own resources to take the actions necessary for starting to meet their emotional needs once more. Learning how to fulfil these innate needs resolves depression and provides the blueprint for quickly handling any relapses.
Usually much progress is made in 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 continuing to take steps to change their expectations. Most cases of postnatal depression can be 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' may be 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 neurotransmitters. Such specific brain damage is very rare.
There can be a physical element to common depression, however. It is becoming increasingly apparent that depression may arise as a result of chronic inflammation in the body – chronic inflammation is caused by chronic stress, which brings us back to needs not being adequately met or difficulties/setbacks (physical or mental) not being addressed in ways that can enable needs to be met.
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
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‘JUST WHAT WE NEED’ is a therapeutic group approach using a Human Givens framework. Dates for the next course are available.