What is depression?

by Ezra Hewing | 22 Mar 2023

Depression is more than just sadness. When people experience depression, they wake up in the morning feeling low in mood, exhausted and lacking motivation to do things they formerly enjoyed.

It is caused by an extended period of stress, where someone is not getting their emotional needs met, pushing them further along the mental health continuum – away from a state of wellbeing.

Here, Ezra Hewing, Suffolk Mind’s Head of Mental Health Education, takes a look at depression and how we can move towards improved mental health.

What is depression?

Depression follows periods of chronic stress and causes a change in a person’s pattern of sleep. We used to think that depression affected our sleep. Now we’re learning that it’s the quality of our sleep that can cause low mood and depression.

In response to stress, you will see an increase in a particular type of sleep called REM (Rapid Eye Movement) sleep. REM sleep is when we do most of our dreaming.

During REM sleep we discharge the emotions we have not acted on while we are awake. If we have unmet emotional needs which cause us worry and stress it drives up the demand for REM sleep.

There are a lot of competing theories for the function of dreaming but what we do know is after a short period of REM sleep people report feeing calmer, more relaxed.

We know the content of dreaming, both in emotional and metaphorical content, matches people’s waking concerns.

We’ve also known, since about the early 1970s, that when people are experiencing depression, they will have longer and more intense periods of REM sleep and they will occur earlier in the night.

When chronic stress leads to an increase in REM sleep there is a loss of the deep sleep needed to repair brain cells. Because dreaming burns up lots of the brain’s energy, people affected by depression often wake up feeling exhausted and lacking in motivation.

Someone with depression may feel low in mood and unable to do anything about the things that are worrying them – even getting out of bed can seem a huge struggle.

How to combat depression?

Anxiety and depression often go hand in hand. We may start off experiencing a degree of stress, and can’t deal with it, so it grows into anxiety.  This can affect sleep and turn into insomnia.

As depression is caused by chronic stress from unmet emotional needs, the way to improve our mental health is by meeting these needs.

If we think about the cycle of depression, it gives us some entry points to break that cycle.

If, for example, someone wakes up and finds it really difficult to get up, it can seem impossible at that time. They may need to break things down into smaller, achievable chunks.

For example, they might start by just getting one leg out of bed before thinking about getting the other leg out.

Then can then think about sitting up. And then think about the next thing to do – which is just to leave the bedroom perhaps.

Break things down into smaller steps.

What people who experience depression report is that as they begin to get active during the day, their depression lifts as the day goes on. It’s usually at its worst first thing in the morning.

It’s about small, gradual steps. As we begin to do things, it begins to lift.

You could also reframe depression as evidence you are normal and human – you are having a natural response to stress and events.

You should also seek help to address unmet needs and learning some skills to reduce stress. You can then start to focus on taking steps to make changes to meet your needs.

Suffolk Mind offer a free course, The Essentials, which introduces you to the Emotional Needs and Resources approach. By learning more about our needs, and natural resources, we can be more aware of what affects them and plan to proactively meet those needs.

Talking therapies like counselling can be beneficial for people experiencing depression. Find out more about our counselling service here.

Read more about Emotional Needs & Resources.

by Ezra Hewing

Ezra Hewing is Head of Education at Suffolk Mind and a Human Givens Therapist. Since joining Suffolk Mind in 2009, he has grown our busy workplace wellbeing service, training frontline mental health workers, doctors, nurses, substance abuse workers, members of the emergency services and heads of organisations, amongst others, in how best to understand and support emotionally healthy workplaces. He holds an MSc in the psychology and neuroscience of mental health from the internationally renowned Institute of Psychology, Psychiatry and Neuroscience, King’s College, London, where he researched REM sleep and mental ill health, with a focus on the symptoms of schizophrenia.

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