It's Not Always Depression: Sometimes There's More Going On Underneath

Woman looking out a window while feeling sad and emotionally disconnected.

When someone comes to therapy saying, "I think I'm depressed," they may describe feeling tired, disconnected, unmotivated, numb, irritable, or just not like themselves anymore. Sometimes that is depression and should be treated as such. But sometimes there is more going on underneath the symptoms. I often think about this through the lens of Hilary Jacobs Hendel's book, It's Not Always Depression. One of the ideas in her work is that many of us have learned ways to disconnect from emotions that at some point felt too painful, overwhelming, or unsafe to experience. Over time, that disconnection can sometimes look and feel a lot like depression.

This is especially important when we think about childhood experiences. Maybe you grew up in a home where anger wasn't acceptable, so you learned to push it down. Maybe being sad didn't result in comfort, so you learned not to need anyone. Maybe you had to keep the peace, take care of everyone else, or become the "easy" child who didn't cause problems. Some people learn to worry, overthink, people please, stay constantly busy, shut down, scroll on their phones, or disconnect from what they're feeling. We sometimes call these defenses. I don't think of defenses as something bad that needs to be taken away. They developed for a reason. They helped protect us from emotions or experiences that, at the time, we may not have known how to handle.

The problem is that the same defenses that helped us earlier in life can eventually keep us disconnected from ourselves. A person might say, "I don't feel anything anymore," when underneath the numbness there is sadness that has never really been grieved. Someone who seems depressed and withdrawn may have anger they've never felt safe expressing. Someone else may spend most of the day worrying and not recognize the fear, hurt, guilt, or shame underneath it. This is why I sometimes encourage clients to become curious about their symptoms rather than immediately trying to make them disappear. What am I feeling underneath this? What might I be protecting myself from? When did I learn that feeling this emotion wasn't safe? Hendel describes a helpful way of understanding these layers through something called the Change Triangle, which helps identify our defenses, anxiety, guilt or shame, and the core emotions underneath them.

This doesn't mean depression isn't real, and it certainly doesn't mean that everyone experiencing depression simply needs to uncover a hidden emotion. Depression can have many causes and deserves appropriate assessment and treatment. But for some people, treating symptoms alone doesn't seem to get to the heart of what's happening. In my work at Asbury Counseling, I help clients slow these patterns down, understand how they learned to protect themselves, and safely identify and process emotions that may have been pushed aside for years. Sometimes feeling better isn't about learning how to stop feeling. It's about finally learning how to feel what has been there all along.

Learn more: Hilary Jacobs Hendel, author of It's Not Always Depression, provides an excellent explanation of the Change Triangle and how our defenses, anxiety, shame, guilt, and core emotions interact:
https://www.hilaryjacobshendel.com/whats-the-change-triangle