When Depression is in your bed

Understanding Depression Through the Nervous System

• Trish Sanders, LCSW • Season 1 • Episode 5

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Talking about depression can often lead to what feels like a dead-end, a place in which we understand that someone feels bad, but not necessarily what can be done to help.  This may lead to feelings of isolation, frustration, hopelessness and more.  But what can be possible if we reframe the conversation and increase awareness of what is truly happening in the experience of depression?  Join host, Trish Sanders, as she navigates the profound connection between depression and our nervous system. In this episode, she delves into polyvagal theory—a groundbreaking framework that reveals how our emotional responses are rooted in our body’s autonomic states. 

Knowing that the disconnection that is a hallmark of depression is actually manifested as a protective nervous system response opens up new avenues for healing and self-compassion.  Trish shares personal insights and practical strategies to gently nurture ourselves as we shift from immobilization and collapse to safety and connection. 

Expect to learn about the three main states of our nervous system and how they influence our experience of depression. Embrace the idea that it’s okay to take small steps toward healing; every effort counts on the path to reclaiming joy and connection. If your nervous system is feeling a little frazzled, this episode provides a supportive perspective that is both empowering and compassionate. 

- If you are looking to take the first step towards improving your connection and communication with your partner, check out this FREE monthly webinar on "Becoming a Conscious Couple,".

- If you and your partner are ready to co-create the roadmap to the relationship of your dreams, join us for the next in-person "Getting the Love You Want" Weekend Couples Retreat!

For support in how to have deeper connections and better communication in the relationships that matter most in your life, follow the host, Trish Sanders on Instagram , Bluesky or LinkedIn.

Speaker 1:

Hello and welcome to the when Depression is in your Bed podcast. Are you or your partner, or perhaps both of you, struggling with depression? Are you feeling frustrated, hopeless or even ashamed, because you just can't seem to figure out how to improve your life or your relationship? Well, if so, keep listening, because in today's episode, I will begin to explore a perspective on depression that you likely haven't heard about before, and this perspective can change everything. By truly understanding the mind-body experience of depression and, specifically, the vital role of the nervous system, a path towards healing and growing through the suffering, a path towards the more joyful, more connected life and relationship you want to have, begins to emerge. I'm your host, trish Sanders, and I can't wait to begin to share all of this with you. Let's get started.

Speaker 1:

In the last episode, which was called Beyond Diagnosis Understanding Depression, I began to move past the diagnostic criteria or the symptoms that are used to diagnose clinical depression into the way that I have come to understand depression through my own experience, and what I am going to share today is how, the ways that I have come to understand depression over the last 30 plus years is actually connected to our nervous system, which I knew, of course, for many, many years. There's a mind-body connection, but it was only in the last few years that I became aware of polyvagal theory, and this was a life changing discovery for me, because I started to understand what was truly happening in my body experience and how it was connected to the experience I had of depression. And the best thing about knowing this was that it gave me an even clearer understanding of what I could do when I was feeling depressed, and I'm so excited to begin to share this information with you today. I am intentionally doing this a little bit backwards, because I'm going to tell you a little bit about polyvagal theory today, but focus on how the nervous system connects to the experiences of depression that I shared in my last episode, and then in the next episode I will explain polyvagal theory a little bit more comprehensively Today. Just to begin our discussion.

Speaker 1:

Polyvagal theory is a neurophysiological model which basically just means that it is a study of how the nervous system works, and it was created by Dr Stephen Porges. Essentially, it explains how our autonomic nervous system, particularly the vagus nerve. Polyvagal means the three states that our nervous system can be in, and one, essentially, is a state of safety and the other two are states of survival or defense. So when we're feeling grounded and safe, then we are in what's called ventral vagal, and I'll talk more about that in the next episode. But when we feel threatened and this can be a physical threat or an emotional threat we can go into a survival response, which, of course, is very helpful. If you're driving a car on the highway and someone goes to cut you off, it's excellent that we have a very fast acting survival response that, before our eyes even register, that vehicle is next to us. We might not even be able to say what color the car was or what the model or make of a car was, but our nervous system actually can process very quickly that we are in danger and we need to take action, and so we might turn the wheel very quickly to change lanes or we might jam on the brakes In this example. That's an excellent function of how our nervous system works with our brain to keep us safe. In this example, this is mobilized response to threat, which means that I am perceiving a threat and I have to do something about it. We take action in order to protect ourselves from threat, and this is called our sympathetic state, our fight or flight response.

Speaker 1:

I will also talk more about the sympathetic state in my next episode, but for today, what I want to start to really dive into is the third state of our nervous system. Our third state is an immobilized response to threat. Third state is an immobilized response to threat. Essentially, it is my nervous system is picking up cues of danger and I feel powerless to do anything about it. Perhaps it feels too overwhelming or I don't have the resources, maybe I'm too tired or I don't know what to do something like that, and so we go into a shutdown. And I will talk more about the value of these immobilized responses another time, but again, today I want to focus specifically on how the nervous system connects to how I have come to really understand depression, because I find it very helpful in beginning to understand what can I do when I feel depressed, because now I have this new way of thinking, this new language, what can I do when my nervous system is in this state? And so I really want to focus on that today, even though there's a wealth of really valuable information that I will definitely share with you as we move through podcast episodes.

Speaker 1:

So this immobilized response to threat is called dorsal vagal. The dorsal vagal state serves a very important purpose, and when we don't have the resources to fight or run, we can go into shutdown and be in a restorative state. However, when people talk about clinical depression, essentially what is happening is that their nervous system is more or less stuck in a dorsal state, more or less stuck in this immobilized, defensive, protective state, and so I want to cover the three components of how I have come to understand depression that I discussed in the last episode and explain how they are connected to our nervous system, which I have only relatively recently began to explore through Dr Porges' polyvagal theory. So the first thing that I shared in the last episode was that I have come to simply define depression as disconnection.

Speaker 1:

What this means, through a polyvagal lens or through a nervous system lens, is that when our nervous system feels threatened and we feel powerless or helpless, or we don't have the energy or resources to fight or run from a threat, we do disconnect. It is not a healthy, helpful response to threat to connect. We don't want to be close, we don't want to reach out to something that's potentially threatening us. We want to either attack it or run from it or disappear, be invisible. Essentially, it doesn't really make sense to reach out in connection when we're trying to protect ourselves. Protection is a very me first way of thinking and way of acting and this is extraordinarily important. When our body is in a survival state, we are not able to connect. We are only able to connect when our nervous system is in that grounded, safe state of ventral that I will talk about next time.

Speaker 1:

Depression is disconnection is the ultimate self-protection and to understand the function of the nervous system, that we are not disconnecting because there's something wrong with us. We are not disconnecting because we're actually not capable or not good enough or powerless. We're not hopeless. It's not that we absolutely can't handle life, it's just that in this moment our nervous system is trying to protect us and so we are disconnected and we are withdrawn. We're trying to be invisible, trying to disappear, to try to keep ourselves safe.

Speaker 1:

As I talk more about polyvagal theory and more about depression through this lens, I find it to be such a relieving breath of fresh air. It is so completely shame free. There is so much stigma attached to someone who is depressed that they should just pick themselves up by their bootstraps and push and just make themselves feel better if they just do something, get out of bed, just take action. And while these are helpful ideas, when your nervous system is trying to protect itself, it's not easy to just do something. If your experience is, I can only be safe or I can only survive if I withdraw or disappear or I'm invisible, or if I have to disconnect in order to stay alive, it wouldn't really be a very good defense system if it was easily changed. Defenses need to be rigid, they need to be firm, so it's not such an easy switch to say, okay, well, I'm feeling disconnected because this is what's going to help me survive. Oh, I should just connect now, I'm okay. It's not quite like that. If getting out of bed is a cue of danger to somebody, then they're going to stay in bed because the feeling is I don't have the energy to get out of bed and getting out of bed is dangerous and I might die. And so it makes a lot of sense that we would really hold on to and stay very connected to our disconnection. Again, I will talk a lot more about this and what this means and how we can move to find safe connection.

Speaker 1:

But to know that depression is disconnection is explained through the nervous system experience that we are hiding to keep ourselves safe. There's really nothing wrong with us at all. The problem comes in when we are unable to bring our nervous system back into a state of safety and groundedness and connection. And for many of us, we had an experience earlier in our lives in which our nervous system learned that being disconnected, that being invisible, that hiding, that withdrawing, that being small was actually the way to keep us safe. Our nervous system took that learning into our teenage and adult lives and if you can start to understand that our body was really being very functional and working in a way to protect us and actually shift to a place of gratitude like wow, my body was just protecting me. I'm so grateful for that. Isn't that wonderful that my nervous system and my brain are hardwired to keep me safe?

Speaker 1:

When I was a little kid and I didn't have a lot of resources or choice perhaps because kids don't really have choice a lot in our society they're told what to do, when to do it. There's parents and there's teachers and there's family members and there's all sorts of people telling kids what to do, so their choices are really limited and so our nervous system and our brain really come to our rescue when we're young. But if we had that experience very often, that being in that dorsal state, that immobilized state, it is safer to do nothing than to try to take action. If that's the lesson that we have learned, then we are going to, in our adulthood, really stay committed to that. Well, this is the way that I find safety. I disconnect, I play small, I will avoid danger by being in a dorsal state. For me, this was an incredible aha moment, like, oh okay. Well, this is why depression feels like disconnection. It's not safe to connect to myself, or it's not safe to connect to anyone else, or it's not safe to connect to the larger world.

Speaker 1:

Now, the second piece of my understanding of depression that I shared in the last episode was what I call depression goggles. It is the experience that I came to understand that when I was looking at myself or others or the world, when I felt depressed, it was very different than when I didn't feel depressed. When I'm depressed and I think of myself, I often think things like I'm worthless and I'm incapable and I am not deserving of happiness, and a lot of very negative things, certainly hopeless and I'm powerless. These are some thoughts when I'm depressed I believe are absolute truths, and about others, people don't care about me, no one's really there for me, I'm not really important to anyone, and the world, the world, is often just so overwhelming it's not really even worth trying. Those are some of the thoughts for myself when I'm wearing my depression goggles, when I'm in a depressive state. That's some of what I see, that's the lens that I look through and how things appear to me. And, like I said, I have called that depression goggles.

Speaker 1:

Through polyvagal theory, I have learned that the interpretations, the stories we tell ourselves about ourselves and others and the world are directly connected to the state of our nervous system. I will expand upon this idea in future episodes, but the short version is that when we're in our eventual state, which is that safe, calm, connected place, we will experience ourselves as kind, loving, able to learn, able to make mistakes, able to try again after making a mistake. Other people are helpful, trying their best, available for us, kind, loving, the world is full of opportunity, that kind of thing. When we are in a sympathetic state, that fight or flight, mobilized, response to threat state, we might feel that we have to do everything, we have to take on all the responsibilities. If we don't do it ourselves, it won't get done, and other people are always out to get us, trying to give us a hard time. They don't know what to do. No one comes through for us and the world seems very dangerous.

Speaker 1:

There's a lot of problems, a lot of fires, one thing after another that we have to take care of, and then we're in that dorsal place, that immobilized, shut down, disconnected place. We think these thoughts that really are surrounded around powerlessness and hopelessness, and so it makes complete sense that when we're in that place, that thoughts of death and suicide come and are attached to the state of our nervous system. So here is, if not the most valuable, one of the most valuable things that I have learned in the past several years that has created a huge shift in how I've been able to respond to my own depression and my husband's depressive episodes, that we don't have to get stuck in the stories, because they're just interpretations that are linked to our nervous system state. What is a much more helpful focus for us is to change our nervous system state and, all of a sudden, instead of trying to convince yourself that, no, you're really a very capable person and you absolutely can get out of bed and brush your teeth, or you absolutely can complete this project on time, or you absolutely can get up and do this public speaking thing, or you're actually a really good parent which, when you're in a depressed state, you can tell yourself those things till you're blue in the face. But realistically, most of the time those things won't work.

Speaker 1:

And this is also a reason why, although I am a fan of affirmations in certain cases positive affirmations when you're in a very depressed state you don't believe those affirmations because your nervous system is saying nope, they don't feel like your truth in that moment and so you discount them. Your nervous system feels like you're lying to it, which in and of itself can be a cue of danger, like nah, this isn't true, I'm not really capable, you're trying to get one over on me and you dig in further to a depressive state. So depression can really feed itself. Because the more you can try to push yourself to move out of depression, the more your nervous system might hold on to what feels like safety, that shutdown, that powerlessness, that immobilized state, that not doing anything right. If you remember, if we take from our childhood, it was safer to not do something than to take action, then we're not going to easily move into an active state.

Speaker 1:

And so the idea that we don't have to convince ourselves of a new story because I laugh, because if you have been in a depressed state and someone tries to tell you something positive and I've had so many loving, caring, well-intentioned friends, family, certainly even therapists say to me things like of course you're capable, look at what you've done, or look at what you've accomplished, or you're being so hard on yourself, trish, you've really got this. And when I'm in that place, I don't believe them for a second. Now, when I come out of my depressive state, when, in my language, when I take off my depression goggles, then there's a whole new world of possibility available to me. But when I have on my depression goggles, none of that seems true and I can't receive those positive statements from myself or from anybody else. Now, as a partner of someone who's depressed, this is also very challenging, because I can tell my husband that I love him and that I think he's amazing, and if he's depressed he's just not going to be able to receive that, and then I might feel frustrated and I might tell myself a story that his lack of ability to receive my care means he doesn't care about me, and now we can spin off into a whole different conflict, which I have been in. Many versions of conflicts like that come from that place of my nervous system experiencing a cue of danger for my husband's nervous system state, and then he experiences a cue of danger from my nervous system state, and we go back and forth until both of us are really in very unhelpful places, and I will share many, many stories with you so you can really get a sense of what has been very unhelpful and what has escalated situations and made them far worse, and also all the things I have learned that really can help de-escalate situations and make things better or keep them stable. As I mentioned before and you'll hear me say this many times One goal for dealing with depression is to not make it worse, and relationally that approach absolutely holds water. You cannot force your partner to be somewhere where they aren't yet, and so sometimes the goal is not necessarily to make things better, but just not to make them worse. And again, we'll talk more about strategies over time, so keep listening.

Speaker 1:

What I refer to as depression goggles over the course of my life my professional and personal life is explained in polyvagal theory, that the interpretations you make are in fact, tied to your nervous system state and again, the incredible, profound, empowering impact of this is that we can change the stories by changing the state of our nervous system, the stories by changing the state of our nervous system. And it takes some practice and it's not a switch. Our nervous system, in fact, can take some time to shift states, but it is actually very doable to start creating a felt, embodied sense of safety, meaning that your body feels safe. This is not someone telling you you're safe, everything's okay, because when we don't feel safe, we don't feel like everything is okay, we don't feel like everything is going to be fine in the end. We'll work this out. That seems like an absolute lie when you're in a deep dorsal state, and so to know that you don't have to convince yourself. It is not usually effective, and there's a reason why. But we can learn how to create this embodied sense of safety, how to help our body feel safe from a sensory experience in order to begin to move us out of dorsal.

Speaker 1:

Which brings me to the third component that I talked about in my last episode of what I call depression steps, and so I described this. If you can imagine a set of 10 steps, it could be more or less. But if you can imagine a set of 10 steps and the bottom step is the deepest, darkest, worst depressive episode you could be in, and then you go up the steps and then the first step at the top is still depression. But the top step is not that severe. It's more of like the numbed out, going through the motions kind of depression. You're still going to work or school, you still might go out, but it might not be really that fun for you, or you still might take part in certain activities, but they just don't feel very satisfying, right?

Speaker 1:

So if you can imagine this set of steps, and what has been important for me in thinking about the steps of depression, is that when you're at that darkest, lowest step, that bottom step, the worst depression you can be in, and you put in a lot of effort to try to move a step up, you still feel pretty awful. But then the interpretation that people often make certainly that I have made, that my husband has made is well, I put in all this effort and I still feel terrible, so it's not working, and so then you slide right back down a step, because now you feel hopeless and your interpretation of I'm powerless, I really can't do anything, I can't make myself feel better, feels like it was reaffirmed, like, oh see, look, it's true, I put an effort and I still don't get anywhere. But we fail to realize that we are actually improving, we are actually making progress and we have to keep making progress and again, sometimes you're not gonna have the resources to make progress, to go up another step. So what do you have to do? Try to stay on the step you're on, as opposed to sliding back down to a deeper level of depression.

Speaker 1:

Now, this phenomenon is also captured in polyvagal theory. First of all, polyvagal theory says that our nervous system only has three states, that it can be in One state of safety, the ventral, vagal state, and then two survival states or protective states. One is the mobilized, fight or flight, sympathetic state, and then the other is the immobilized, disconnected, dorsal state, and so those three states have different shades, so to speak. Again, if you imagine the steps, the deepest depression may be a color black. For me, I would color it black, and then, as you go up the steps, for me, I might think of those as gray, but it would start dark gray to a medium gray, to a lighter gray and the top step would be a very, very light gray.

Speaker 1:

And in the nervous system it takes time to move through those different shades to get to a place of feeling safe. To move through those different shades to get to a place of feeling safe, to move actually out of the dorsal state. It takes a certain amount of time and it can vary. It could be 90 seconds perhaps, depending on how far down you are and what is helping you have an embodied sense of safety, being able to uplift you into a sympathetic state, that mobilized state which could have the energy of just doing something, the energy of being able to get out of bed and brush your teeth or, for me, the energy to do my administrative work.

Speaker 1:

In my private practice there's some mobilized sympathetic energy that I need to do that and sometimes that feels very overwhelming and very scary. So I stay stuck in my dorsal state and then I don't do anything but to know and have compassion that our nervous system is responding to a cue of danger and I need to be able to increase the cues of safety and reduce the cues of danger, and there may be only one cue of danger, but it may feel very heavy and very big. It may be weighted in such a way that there might be many cues of safety around, but if that cue of danger feels enormous, I'm going to stay in a defended survival state. So I think it's so helpful to realize that if we're staying stuck essentially in the dorsal state, we can still help ourselves feel a little bit more safe incrementally, in little bits, in little chunks, in little steps, and we can move ourselves gently up the steps of depression.

Speaker 1:

And it might take some time and, to be honest, we live in a society where we are often not granted much compassion at all, let alone much time or resources for us to be able to take the break that sometimes our nervous system really needs to take. And we can stay stuck in a dorsal state for a very, very long time. That's what a long depressive episode is, because we're feeling so threatened by whatever it is. I mean again, sometimes the idea of just getting out of bed to brush your teeth seems really threatening. And then we shame ourselves, or sometimes we are shamed by others, that that's not such a hard thing to do, and what is a cue of danger for one person may not be a cue of danger for another person. But sometimes we need to give our nervous system a long period of time to truly get that restorative time that it needs and to get enough cues of safety that feel like they're heavily weighted enough to be able to truly start to not only just move us up and out of the dorsal experience but be able to move us into taking action in a way that feels safe and then eventually bringing us into that eventual safe, connected place.

Speaker 1:

For me, understanding the connection of the nervous system and the functioning of the vagus nerve and how our body is trying to protect us and how this is directly related to our mental activity, our mental health and what's happening for us, the interpretations we make and how we see ourselves and the world and others, was so incredibly helpful because, again, this is a shame-free, judgment-free perspective. This is a perspective that there is nothing wrong with you, for where your nervous system is, there's a reason why your nervous system has gone into self-protective mode. You're not crazy, you're not defective, and of course, I'm saying that you're not this, you are not but these are things that I have felt very much over my life. I am defective has been a core belief of mine for as long as I can remember, until really just the last few years. That I've really been able to release that and I knew that that was attached to my depression goggles.

Speaker 1:

But when I was in a safe place, it was so easy for me to experience a cue of danger that my nervous system would go right back into a dorsal place and those thoughts would come back. And then it was this sense of inevitability, like, oh well, this is how I'm always going to feel and I'm always going to get back to this place. And then I would feel powerless, or parts of me would believe that that was my true self, that those were my true thoughts, that I was hopeless and powerless and incapable and defective and not deserving of happiness, and I identified strongly with that as a truth. And so I will continue to explore depression through a polyvagal lens and really focus on what I have learned to help move from a dorsal state back to a ventral state, because I have found it to be among the most helpful strategies in dealing and healing through depression and really understanding that our nervous system is communicating to us and if we can listen to what it's communicating instead of shaming ourselves or feeling like there's something wrong with us, then we actually can begin to heal through our depressive experiences and we can certainly improve them. So I will talk a lot more about that.

Speaker 1:

That will be a huge focus of this podcast, but for today, what I really wanted to put out there was how the lived experience of depression is really connected to the nervous system. I hope that in hearing that, you're able to begin shifting. Whatever your interpretations are about yourself or about your partner, about any hopelessness or powerlessness or any of those negative messages that you're carrying or feeling like you're separate from everybody or your partner feels so separate from you, I hope you can start to just begin to shift into the beginning of a new understanding that there's something else going on here that maybe you didn't know was happening and that, if you know what's really going on, there truly is a way to support yourself through depression in perhaps a very different way than you've ever thought about before. So thanks for showing up today. As our time comes to a close and as you continue to travel along on your own unique wellness journey, I leave you with an invitation To move from where you are today to where you want to be. The path may seem long or daunting or unclear, and I want you to know that that is totally okay. You do not have to create the whole way all at once.

Speaker 1:

My invitation to you today is to take a step, just one, any type, any size, in any direction. It can be an external step that can be observed or measured, or it could be a step you visualize. Whatever makes sense to you. I invite you to take a step today Because healing, growth, connection and joy is possible for everyone, including you, and even when depression is in your bed. If you connected with today's episode, please subscribe so you can be notified when each weekly episode gets released. I encourage you to leave a review. Your feedback will help guide future episodes, and please share this podcast with anyone who you think may be interested or enjoy what I have to share. Until the next time we connect, take care of yourself and take a step.