When Depression is in your bed
This podcast looks through both a professional and personal lens to explore the impact depression can have on individuals and on relationships. It takes a non-judgmental, destigmatizing view of mental health that encourages true, holistic healing and growth.
The host, Trish Sanders, is a Licensed Clinical Social Worker and Certified Advanced Imago Relationship Therapist. In addition to her experience in the office with couples and depression, both she and her husband have lived with depression for most of their lives. Trish shares with transparency and vulnerability, while bringing hope and light to an often heavy subject.
Follow Trish @trish.sanders.lcsw on Instagram for support in how to have a deeper connection and better communication in the relationships that matter most in your life.
Subscribe to When Depression is in Your Bed and share it with someone who you think may benefit from hearing it.
- 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: How to Connect & Communicate with Your Partner," at wwww.wholefamilynj.com/webinar
- 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! Register at www.wholefamilynj.com/workshop
When Depression is in your bed
Know Your Worth, Know Your Impact: How Embracing Your Relational Power Shapes Social Change
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
What does it really mean to know that you matter — and how does that shape the impact you have on your relationships and the world?
In this episode, I explore how reclaiming a sense of worth can be a powerful source of energy, agency, and relational influence — especially when we’re feeling shut down, disconnected, or powerless. Through my own experience, I reflect on how depression often shows up as disconnection from self, others, and the world, and how that disconnection can quietly erode our sense that we matter.
Drawing on an Imago and nervous system informed lens, I share a working theory: people who don’t know they matter often don’t know their impact. When worth is unclear, power can feel distorted, either expressed through collapse and withdrawal, or through attempts to assert dominance. Both are understandable nervous system responses to deep relational injury.
This conversation focuses primarily on dorsal shutdown, the immobilized nervous system state where self-care, connection, and engagement with the world feel out of reach. I reflect on how beginning with the assumption that I mattered, rather than waiting for proof, helped restore energy, curiosity, and capacity for connection in my own life.
I also share how being accurately seen and mirrored within the Imago community became a healing experience, allowing growth to layer on top of safety. As my sense of worth strengthened, I became more able to notice my impact on others and to influence the quality of connection without collapsing or exerting control.
This episode is an invitation to consider how small, intentional shifts in the quality of our connections — first with ourselves, then with those closest to us, and eventually with the wider world — can become a meaningful source of personal and collective change.
In this episode, we explore:
- Depression as disconnection from self, others, and the world
- How not knowing you matter impacts nervous system regulation and energy
- The link between worth, impact, and our relationship to power
- Dorsal shutdown and why lack of energy isn’t a personal failure
- Beginning with worth as a foundation for healing and agency
- “I matter because I am here” as a way of interrupting old narratives
- How accurate mirroring supports relational repair and growth
- Why reclaiming worth restores capacity for connection and contribution
- How small relational shifts can ripple outward into larger systems
This episode is an invitation to slow down, question old narratives of worthlessness, and remember that when we know we matter, we’re better able to stay present, relational, and engaged — and that’s how small connections begin to shape the world.
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.
Framing Depression As Disconnection
SPEAKER_00Hello, and welcome to the When Depression is in your bed podcast. In today's episode, I want to build on a recent conversation on being relational and explore how we can reclaim a sense of agency, even if we're feeling powerless. I'll look at how I see depression and disconnection as one and the same. What happens when we don't know that we matter, and how changing the quality of our connections can shift our energy, our relationships, and our impact on the world. I'm your host, Trish Sanders, and I am delighted that you are here. Let's get started. I want to continue the conversation from the last episode about being relational because through my own personal and professional experience and the lens that I look at the world through, I believe that being relational is absolutely key to how we can empower ourselves so we actually can find our way to make the changes that we want to make in ourselves and in our relationship and in the larger world. And there's many different parts of this conversation, but for today, I want to focus on something I mentioned in the last episode about one of the specific parts of what it means to be relational. And I said that being relational means valuing the quality of the connections within a group. And I wanted to explore more about what that meant and how I myself have gone through a process of not only valuing the quality of my connections in my life, but also on significantly enhancing the quality of the connections that I have in my life and what I have done and what that looks like. I've said this before on previous episodes, and it's really core to how I think about depression. And it is definitely rooted in nervous system theory. However, I did not know about nervous system theory when I developed this perspective, but I started to see in my own personal experiences with depression as a teenager and as a young adult, I started to understand depression as disconnection. And then many, many years later, I started to see that through a nervous system lens. And it makes complete sense how this has been my experience because when our nervous systems are stuck in that dorsal state, which is the state of shutdown and collapse and immobilization from a survival place. That's like when we have to shut down in order to protect ourselves. When we don't have the resources or the energy or the know-how to fight, we go into shutdown and hope that the threat will pass. And while that can be really helpful from a survival perspective, if you get stuck there, I would say that that could be called depression. And that disconnect is certainly a signature marker of many people's experience of depression. And when you think about that, depression as disconnection and just the idea of that having disconnection in your life does not translate into having really high quality connections in your life because it is literally the opposite. You do not have high quality connections, you actually are stuck in a state of typically feeling disconnected. And something else that I have come to notice through my own experiences, I have noticed that people who are stuck in disconnection, depression, avoidance, withdrawal, shutdown often don't have a very strong sense of their own self-worth, which of course also makes sense from a polyvagal-informed perspective or a nervous system-informed perspective, because the way that we see ourselves and each other and the world is directly connected to the state of our nervous system. So if our nervous system is in that dorsal shutdown state, then we're going to have on what I call depression goggles and everything is going to look pretty bleak and pretty grim. And so, of course, having a lack of self-worth comes sort of par for the course with wearing depression goggles. And when people don't know their worth, just by extension of that, they don't really know how much they matter. They don't feel that they're worthy and they don't feel like they have value, which they don't necessarily matter to themselves. They don't feel like they matter to others. And certainly if you think about depression, again, this all kind of goes hand in hand. And furthermore, what I have also come to understand about this process is that when people don't know that they matter and they don't know their worth, they often do not know their impact. And I'm going to be talking a lot more about this idea of what happens when you don't know your impact and how that can negatively impact things and how to reclaim knowing your worth, knowing that you matter and knowing your impact so that you can actually have a sense of agency and create the change that you want to see in your smaller life, which is really important, or in the bigger world, which is also really important. But before I go into talking more about that, I want to talk about how someone may find themselves in a situation where they don't feel like they matter or they don't have a strong sense of self-worth. And I would say that while there could be many, many, many different specific reasons, but it probably means that as they were growing up in their early life, could be later in life, but we'll focus on early development for now, that in someone's early development, they didn't have the quality of connection that they needed. So you can kind of start to see this as a cycle, even from this place, that if you grow up with a quality of connection with your early caregivers or other important people around you in your early life, where you weren't getting what you needed emotionally, you weren't feeling seen and heard and valued. That has an impact on who we see ourselves to be. And I can talk a lot more about this from a attachment perspective and a developmental milestone perspective. And maybe I'll talk about that in a few episodes to go into more detail. But just to sum it up for today, something that we say frequently in Imago is that we are mirrored into existence. And what that means is that we develop our sense of trust, attachment to others, how safe we think the world is or is not, our sense of who we are, our identity, and our feelings of being capable, being competent in this world through our relationships. So how we are perceived by others, again, often this means early caregivers, impacts who we see ourselves to be. And I will also mention here that while I am talking about the small microcosm of a family unit, this is also a very similar process that I'm also sure I will talk more about on future episodes if you look at it on a larger society or systemic level. Because for marginalized people, they're often not seen, heard, and valued by the dominant society. And this can create the same emotional rupture that I'm describing here today. So just to keep that in mind as a backdrop, that it's really about the people who are in our family system as well as the larger social system that we grow up in. So if you think about that, the context of growing up in a space, either in your family or in a society where you do not feel like you matter. That is a deep hurt, no matter where it comes from, because feeling like you matter, feeling like you have worth and value is an inherent need in all of us. And if we feel like we don't matter and we don't have value, that can be very dysregulating. And what that means in nervous system language is that it can be a huge cue of danger and it can make your system go into some sort of self-protection mode. So that means your nervous system could go into its sympathetic state, which I'm not going to talk about very much today, but the sympathetic state is our fight or flight mode. And if you think about the experience of feeling worthless and not knowing that you matter, if you go into a fight or flight mode, you might fight to make sure that you matter in this world, that you have power, that other people see you. You may become a perfectionist so you can prove your worth. Those are some examples of a sympathetic response to this type of hurt about feeling like you don't matter. But again, we're gonna save those for another day. Today I want to talk about some of the things that can happen when your nervous system goes into a dorsal shutdown response to feeling worthless and feeling like you don't matter. And essentially that is shutting down, going into avoidance, collapse, and really giving into or identifying or even embracing those feelings of worthlessness. And when you go into that place, that dorsal shutdown, that's a really powerless place. And again, the quality of your connections in your life are not going to be good. They're not going to be rich and fulfilling and abundant, even the quality of the connection you have with yourself, right? I think that from my own personal experience, I have spent so much of my life deeply disconnected from myself and of course others and the larger world. I have found through my own personal experience, largely in my husband, but then I have seen the same phenomenon in myself and in others, is that if you don't know you matter, you often don't know your impact. And this can become the place that is related to how we use power. Similarly to what I was talking about before, the potential sympathetic response to not knowing your impact can be an abuse of power. And again, more on that another time. So stay tuned. But the dorsal response can be not using your power or not even knowing you have power to use, or just embracing and identifying with the feeling of sense of being worthless, identifying and embracing the experience of being powerless and feeling like you actually can't do anything. You don't have the ability or the capability or the know-how or the resources. And these are big topics and there's a lot of branches that I can go down. But I really want to share today my own journey through developing an awareness of this process and getting to a place where I realized how powerless I felt and how I was able to move through that place to where I am today, which is very far from there. And even though I still have a whole lifetime of work and healing and growth to do, I'm light years away from where I began. And I have learned so much about healing myself and my relationships and having an impact on the greater world. And that's what I'm sharing with you today. I've talked about my experience on this podcast before, of course, about what has been a lifelong journey for me of trying to heal and grow and work with my depression and certainly improve my relationship with my husband. That's been a big part of the focus for me for the last almost 22 years. And I have been working on my own self for over 35 years, I would say, at this point. And it wasn't a lack of willingness or desire. I had a lot of willingness and desire. I was missing something to get me more sustainable change or progress. And a turning point for me really came right when I was around 40 or so, where I made the decision that I just refused to feel as bad as I was feeling anymore. And that moment really set into motion so many other things that led to the sustainable changes and the progress that I've been looking for for decades. And what I've come to realize, or how I think about it now, is that even though I was trying to take care of myself, and again, the willingness and the desire to feel better was absolutely present. And I certainly did many things that were valuable and helpful. I just couldn't stick with a lot of them. And overall, I still spent a lot of time in that dorsal shutdown, feeling depressed or disconnected, or also stuck in a sympathetic, like do more, accomplish more, but often feeling overwhelmed and chaotic and not really feeling very accomplished, which again, we'll talk more about sympathetic another time. But looking back, I realize that while it sometimes feels like we have to do something to create movement or to feel accomplished, or even just to make things happen. Like in your head, it makes sense. Like, well, of course, if you want to change things, you have to do something to change things. And while that certainly is true, there is a level of doing something different to get something different. I realized that before the doing could happen, it was more important for me or it was more helpful and created more change to actually happen with me just assuming my worth. Like I matter. I'm sick of feeling like I don't matter. I'm sick of believing this old narrative that I'm worthless, I'm a failure, I don't deserve to be happy. I just refuse to believe that anymore, even if it's still in my head, which again, I've talked about other episodes and we'll talk more about, but that's really where I was. Like, I'm not going to live the rest of my life feeling this way. I'm just going to believe that I matter, period. And for me, something that helped was this idea that I'm here because I matter. And for me, it was sort of this cosmically guided thing of the, I don't know, infinite number of possibilities of who gets to exist, who gets to come into a physical body at this particular moment in time. For me, it was like purpose-driven, like I'm here. And so I must matter. I got to be here in this moment, in this body, in this space and time, in these relationships. And there must be a reason for that. Now, granted, people don't always identify with that, and that's totally okay. For me, this felt substantial and meaningful. If it doesn't feel substantial and meaningful to you, that's okay. Hold on just a sec. But for me, it really resonated deeply, and it was something that I could go back to. And again, it wasn't like I just always felt great, like, okay, I refuse to feel bad. Now I feel great. That's not what I'm talking about. But it was a process of once I assumed my worth, I'm here, I must matter. Things started to shift. The energy that was being often depleted in beating myself up and talking to myself terribly and feeling bad and being disconnected, which is so incredibly draining, I started to get that back. And it started to allow me to have energy to do things to help me actually feel better. And I felt more in alignment with the idea of like, oh, well, I'm doing this because I matter and feeling good matters and taking care of myself matters. So if the idea doesn't resonate for you, I told you to hold on for a sec, you can try flipping that and you can think to yourself, I matter because I'm here. It's much less cosmically driven. It's kind of just like, hey, why not? Right? Like, I'm here anyway. So do I want to continue to believe these regulated stories and these narratives? Do I want to continue to live in these things where I feel really bad? For me, the answer was no. I did not want to continue to live in those spaces. And as I made that decision and just embraced my worth and said, hey, I matter, period. That was enough of a shift for me. Now I will say this didn't happen in and of itself. It wasn't the only thing I tried. Like I said, I've been in therapy for decades. I've been in healing circles, in wellness communities. I've been a part of things, doing things for a long, long time. And with all of that comes a lot of information and awareness, certainly Imago theory and connected conscious communication and nervous system work. So this was not happening by itself. So I don't want to make it sound more simple than it was, but at the same time, it was kind of magic, at least for me. And I hope that it could be magic for you too. Because here's the thing when you start to realize that you matter, then you may very well start to become more aware of the impact you have. Because now you matter. You actually have impact on yourself, on your life, on your relationships. And believe it or not, even if this sounds big for today, you can impact the world. Yep, that's right. You. And as you feel better about yourself, you don't have to fall into collapse and stay there. Sometimes collapse is helpful and necessary. And if you take a moment of break for restoration and renewal, that could be a very positive thing. But you don't have to give up indefinitely and forever. And again, this is sympathetic charge, but just to mention, you also don't have to exert your power or dominance over anybody else because you start to become more and more secure in yourself. You have needs and wants, and you deserve to have them, and you deserve to have a beautiful, wonderful life, and you don't have to abandon yourself, and you don't have to put yourself above anybody else. And now we start to really shift into how becoming more secure in yourself helps you to be more relational with others. You start to be able to connect first with yourself and then probably with the more important people in your life next. But then you can connect more and more with people outside of your closest circle. And this is when we start to create true community that can really be, in my opinion, exactly what we need to shift all the hurt, all the polarization, all the violence that's happening in our world. And if you think about it, it makes so much sense because when I was in dorsal shutdown, I didn't have energy for my own self-care. Getting up in the morning and brushing my teeth and taking a shower was huge, right? And if you think about someone who's in a deep depression, even that kind of basic self-care can sometimes feel inaccessible. Even if you're getting up and going through the motions of day-to-day life, which is another flavor of a dorsal experience or a depressive experience, you're probably not doing the deep self-care things that you need to do. So you don't have energy for yourself. So you're not going to put energy into other people in your life, even the most important people in your life. I certainly was not able to put energy in when I felt depleted into my relationship. And even to my kids, I wanted to put energy in my priority on them, it was high. But when I'm exhausted, I definitely didn't show up as the best mom that I'm able to be, right? That makes perfect sense. I certainly wasn't showing up as the best partner that I wanted to be. And beyond that, of course, even though I believed deeply in the inherent worth of all people, and I became a social worker because I wanted to do social work that made the world a better place, that made our society a safer place of belonging for everyone. I certainly didn't have capacity to put energy into things on that kind of scale when I barely had capacity to take care of myself. And as I started to release these old patterns and reclaim my worth and feeling like I mattered, I started to have more energy to give to myself and take care of myself and also to give to and help take care of others. And this was a huge and significant shift. I've also had over the last 10 years the Imago Professional Community. And they were like another family for me. And they offered me the mirroring that I touched on before that I needed in a different way than I'd had had before in my life. And I really started to see myself through their eyes in a different way. And it helped me to see myself more accurately and helped me to reclaim who I was, which included reclaiming my worth and my power. And through the Imago community, it really became a place of healing and growth for me, creating the environment where healing and growth was possible. And I was able to bring that into certainly my relationship with myself, but also my relationship with Ben and having more energy for myself and being able to take care of myself better allowed me to show up better for my relationship and for Ben himself. And we as a couple have been able to grow through that. And I just want to take a second to say that the Imago community has been such an incredible gift to me for that reason and so many other reasons. And it is part of my intention to be able to create communities for others so that they too can have a space where they can be seen and heard and valued and where they can be mirrored accurately and where they can find a sense of belonging. So this is my mission, people. And if you're listening, you're welcome to be a part of it if it resonates for you. But it's something that I think that everyone really needs to have because being mirrored is so incredibly powerful. And being able to grow into your fullest self through that process has been such a gift to me that it's something I want to make accessible to the entire world. So everything that I experienced with the Imago community, I was able to bring back certainly to myself. It deeply supported my own healing process. And I was also able to bring that into all the other relationships in my life as a mom and of course with Ben. And I was able to mirror him more clearly. I was able to bring more curiosity. I was able to improve the quality of the connection that we had by showing up with more safety and creating a sense of belonging for both of us. It wasn't a fight that it was either I got to exist or he got to exist or my needs mattered or his needs mattered. It wasn't a battle, which again is a sympathetic kind of energy. And it also wasn't a hopelessness, which is a place that Ben and I have found ourselves in many, many times, both of us being in a dorsal collapse of why put effort in? Can we even make this relationship better? That kind of place. But I was able to bring that into my relationships with Ben. And I do recommend starting these kind of processes, of course, with yourself, but then with the closest people that you have in your life. But I'll talk more about that in a moment. A concrete example of what does it mean to mirror and to use this process to change the quality of the connections you have. Just the other day, I had this experience at Ben, and it was this tiny micro moment, and it was so powerful. We were getting ready in the morning. They was getting ready to go to work, and I was just getting ready for my day and getting our daughter to school. And we weren't fighting, we weren't arguing. The quality of the connection between us was not bad. However, it also was not good. I would probably say it was more in the neutral range, but I noticed it and I thought to myself, I bet I could make this better. And all I did was look at him, make eye contact, and give him a smile. And guess what? He smiled right back. He mirrored my smile. And he mirrored my smile because he felt seen. He felt me seeing him, right? And it wasn't just us going through this world side by side, which was okay. That wasn't a negative, but I was able through that conscious moment to create connection that made that moment feel sweeter, but it also lasted and had a ripple effect on the whole rest of our day. And these little tiny micro moments are really where our power lies and their core to what I'm talking about today. Because the idea of changing the whole world might feel really big and daunting. And it's also not necessarily possible for us to take action that's going to help everyone today in this moment. Unfortunately, as much as I would like to end suffering for everyone in this very moment, that's not realistically possible. And thinking about that for too long can be overwhelming and can certainly cause me to go into shutdown and hopelessness as well. But if I think, what can I do? And starting with the relationships that are the most important in your life, whether it's kids or friends or family or a romantic partner, starting with those people and taking those micro moments. Because once you start to realize your worth, you start to realize how incredibly powerful you are and how much impact you have. And you can take the impact that you're having on yourself and on your close relationships and take that outside to your neighbor and the person at the grocery store and other people that you meet in this world. And we can start to create this ripple effect. And then we can start to enhance the quality of the connections we have with many, many people, and we can start to improve the quality of the connections of entire communities and yes, of the entire world. The message that I really Want you to hear today is that when we begin to reclaim our worth and we choose to believe that we matter, we start to increase our awareness. We start to better understand the impact that we have and the power that we have. And when we start to make those shifts, we start to reclaim our energy. And when we start to reclaim our energy, we start to increase the capacity that we have to shape and influence the quality of the connections that we have in our relationships, in our communities, and in our world. So while I totally understand feeling overwhelmed and feeling like you don't have capacity, when you start to embrace your own worth, it'll help you embrace the worth of others. And when we realize that we all matter, then we can start to act in ways that are truly relational, that support wellness and belonging for all. As our time comes to a close, I ask you to keep listening for just a few more moments because I want to thank you for showing up today. And I want to leave you with an invitation as you hit stop and move back out into the world on your own unique wellness journey. In order to move from where you are today to the place where you want to be, the path may seem long or unclear or unknown. And I want you to know that if that seems scary or daunting or downright terrifying or anything else, that is totally okay. Know that you do not have to create the whole way all at once. We don't travel a whole journey in one stride. And that is why 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 taking in your mind. It can be a step towards action or towards rest or connection or self-care or whatever step makes sense to you. I invite you to take a step today because getting to a place that feels better, more joyful, more connected than the place where you are today is possible for everyone, including you, and even when depression is in your bed. If today's episode resonated with you, please subscribe so you can be notified when each weekly episode gets released. I encourage you to leave a review and reach out to me on social media at trish.sanders.lcsw. Your feedback will help guide future episodes, and I love hearing from you. Also, please share this podcast with anyone who you think may be interested or who may get something from what I have shared. Until the next time we connect, take care of yourself and take a step.