Depression Explained

Depression is one of the most common mental health difficulties experienced across the world. The World Health Organization estimates that hundreds of millions of people are living with depression, making it one of the leading causes of disability globally.¹ In the UK alone, millions of people will experience depression at some point in their lives, and for many it is a recurring condition.²

Depression affects far more than our mood. It can leave us feeling exhausted, hopeless and disconnected from ourselves and the people around us. It often brings with it feelings of guilt, shame, self-criticism and low self-worth. Many people describe it as though they are carrying an invisible weight that nobody else can see.

Understandably, when we feel this way we look for ways to cope. Some people withdraw from family and friends, others throw themselves into work, while some turn to alcohol, drugs or other behaviours that temporarily numb emotional pain. Although these strategies often provide short-term relief, research consistently shows that prolonged isolation and avoidance tend to maintain depression rather than resolve it.³ Human beings are fundamentally relational creatures. We recover best when we feel understood, connected and supported.

For many years depression was explained almost entirely as a chemical imbalance within the brain. While biology undoubtedly plays an important role for many people, our understanding of depression has become much richer. Modern psychology recognises that our mental health is influenced by the interaction between our biology, life experiences, relationships, personality, environment and sense of meaning.

Psychotherapist Tim Cantopher suggests that depression is often "the curse of the strong."⁴ Many people who experience depression are those who have spent years coping, carrying responsibilities and putting the needs of others before their own. They become so accustomed to being strong that they lose touch with their own emotional needs. Eventually, the mind and body begin to protest.

Sigmund Freud believed that our emotional difficulties are not random. He proposed that depression can sometimes emerge when painful feelings remain outside our conscious awareness.⁵ More than a century later, psychotherapist Stephen Grosz echoes a similar idea, suggesting that our symptoms often tell a story that we have not yet fully understood. Rather than asking, "What is wrong with me?" therapy gently encourages us to ask, "What has happened to me?"

Many people arrive in therapy believing they "shouldn't" feel depressed. They may say, "I have a good family, a good job and a comfortable life. I have no reason to feel like this."

Yet depression is rarely a simple calculation of how fortunate we are. Viktor Frankl, writing after surviving the Nazi concentration camps, observed that human beings need more than comfort; they need meaning. As he famously wrote:

"Those who have a 'why' to live can bear almost any 'how'."⁶

Depression can sometimes leave us feeling disconnected from that sense of purpose, making even ordinary life feel overwhelming.

Psychiatrist and psychotherapist Irvin Yalom reminds us that many psychological struggles arise from universal human concerns: loss, isolation, uncertainty, freedom and mortality.⁷ Depression is not a sign of weakness or failure. It is often a deeply human response to life's difficulties.

M. Scott Peck begins his classic book The Road Less Travelled with three simple words: "Life is difficult."⁸ While these words may sound stark, they are also strangely reassuring. Much of our suffering comes from believing that life should not be difficult. Accepting that struggle is part of being human often allows us to face our difficulties with greater compassion rather than self-criticism.

One of the greatest misconceptions about depression is that people simply need to "pull themselves together." If recovery were simply a matter of willpower, very few people would remain depressed for long. Depression affects our thinking, motivation, energy levels, concentration and ability to experience pleasure. The very activities known to improve mood such as exercise, spending time with others and maintaining routines are often the ones depression makes feel impossible.

This is where therapy can make a profound difference.

Talking therapy offers more than advice. It provides a safe, confidential space in which to understand your experiences, make sense of difficult emotions and discover healthier ways of coping. Together with a skilled therapist, you can begin to identify patterns that may have developed over many years, understand how past experiences continue to influence the present, and develop greater self-compassion.

Therapy also helps us recognise the beliefs we hold about ourselves. Sometimes these beliefs developed in childhood and have quietly shaped our lives ever since. They may tell us we are not good enough, that we must always be strong, or that asking for help is a sign of failure. Bringing these beliefs into awareness is often the first step towards change.

Depression carries enough pain without the additional burden of shame. As Stephen Fry once observed:

"It's rather like asking someone what they are so depressed about is like asking someone what they have to be cancerous about."

Depression is not a character flaw, nor is it evidence that you are weak. It is a condition that deserves understanding, compassion and effective treatment.

At The Practice, we recognise how difficult it can be to ask for help. Depression often convinces people that nothing will change or that nobody will understand. Yet reaching out is often the first and most courageous step towards recovery.

If you are struggling, please know that you do not have to face it alone. Whether through psychotherapy, counselling, psychological support or, where appropriate, medication prescribed by your GP or psychiatrist, there are effective treatments available. Recovery is possible, and many people who once believed they would never feel better go on to lead rich, meaningful and fulfilling lives.

As Carl Jung wisely wrote:

"I am not what happened to me, I am what I choose to become."

Sometimes, the first step towards becoming that person begins simply by asking for help.

By Jane Barnfield Jukes, founder of The Practice

Footnotes

World Health Organization. Depression (2023).
Office for National Statistics. Measures of National Well-being and Mental Health in the UK.
Roy F. Baumeister and Mark R. Leary, "The Need to Belong: Desire for Interpersonal Attachments as a Fundamental Human Motivation," Psychological Bulletin 117, no. 3 (1995): 497–529.
Tim Cantopher, The Curse of the Strong (London: Vermilion, 1996).
Sigmund Freud, "Mourning and Melancholia" (1917).
Viktor E. Frankl, Man's Search for Meaning (Boston: Beacon Press, 2006 edition), 104.
Irvin D. Yalom, The Gift of Therapy (London: Piatkus, 2002).
M. Scott Peck, The Road Less Travelled (London: Arrow Books, 1978), 13.