Depression – The Other Side of the Threat Coin

By Kathryn Spence

Accredited BACP Psychotherapeutic Counsellor, Accredited BABCP CBT Therapist, EMDR Therapist

InnerFocus Therapy

11 December 2022

Depression is the opposite side of the same threat coin as anxiety

We often think of anxiety and depression jointly, but as different presentations. However, actually they’re both a response to either a real threat or a perceived threat. When we perceive a threat, we go into a state of fight, flight or freeze (as well as fawn and attach but these are not discussed in this blog). Fight or flight, a state of hyper-arousal, is typically what we understand as anxiety – our body speeds up in order to escape danger by running away or fighting. Freeze, a state of hypoarousal, is how depression manifests. In response to a real danger, this freeze response helps us survive danger by ‘playing dead’, dissociating, fainting, or freezing until the danger is over. This is extremely adaptive. However, when the danger is over and in the past, or it is imagined, or it is future based, the same survival mechanism may still kick in and we go into a state of freeze.

This can lead to a chronic state of 'freeze', it's like a state of hibernation – we withdraw, become lethargic, tired, can’t think and can’t concentrate, we have little interest in doing things, have low motivation – we freeze in life! This may then be diagnosed as depression.

Evolutionary-wise, this is actually a great survival mechanism, not only to survive acute danger as described above, but also longer states of scarcity. To understand this, we need to understand how early humans evolved to deal with stress. Early humans used to live more like other mammals. We were hunter-gatherers and exposed to a lot of physical dangers (other predators, poisonous foods, cold weather, competition for food, poor shelter, other hunter-gatherers etc.), so they could protect themselves by fight or flight. However, another major stress that early humans faced was not having enough to eat or drink. In order to survive this threat, another survival mechanism used was the conserve and withdraw response. This allowed bodies to slow down in order to save energy and this would somatically feel similar to depression now. Over the generations, both of these survival responses have been hardwired into the way humans react under threat.

The survival response our body automatically choses when we’re facing threat depends on:

• The specific threat we’re facing

• What has helped in the past keep us or make us feel safe

However, in the present day, humans don’t usually live in such a physically threatening world. Perceived (or non-immediate) threats can include:

• Change

• Judgements from others

• Loss

• Transitions and adjustments in our life

• Work stress

• Fear of failing

• A fear of social rejection

• Health conditions

• Feeling out of control

• Mistakes

• The list is endless…

When we’re in a state of hypoarousal (depression), we need to move ourselves back to our window of tolerance, where our survival needs are for rest and digest as well as social connection.

Ways to reduce our threat response and feel safe again

Identify what your threat is

• Ask yourself, what am I worrying about / scared of / anxious about?

• Is it happening now?

• If no, is it likely to happen?

• If yes, is it in my control?

If it is a threat that is happening now, then use problem solving, either alone if it’s fully in your control. Or, if it needs a team effort, enlist help from others.

If it is not happening now, then remind yourself that there is no threat in the here and now and that you’re safe, and let the worry / thought pass. Use your Wise Mind to take into account your emotions and reason to think more rationally in the present as well as respond in ways that will help you in the long-term.

Behavioural Activation

One of the main behavioural changes we experience when we feel depressed, or are in a state of hypoarousal, is to withdraw and stop doing. This is totally understandable as we are more tired, we’re thinking more negatively about ourselves and life, we have less interest and motivation to do things, and often can’t concentrate and have poorer memory. However, our instinctual conserve and withdraw response is 'turned on' mistakenly when we’re not in actual times of danger or scarcity. As a result, we actually need to do the opposite of what our bodies are telling us:

• Seek out activities you used to enjoy

• Read a book you’ve read before and enjoyed (so you feel less frustrated by a lack of concentration and your mind wandering)

• Try something new

• Seek out social connection

• Listen to upbeat music

• Do yoga or meditation

• Exercise

• Play a game

• Go for a walk

• Tidy something up

• Cook a meal

• Give yourself your Daily D.O.S.E.

Whatever you do – and it doesn’t have to be big or extraordinary, so don’t discount anything – it is important to acknowledge that you have done something when you’ve had to fight against your body’s survival strategies, so ensure you praise yourself.

Behavioural Experiments

If you are unsure of whether your threat is going to happen, and at the same time, if it did come true it’s not truly dangerous, then test it out. For example, you're worried that if you make a mistake at work then you’ll be ridiculed or sacked, or if you go out in public without make-up and feel people will stare at you or laugh:

• Write out what are you predicting will happen?

• How likely do you think that will be (e.g. 0-100%)?

• How scary does that feel to do (e.g. 0-100%)?

• Feel the fear and do it anyway.

• Evaluate the results.

• Praise yourself no matter what happens that you confronted your fear and anxiety.

• Continue this with more and more exposure until you feel your threat level is reduced.

Changing our mindset

When we’re feeling depressed, we are more negative in our thinking. We need to counter this, as it is more often than not, utter rubbish we’re talking to ourselves, despite how true it may feel. Focus on what you’re grateful for, what positive qualities you have, what’s good about you.

Deal with the past

If your threat is related to past traumas or difficulties, then identify what your experiences were and seek support, e.g. via therapy, to resolve these and leave them in the past rather than being triggered in the present.

Show Sources:

Bennett-Levy, J., Butler, G., Fennell, M., Hackman, A., Mueller, M., & Westbrook, D. (Eds.). (2004). Oxford guide to behavioural experiments in cognitive therapy. Oxford University Press.

Engel, G.L., & Schmale, A.H. (1972). Conservation-Withdrawal: A Primary Regulatory Process for Organismic Homeostasis. Spain.

Linehan, M.M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.

Porges, S. W. (1995). "Orienting in a defensive world: Mammalian modifications of our evolutionary heritage. A Polyvagal Theory". Psychophysiology. 32 (4): 301–318.

Veale, D. (2008). Behavioural activation for depression. Advances in Psychiatric Treatment. 14, 29–36.

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