The development of depression is influenced by numerous factors. However, a common characteristic among those affected is limited access to their own emotions. The psychologist Stefanie Stahl explains in an interview why this limitation can often be traced back to experiences from childhood.

Depression comes in a variety of forms and degrees of severity. On the one hand, the disease can be explained by genetic factors, but on the other hand, its origin and severity always have to do with a person’s individual biography. Lifestyle, trauma and childhood play an important role here.

The well-known psychologist and best-selling author Stefanie Stahl explains in the FOCUS online interview how depression is related to the emotional world of those affected, why the cause of the illness can often be found in the first years of life and what can help.

Ms. Stahl, why do some people develop depression and others not?

Stefanie Stahl: Metabolic processes, genetic factors, but also trauma play a role in the development of depression. Most of the time, several things work together: someone may have a genetic predisposition to depression and then stress-causing factors come into play. The most typical and well-known depression that everyone experiences from time to time is a strong grief reaction to experiences of loss.

But clinical depression looks a little different. People don’t necessarily feel sadness, but rather they complain about a complete lack of feelings.

Why is it dangerous when we no longer feel anything?

Stahl: Without our feelings we would have no value in life. If we feel nothing – as is the case with severely depressed people – then everything is indifferent and irrelevant.

Our feelings evaluate what we experience. It is incredibly important that we can feel happiness, because otherwise life would mean nothing to us.

This is exactly the case with depressed people: they feel neither happiness nor hope. Hope is the substitute drug for happiness. This means: If you are currently in a difficult life situation and at least have hope that things will get better at some point, then you can persevere. But when you lose hope, your will to live also crumbles.

Without our feelings we would have no motivation to do anything at all. Does this also explain the lack of motivation in depressed people?

Stahl: Yes, because feelings always make suggestions for action. That is, by evaluating what we are experiencing, feelings also advise us in which direction we should go next. Whether we approach each other and say, this seems to be a good direction, I will do that, i.e. make a positive decision for something, or decide against something if necessary. People who have poor access to their emotions always have difficulty making decisions because they don’t have a clear emotional choice in which direction to move.

Depressed people have the impression that they are at the mercy of their mood, their relationships, their entire life and no longer have any options for action. This creates a state of resignation and the abandonment of all efforts.

What do people in Germany get sick with? In a major focus area, FOCUS provides online information about the four major widespread diseases

We shed light on the medical background surrounding causes, symptoms, risk factors and treatment options. At the same time, we show you what you can do for each illness to minimize the risk.

In case histories, one affected person also reports on their life with cancer, heart disease, dementia or depression – moving, sometimes sad, but always encouraging.

Why can someone have poor access to their feelings?

Stahl: Childhood plays an important role here. Because our brain still has to connect in childhood. We are born with a relatively unfinished brain, but one that offers an incredible number of possible connections. The connection always occurs in close interaction with the environment. Parents are, of course, an essential part of the environment.

If the parents do not manage to adapt sensitively to the child and its needs, then the child learns very early to adapt to the parents. The child behaves in such a way that it harmonizes as well as possible with its parents. Children are dependent on their parents and have to get along with them. Children also always love their parents and will do anything to please their parents.

If I learn very early on to always adapt to my parents, i.e.: How do I have to behave so that my parents are happy? How do I have to behave so that mom and dad don’t fight? How do I have to behave so that I am praised as much as possible or so that I am scolded as little as possible? If the ability to adapt is very high in childhood, then the child learns very early on to suppress its own wishes and needs, which are always closely linked to feelings. As a result, the child develops a poor connection to his feelings.

Can you give an example?

Stahl: A four-year-old comes home from kindergarten and is sad because his friend didn’t want to play with him. If the mother or father doesn’t respond to this, or even says, “It’s not that bad,” and something like this happens more often, then the child doesn’t learn to name these feelings correctly. But if the caregiver says: “You are sad,” then the child already knows: Ah, this feeling that I am feeling is called sad. And secondly: The feeling is appropriate and I can be sad. Through this verbal and sensitive support, children develop a connection to their feelings.

Why is early childhood so crucial?

Stahl: Our limbic system, the seat of emotions, is still partially developing in the first two years of life. If parents are unloving, or have little time, or perhaps also have little ability to bond and the baby cries a lot but no one comes, so that his wishes for closeness are not properly heeded by the parents – then this baby learns early on to suppress these desires for closeness it doesn’t always come to need. And then certain hormonal circuits in the brain actually do not develop properly. However, hormones are the carriers of our emotions. If this happens in the first two years of life, then that person will have problems in adulthood.

What problems, for example?

Stahl: People who are over-adapted at heart because they learned to deny their needs and feelings as children have a predisposition to burnout, which can also develop into depression.

Because if you don’t really notice your feelings, you won’t notice when you’re very exhausted and need a break. These people are much less aware of the limits of their resilience, so they go beyond their physical and mental limits for a very, very long time and still have the feeling that their efforts are unsuccessful. They try incredibly hard and don’t even feel successful.

What can help people who have depression?

Stahl: That depends on how severe the depression is. In severely depressed people, the brain metabolism is so out of balance that medication, or what I currently think is very promising, MDMA preparations, must first be used to help them get out of this state. Because these people can no longer be reached through conversations.

In the case of mild and moderate depression or burnout, which is exhaustion depression, it is important to reestablish a good connection with your own emotional world. As already mentioned, if people were over-adapted in their childhood and always thought about what others expected of them, they often have difficulty correctly perceiving their own needs and desires.

It is therefore helpful to consciously pay attention to yourself, to consciously feel your own feelings and to take responsibility for ensuring that you are well – instead of expecting something positive to happen on the outside.

What is the best way to get in touch with your own feelings?

Stahl: The most important thing is that you actually feel the feelings. This sounds banal, but many people have difficulty with it. It can help to take stock and ask yourself: What are feelings that are familiar to me and that I allow myself to feel? And: Are there perhaps also feelings that I am not very familiar with?

Then you can also take a look at your childhood: What was it like at home? Do I feel all the feelings? Or were there certain feelings in my parents’ home that my parents couldn’t handle well, so I learned early on to push them aside and suppress them?

Next, you can try to get back in touch with your feelings better. And that usually works if I pay attention to them at all. Because ignoring feelings is an automatic process for many people. This automation can be countered with mindfulness.

Mindfulness?

Stahl: I recommend that those affected stop and ask themselves ten times a day: How am I actually feeling right now? What need do I have right now? That doesn’t mean that you give in to every need straight away. But that you even notice it. This means that you begin to train your perception of your own emotional life more strongly again.

And if you notice that there are feelings that don’t want to show themselves, then you can trigger them. For example, if you realize that I have a very bad approach to sadness, then you can specifically watch a sad film. Or if I notice that I am very inhibited by aggression, then I can use a small spark of anger – not push it away straight away, but give it space inside.