Exploring Depression in the Head, Heart, and Gut

Emotion Series #11

June 23, 2023
Joe and Brett focus on depression and how it shows up in our thoughts, emotions, and nervous systems. Learn how to examine your direct experience to uncover the root causes of depression and get unstuck by relating to yourself in a different way. The conversation includes pointers for showing up for friends or loved ones who are feeling depressed.

Episode Intro: Welcome back to the Art of Accomplishment where we explore how deepening connection with ourselves and others leads to creating the life we want with enjoyment and ease. In today’s conversation, Joe and I focus on depression and how it shows up in our thoughts, emotions, and nervous systems. We talk about how to examine our direct experience to uncover the root causes of our depression and how to get unstuck by relating to ourselves in a new way. We also offer tips and stories about how to show up for friends and loved ones who are feeling depressed. I hope you enjoy it.

Brett: Good morning, Joe.

Joe: Good morning, Brett.

Brett: I am tired. I did not get that much sleep this week. We are preparing for our wedding. There is a lot there. There is a lot of work stuff going on. There is a lot happening in my family health wise. A lot of that is not looking really great. There is definitely just a lot. This is my fifth hour on Zoom so far today, but the good news is it is my fifth hour of Zoom with either you or Tara, which is pretty cool. That’s a pretty cool morning.

Joe: It was a good session this morning. I enjoyed it.

Brett: I enjoyed it a lot as well. We have been getting some requests from folks for topics, and something that has come up a lot recently has been requesting that we talk about depression.

Joe: Wow. It is one of my favorite topics to talk about, so that’s wonderful.

Brett: We have touched on it, but we haven’t had an episode on it.

Joe: If I recall correctly, our first iteration of our first episode was on depression. It was like three hours, and all of our friends who listened to it said we had to make it shorter and we were wandering. We never came back to it, so this is perfect.

Brett: I think we have our shorter game dialed a little bit despite us continuing to talk about it for a while. Let’s get right into it.

Joe: Perfect. Just for everyone listening, that was a professional segue.

Brett: I paid good money to learn that segue and license it from the professionals. Let’s do it. What is depression, Joe? What is this about?

Joe: I think it is something I wanted to be really particular about how I define this thing. I first want to say I am not talking about it in a clinical psychological way. What we are about to do is not to diagnose somebody. I am just going to tell you about my experience of working with people who have suffered from depression. What I have noticed is there are lots of good definitions of it, but the thing I would say is that I would define it very particularly from the place of the head, heart and gut or the human brain, the mammalian brain and the reptilian nervous system brain. I think it makes a lot of sense to define what depression is from those three places and to separate that from the symptoms of depression. I think oftentimes what’s happening is people are really working on the symptoms of depression, and they are not working on the root causes. My definition is how I see the root causes. That’s why it is the definition, and I am not defining it by the symptoms.

Brett: Got it. We are describing these three nervous systems, the human, the mammalian, and the reptilian and we also refer to that a lot in this work is the head, heart and gut. Let’s start then. How would you define depression or introduce depression as it relates to the head?

Joe: In the psychological clinical approach, there are different levels of depression, and some can get into losing touch with reality. I’ve had a friend go through that, and so I am not speaking to that at all. When somebody can self-identify as depressed, that’s what I am speaking to when I define it this way. In the head, it is a tremendous amount of negative self-talk. It means the voice in the head is very negative and very regular. That’s how I would define it. Negative self-talk is going to be a lot of shoulds, why didn’t you do this, and abusive voice in the head that’s happening a tremendous amount. It is going to be second guessing everything that happens. It is very abusive and very critical self-talk.

05:50 Brett: If someone is listening and thinks they don’t have a voice in their heads, how might that still show up in the mind if it is not something people identify as having a voice or words?

Joe: I think with depression there is a voice. I’ve never met anybody who has that level of depression. Well, that’s not true. I have met a couple of people, but they have done a lot of work to have a different thing than the voice in the head working. I know some people who are long term meditators. The voice in the head has moved away, but the depression is still there. When we talk about it, that’s where I would say the heart and the nervous system come in. It is all three levels, but some people are probably asking what we mean with voice in the head because they have never really explored that. What I would say is just be silent and listen. You will hear yourself tell yourself something, and that’s what I am talking about with the voice in the head. If you start paying attention to that, there is going to be a lot of you should have done this, you should do this, you should really do it this way, what’s going on here, and you didn’t do that right. Hurry up and get that done. Why haven’t you done this yet? You are 35 and you haven’t blah, blah, blah. Did you see how they thought of you? They didn’t like that at all. It is going to be that kind of perpetual negative self-talk. That’s what is happening on the head level of someone who is working with depression.

07:24 Brett: Let’s move down to the heart. How does it show up on the heart level?

Joe: Emotions. Particularly stuck anger, occasionally stuck grief, but if you are listening to this and you are thinking anger is bad or anything like that, I would say there is a 97% chance it is stuck anger. That’s the first place to go. Basically, when you are feeling angry, it all goes towards yourself. Since it never gets released, it never finds an out. It never finds a way to move away from you because you are not allowed to express it all. It keeps on coming back at you. That lack of expression of anger, and that can be for many reasons. There is that anger episode we have. It can be because my dad was angry, and I am never going to be like that. I was told my anger wasn’t acceptable here, and temper tantrums weren’t welcome. There are a lot of reasons people don’t get angry, but it means there is no expression of anger. In that, I am not suggesting that you go out and start yelling at people. You can express anger without doing it at anybody. In modern society, it usually has the quickest change of depression than any other thing, moving and expressing that anger on a regular basis.

Brett: You just described almost all or most cases. What about the other cases? You said stuck grief. How does that show up?

Joe: Stuck sadness, and oftentimes underneath the anger there will be some sadness, too. For maybe 3%, they can’t get sad. There is no capacity for tears or crying or that kind of stuff. That can create some depression too, but typically it is anger. If the anger moves, the tears will come naturally.

Brett: How would you know if this applies to you? Someone is thinking they feel depressed, but they don’t feel like there is any anger there. It is just about bad things happening to me or it is about my situation. There is nothing to be angry about. What kind of exploration would you offer?

Joe: Go get angry and tell me what you think. Typically, if someone thinks they cannot identify the anger, I would point out all of the ways they are passive aggressive, all of the ways in which they use being stuck or despondent or apathetic or rebellious or not being on time, and how they have somebody in their life who is their authority figure and is constantly upset with them because they haven’t been doing the thing they need to do as well as the fact that they are not in touch with their own wants. They are just constantly having a life where there are people they are disappointing and then they beat themselves up for that disappointment. I would say all of that is repressed anger as well as feeling of being stuck all of the time and not being able to change their situation. All of those things, to me, are anger that is repressed.

What I normally do in a coaching session is I take away their capacity to be passive aggressive. I will just push them and point to the anger. Eventually they get really upset with me. Then I say yeah, look, you are angry. That’s what I am talking about right there. Then they will start smiling when they see it. All of that is really not necessary. If you are depressed, get angry. Even if you think there is nothing to get angry about, I don’t know how to get angry, I can’t get angry or I try and it goes away, no, pretend you are in a play and your job is to get as angry as heck and angry until you have complete clarity. That’s the role you are playing. Your body is going to want to collapse. See yourself as an actor trying to play this role and give the most compelling performance ever. Your mind might say this isn’t true. That’s fine. I am just acting. That’s fine. Move the anger and see what happens. That’s the experiment. Don’t worry about what your head says for a minute. For those who are depressed who are listening to this, you have been listening to everything the voice in your head says for years and this is exactly where it has gotten to. If you think that’s the thing to listen to, you should expect the same results as you have right now. Instead, see what it is like to listen to your anger for 40 minutes and see what happens.

Brett: We have a couple of episodes on anger in the Emotions series that would give you some further signposting on ways to make that something that doesn’t reify shame or prove the story that your anger is dangerous or causing you to hurt people.

Joe: I highly recommend listening to the anger episode if you are going to do this.

12:50 Brett: We have spoken about how the head and the heart are involved in depression and how it shows up in those parts. How about the reptilian nervous system?

Joe: A good story on the nervous system, I was doing my first company. I went to an acupuncturist, and they said my adrenal glands were getting beat up and gave me some stuff for my adrenal glands. I asked this acupuncturist because it was my first time there if they were a Western doctor, what they would do. He said you would wait for a while and then you would start drinking a ton of coffee, maybe energy drinks and then you would get depressed, and they would give you antidepressants. The way he saw the system work was that anxiety is a big part of the depression. Twenty years later, they are starting to treat depression with anti-anxiety depression. Western people are catching up a little bit, but it is still not touching the adrenal system like acupuncturists.

The idea is that if you have been running on adrenaline over and over again, you get depressed. There are a couple of ways you can see this typically with folks. If you are constantly under self-attack from the voice in your head, you are constantly under stress. Each one of those comments is this little adrenaline boost. Another way that is really typical is I cannot tell you how many CEOs I know that when they retire, they spend a lot of time in their pajamas. They are not motivated and then they beat themselves up for not being motivated. They are suffering from their adrenals being spent, and the negative self-talk doesn’t help them recover. That’s another way to look at it.

I remember listening to Billie Jean King. Probably a lot of people don’t know who she is anymore. She was a women’s rights activist who was a professional tennis player. She was really advocating for women’s rights, some version of feminism at the time. I was listening to her talk in the 90s. She played in the 70s or something like that. She said that she woke up today and she knows she isn’t tired from yesterday. She is tired from the 70s. I know a lot of folks that are in that kind of a situation. That would be another way to describe it. Unfortunately, when people go into that, they start beating themselves up for not being productive or active instead of just allowing themselves to recuperate, which can take months.

Brett: Another question for another time, but I want to say it. How many CEOs do you see that are not in adrenal fatigue in their role?

Joe: That’s a good question. I am not going to answer that right now. That would be a crazy tangent.

Brett: That’s for another time. We have spoken to the head, heart and the gut. What else? What are some other levels on which we could define what you see?

16:20 Joe: I don’t know if this is a definition or a symptom. If it is a symptom, it is one that if you treat it seems to go to the core problem, which is the connection level of it. Most of the people who start getting into some sort of depression start isolating themselves. They either isolate themselves by just being alone a lot or they isolate themselves by making sure the interactions they have are not fulfilling and don’t have deep connection. In one way or another, they are isolating themselves. Negative self-talk has made it so that they are very ashamed, and so they don’t speak about certain things. They are not open with anybody about what’s happening inside of them. They don’t have a sense of community. That is a great way to address depression is to actively work on building your community and making sure those connections are deep and meaningful. I think that would be the social way I would describe depression. Like I said, I think it is a bit of a symptom and a bit of a cause. I don’t know exactly how to define it in that way, but I do know if you address it, it can change depression a lot.

Brett: Being both a symptom and a cause can make it that there is a feedback loop that can go in either direction, a negative feedback loop that can go either direction. A negative feedback loop of disconnection and isolation, or the positive news here is you can get into a positive feedback loop, which is really what a lot of the work that we do involves, a lot of group work, group connection and really opening up the capacity for that connection to impact your nervous system and set you down a more positive feedback loop.

Joe: Yes, I think that’s the thing about depression in general is there is a feedback loop to it. You start negatively talking to yourself. Then you start believing it. Then your performance is less, so then you talk more negatively about yourself, which means again you are going deeper into non productivity or not being who you want to be. If you tell yourself every day you are shit, you are going to start acting more like shit. If you tell yourself not to get angry every day, you are constricting and all of it feeds on itself, which is interesting. Some idiosyncrasies don’t feed on themselves like this, but this one really feeds on itself.

Brett: That seems true up and down the nervous system, too. You have anxiety and you are not even aware of the anxiety. The kinds of emotions and thoughts you are going to have on top of that anxiety are going to be anxiously produced thoughts, which are going to be the kinds of thoughts that will trigger you, causing more chemicals of fear to be released in your body that you may or may not be aware of because your emotions are stuck. That cycle also perpetuates.

Joe: They are all related. The negative self-talk makes your nervous system feel under attack. It creates more anxiety. The more anxiety you have, the more you are trying to get out of it, which makes you feel stuck. There are so many ways in which this all feeds each other, which is I think what makes it apparently challenging to get out of. It is not actually challenging to get out of. I know so many people who have totally turned the corner on this and can do it in really short periods of time.

Brett: I can imagine a number of listeners who were maybe having a hard time accessing their anger until you said it is not really challenging to get out of.

Joe: Good. Getting angry is easy. I don’t believe you can’t get angry.

20:25 Brett: What are some of the other symptoms? One of the things I notice is, especially when I have been in a place of feeling depressed, it is amazing how difficult it can be to see through the forest and actually notice it and realize that’s what is happening. What are some other symptoms you might see in someone’s life?

Joe: A couple of things on the symptoms and thoughts. You believe them, but if you really take a close look at them, you will notice they are automatic, not based on data, and they contradict each other. You will notice all of the negative thoughts all have that. They are constantly attacking you instead of trying to adjust. The voice in your head isn’t trying to adjust itself. It is trying to adjust you, which is abusive. That’s something to see. As far as straightforward symptoms, you have pessimism, forever thinking, such as it is never going to change, it is always going to be like this, how I am ever going to get out of it, and the feeling of being stuck. You have soul dysmorphia. You can’t see yourself clearly. You have friends telling you how awesome you are, and you can’t believe it. You have a short attention span. It is very hard for people to focus when they are depressed. There is adrenal fatigue. Those are all some of the things. You don’t have the energy to do something, that feeling. Those are all symptoms of depression.

Oftentimes that’s what people go after. People think they just need to think positively. They say they wish they weren’t so tired. They feel they need to do something to stop being fatigued or they are stuck when they don’t want to be stuck. They are constantly working on the symptoms, but they are asking what it is like to not speak to themselves negatively, what it is like to move their emotions, what it is like to put myself constantly in places where my nervous system can relax, or how I can stop believing the voice in my head. Those are what are far more likely to solve the problem than asking how you can become more optimistic or how you can see yourself more clearly or how you can focus or how can I not be fatigued. That’s typically why people think it is really hard because they are treating the symptoms instead of the consequences.

Brett: There is a thing you said a moment ago about there being no data behind any of the thoughts. I think that’s partially true, but the partial not truth behind that is there is data behind that, but it is selective data. The belief that it is hard to get out of comes from that it has not worked to do what you have been doing to get out of.

Joe: There is the data. You are 40 and you don’t own a house. That’s true, and it is data but it is very selected data. It is not seeing everything that you have. It is always looking at the negative side of the equation and never looking at the positive side of the equation. You are treating yourself the way you wouldn’t treat somebody else.

Brett: You think you have tried this, that and the other thing to treat my depression, and it hasn’t worked. Therefore, it is hard. All of the things you may have tried may have been to treat the symptoms in the way you just described or strategies to change your circumstances. Sometimes they might have been perfectly orchestrated to not work.

Joe: The other way to present the same thing you are saying is in every way you have tried to fix yourself, you have assumed there is something wrong with you, you need to be fixed and this is how you are going to fix it. That won’t work.

Brett: But that can be such an alluring thing. There is going to be a plan. I am going to execute on that plan, and then the plan is finished. Voila. Freedom.

Joe: You can have that. It just can’t start with the assumption of there is something wrong with you that you have to fix. If you are thinking that your voice in the head isn’t competent and you need to help the voice in the head become competent, that’s a very different approach than if there is something wrong with you that you have to fix.

Brett: The very premise of there being something wrong with you is the thought that triggers the fear in the nervous system and the self attack.

Joe: It literally is the depression. There is a way to think of it as the something wrong with me is the depression. Any fight to make yourself better is part of the self fulfilling prophecy of depression.

Brett: If we boil it down to the belief that there is something wrong with you being the core here, what are some things you can do? Let’s say belief just feels really persistent. Maybe your mind sort of gets it, but you can’t fully let that in or explore it. What are some things you can do that would be something other than treating the symptom?

Joe: I spoke to some of them, so I will probably speak to them again and see what else comes up. On the head part of it, you can do simple things like noticing every time you use the word should and see what it is like to change it to the word want and looking at the negative self-talk and questioning it to notice how it is not sensical. Literally write down the 20 most persistent negative self thoughts and then literally debate them with yourself. Take the other side and see if the voice in your head is accurate. Really debate with it. At some point, you get to a place where any of the negative self talk, you know that is bull shit. There is a little bit of truth in each of them, but the general premise is bullshit. That makes the change happen really quickly when you can see that. Another way to deal with it is when you have the negative self-talk, most likely now you listen to it and agree with it. You fucked up. Yeah, I fucked up. Instead of thinking you fucked up and you realize that’s shitty management and that’s now how you should be managed. That’s bad coaching. You hear you fucked up. Is this the voice in my head talking to itself or to me? Did I fuck up or did you fuck up?

Brett: Did I fuck up while listening to you for the past 10 years?

Joe: Or you fucked up. You shouldn’t have done that. You can literally respond to the voice in the head and say you see that it is really scared and it is okay that it is scared. There are lots of iterations you can try, but one of the things with the voice in the head is if you treat it differently, it starts behaving differently. Most of us accept and acquiesce to the voice in the head. We do this kind of, like Fitzburls talked about, overdog and underdog. The overdog is the voice saying you should do this, and the underdog says yeah, I should you, fuck you. The fuck yous are all of the ways you sabotage yourself. I should do that, and then you don’t do it. I shouldn’t watch video games, and then you keep on watching video games. That’s the underdog’s role. Once most people start realizing the voice in the head is the issue, they try to change the voice in their heads but you can also change the response. It could be like thinking you shouldn’t have done that, and you think yeah, I really shouldn’t have done that. I am such a bad person for having done that, or you can hear you shouldn’t have done that and your response can be singing a musical. You think you repeat yourself a lot, and yet I still don’t listen to you. Maybe try a different way. For the head, those are some of the ideas.

In the heart, it moves the anger. The best way is to listen to the parts of our podcast about anger. I don’t want to go into all of the ways to do it. It is very big. Then for the nervous system it is really about accepting pleasure and wanting yourself to be in a calm state, a massage, time in water, cold lunches, hot saunas, stretching, anything that allows you to feel the pleasure. What I notice is that oftentimes that pleasure is taken away with shame. The simple things you can get a lot of pleasure from like eating, breathing, walking or talking to a friend are all interrupted with shame, so it is about how you take pleasure in your daily life and all of the little things that are there. Just fully physical, enjoyable. Listening to the way my voice is vibrating and my vocal chords right now, that has a pleasure in it. That breath has a pleasure in it. How do I relax into pleasure? That is a great way to work with the nervous system.

Brett: What I am seeing is this arc from the head to the heart into the nervous system. One pathway I hear you describing is you can work with the relationship you have with the voice in your head. You might think you fucked up that opportunity, but if you listen to it and work through that relationship, you will recognize that you really wanted that opportunity. There will be some emotion under that. That moves it down into the heart. There is some heartbreak, grief and not getting what I wanted or not showing up the way I wanted to or whatever it was that the voice really wanted for me and all of the other parts of myself.

Joe: There is also fuck you voice in the head for talking to me like that. What the fuck? There is also that anger.

Brett: Then when that emotion moves, there is spaciousness in the nervous system. That third piece I hear you talking about is allowing there to be pleasure in the nervous system. It has been so used to being constricted in such a way as to be congruent with that abusive voice in the head and the stuck emotions in the heart.

Joe: That’s true for some folks, and then for some folks it is all about moving the anger. I don’t want anyone to think there is a particular order that works. Any way you want to do it is great. My experience in modern day is that the anger moving is probably the best and quickest response. The other thing is obviously community. It is a deeper connection. We talked about this. The last thing somebody can do is increase their connection, their sense of community, and be more vulnerable whether that’s a 12 step program or a course with us. There are a thousand ways, groups, psychologists, whatever you can do to share what’s going on with you and feel supported.

32:55 Brett: Whatever is a good match for you. How about the case where you have a friend who is depressed or a partner? What would you have to say about that?

Joe: Again, the issue here is what I spoke about earlier, which is if you come in with the premise that there is something wrong with you and I am here to help you or I am here to help you, which means there is something wrong with you and you are not capable, then you are only deepening the problem. There is a guy whose name escapes me unfortunately but he was a Quaker with this really strong community. When he got depressed, all of these folks came in to help him out. He said they all made the problem worse because everybody was coming in and telling him what was wrong with him. They said you could do this and here is how you can help. Good intentions, but what a depressed person hears in those moments is this is what’s wrong with me.  

He said the only person who helped him was someone who just came in and washed his feet every Tuesday, which basically was the only person who was saying you are great and perfect just the way you are. You don’t need to change a thing. He said that was the only person who was helpful during his depression. Oftentimes when we are trying to fix somebody who is depressed, we won’t want to feel it. We think there is something wrong with them. We are aggravated by them. We want it to change at some point, and so we are sending them the message that they are broken, which only amplifies the whole problem. However you do it, the idea is to send the message that you are whole.

Brett: I love the foot washing thing. It is an amplification in the other direction. He could have said I am here with you. You feel depressed. That’s okay. There’s nothing wrong with you. But he went big.

Joe: I recently had a client who had this moment where they got in touch with this very deep love, a deep sense of love, service and emotionalness, which is cool. It had done a lot to help their friend who was depressed and who had revisited them after a month of that. It was how they were moved. It wasn’t a prescription. I think that he bowed to the feet. Any way you can send the message that you are great just the way you are, and I can love you unconditionally. It is what they need to learn to do for themselves, so you can be an example of that. You can lead them in that way.

Brett: What if you can’t? What if you find yourself unable to love the part of somebody that feels they are bad or wrong because it makes you feel scared or oppressed or responsible?

Joe: It is not your job to fix anybody, so there’s that. That’s a really good signal about the thing you can’t love about yourself. If you are really in it for your own freedom, then the best thing is to learn to love the part of yourself that you can’t love in them. That will provide a lot of freedom for you. Your job isn’t to fix somebody. If you are not able to contribute to them in a way that is beneficial, then not doing harm is great. Maybe it can be a text message every once in a while. It doesn’t have to be hanging out with somebody for 5 hours every week and listening to them tell you about how everything in their life sucks.

Brett: If it came out of the obligation, it would be another way of saying they are broken and you are there to fix them even if it is by being with them in the way you heard on the podcast.

Joe: That’s right. Exactly. It can’t come out of obligation.

Brett: This was fun.

Joe: It was good. It wasn’t three hours.

Brett: It was much more bite sized and manageable than the first iteration. It was a joy for me to record.

Joe: It was a pleasure. Hopefully you can get some sleep and rest and get off Zoom.

Brett: Maybe someday.

Joe: At least enjoy it.

Brett: I am. My nervous system will get some rest some time.

Thank you everybody for listening. If this episode brought up some thoughts or questions, we would love to hear from you. You can reach out to us on Twitter at artofaccomp or you can email us at Take care. See you next time.

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