Can EMDR Help With Depression? I St. Paul, MN
When most people hear about EMDR therapy, they think about trauma and PTSD. But what about depression?
Major Depressive Disorder (MDD) can be complicated. For some people, depression has a strong biological or genetic component. For others, trauma, attachment wounds, chronic stress, grief, shame, or painful life experiences may contribute to depressive symptoms. And for many people, it isn't one or the other—it is a combination.
This is one reason Eye Movement Desensitization and Reprocessing (EMDR) therapy may be useful for some people experiencing depression.
EMDR isn't about convincing someone to “think positively.” Instead, it can help identify and process experiences, emotions, beliefs, and triggers that may be contributing to a depressive state.
In EMDR Solutions II, EMDR therapist and author Robin Shapiro discusses using EMDR as part of treatment for chronic and severe depression. Importantly, she does not describe EMDR as a universal cure for depression. Instead, she presents it as one component of a broader treatment approach that can include a strong therapeutic relationship, emotional regulation, medication when appropriate, nervous-system regulation, and EMDR processing.
That distinction is important.
What Is Major Depressive Disorder?
Major Depressive Disorder is more than having a bad week or feeling sad.
Depression can affect nearly every part of someone's life. A person may experience low mood, loss of interest or pleasure, exhaustion, difficulty concentrating, changes in sleep or appetite, hopelessness, guilt, irritability, isolation, or thoughts of death or suicide.
Depression can also feel intensely physical.
Some people describe feeling heavy, slowed down, disconnected, numb, or almost unable to move. Getting out of bed, showering, eating, answering a text, or going to work can suddenly require enormous effort.
This is one reason treating depression isn't always as simple as changing your thoughts.
Sometimes the entire nervous system seems to be saying:
Shut down. Withdraw. Stop.
What Does EMDR Have to Do With Depression?
EMDR therapy is most strongly associated with the treatment of trauma and PTSD. However, trauma and depression frequently overlap clinically.
Painful experiences can shape what we believe about ourselves.
A child who experiences repeated criticism may eventually develop the belief:
“I'm not good enough.”
Someone who repeatedly experiences abandonment may internalize:
“I don't matter.”
Someone who grows up feeling responsible for everyone else's emotions may learn:
“My needs aren't important.”
A person who has repeatedly felt powerless may begin to believe:
“Nothing I do will change anything.”
Over time, these beliefs can become deeply embedded. A person may intellectually understand that they aren't true while still feeling as though they are.
EMDR provides a way of working with the experiences connected to these beliefs rather than only challenging the beliefs at an intellectual level.
Depression Isn't Always Just Sadness
This is one of the more interesting ideas in Shapiro's discussion of EMDR and severe depression.
Sometimes what looks like depression on the surface may involve other emotions underneath it.
There may be:
anger
fear
grief
shame
helplessness
rejection
loneliness
resentment
emotional overwhelm
If someone learned early in life that certain emotions weren't safe—for example, that anger would result in rejection or conflict—they may become very good at suppressing those emotions.
But emotions don't necessarily disappear simply because we don't express them.
In the clinical case Shapiro describes, a client's depressive shutdown was connected to a stressful interaction with her boss. As the therapist explored the experience, anger emerged underneath the depressive response. EMDR processing focused not simply on “getting rid of depression,” but on helping the client experience and tolerate her emotions differently.
That gives us a different question to ask in depression treatment:
Instead of only asking, “How do we stop the depression?” we may also ask, “What is happening underneath it?”
EMDR Can Help Identify the Experiences Connected to Depression
When using EMDR for depression, we don't necessarily target “depression” itself.
Instead, an EMDR therapist may become curious about what activates the depressive state.
Maybe you notice that your depression becomes significantly worse after criticism.
Or rejection.
Conflict with your partner.
Making a mistake.
Feeling like you've disappointed someone.
Feeling excluded.
Being overwhelmed at work.
Experiencing a loss.
Feeling out of control.
An EMDR therapist may then explore whether the present situation connects with earlier experiences.
For example, being criticized by your boss today may activate the same emotional network associated with being criticized by a parent decades ago.
Your adult brain may know:
“My boss is frustrated with something I did.”
But another part of your nervous system hears:
“I'm a failure.”
Those are very different experiences.
EMDR can help identify and process the memories and beliefs that make present-day experiences feel much bigger than the present moment alone would explain.
Sometimes the First Step Isn't Processing Trauma
One of the most important parts of Shapiro's approach to severe depression is what happens before and around EMDR processing.
When someone is profoundly depressed or shut down, immediately diving into painful memories may not be helpful.
Instead, therapy may first focus on helping the person become more present and regulated.
Shapiro describes using breathing, interpersonal connection, body awareness, bilateral stimulation, and other strategies to help a severely depressed client move out of a more shut-down state before deeper processing. During EMDR, she also emphasizes helping the client stay physically present, breathe, remain socially connected, and take breaks when needed.
This is an important part of good EMDR therapy.
The goal isn't to push someone through trauma processing.
The goal is to help the nervous system process difficult material without overwhelming the person.
EMDR for Depression Is More Than Eye Movements
EMDR is sometimes described online as though a therapist simply has you think about something upsetting, moves their fingers back and forth, and the problem disappears.
Actual EMDR therapy is much more nuanced.
Especially when working with chronic depression, complex trauma, attachment wounds, or dissociation, the therapist needs to understand the client's capacity to tolerate emotion and remain present.
Treatment may involve building resources, strengthening emotional regulation, identifying patterns, developing awareness of body sensations, increasing connection, working with different parts of self, and determining which memories or current situations are appropriate EMDR targets.
Only then might deeper processing occur.
At Sage Leaf Wellness, we believe EMDR needs to be adapted to the person—not that the person needs to adapt to a rigid EMDR protocol.
What If My Depression Is Genetic or Biological?
This is an especially important question.
EMDR therapy does not require us to assume that every case of depression is caused by trauma.
Some people have significant biological or genetic vulnerability to depression. Medication may be an important component of treatment, and EMDR is not a replacement for appropriate psychiatric or medical care.
Shapiro makes this distinction particularly well when discussing chronic severe depression. She uses a medical metaphor to explain that EMDR can sometimes function less like a one-time cure and more like one component of ongoing treatment.
In the clinical example she describes, trauma processing was helpful. The client became more resilient and less reactive and experienced fewer depression-related sick and vacation days. However, Shapiro also explicitly acknowledges that EMDR did not eliminate the client's underlying tendency toward depression.
We think that's an important and realistic way to talk about EMDR.
The goal of therapy isn't always:
“I will never feel depressed again.”
Sometimes the goal is:
“I understand what happens to me, I recover more quickly, I have more tools, my triggers don't take me down as far, and depression has less control over my life.”
That is meaningful progress.
EMDR May Help With the Triggers That Send You Into a Depressive Spiral
Many people with depression recognize the experience of being relatively okay—and then something happens.
A relationship conflict.
An email from your boss.
A mistake.
A rejection.
A disappointing interaction.
Someone doesn't text back.
You feel like you've failed.
Suddenly, you're not just upset about what happened.
You're questioning everything.
I'm a failure.
Nobody actually wants me around.
I'm terrible at my job.
I'm always going to feel this way.
Nothing ever works out.
A relatively contained event becomes evidence for a much larger negative story about yourself or your life.
EMDR may help us identify why that particular experience carries so much emotional weight.
Sometimes we discover that today's trigger has tapped into something much older.
EMDR Can Also Help Us Work With Negative Beliefs
Depression often comes with extremely painful beliefs about ourselves.
EMDR calls these negative cognitions.
Examples might include:
I'm worthless.
I'm not good enough.
I'm unlovable.
I don't matter.
I'm powerless.
I'm a failure.
I can't handle this.
During EMDR, we're interested in where those beliefs came from and what experiences continue to reinforce them.
The goal isn't simply to replace “I'm worthless” with “I'm wonderful.”
If only therapy were that easy.
Instead, EMDR helps the brain process the experiences associated with the negative belief so that a healthier belief can begin to feel emotionally true—not just intellectually correct.
Learning to Feel Without Becoming Overwhelmed
Another important theme in Shapiro's discussion of depression is affect tolerance—essentially, our ability to experience emotions without becoming completely overwhelmed or shutting down.
For some people, depression may function partly as a form of emotional shutdown.
Feeling nothing can sometimes seem safer than feeling everything.
In a clinical case Shapiro describes, EMDR work included helping the client move toward the belief that she could have and tolerate her feelings. The work then extended into imagining future situations in which she could advocate for herself, breathe, experience anger or fear, and remain present rather than collapsing into the old pattern.
This is one of the things we love about EMDR.
We're not only asking:
“What happened to you?”
We're also working toward:
“What would you like to be able to do differently now?”
What Might EMDR Therapy for Depression Look Like at Sage Leaf Wellness?
At Sage Leaf Wellness in St. Paul, MN, we don't assume that everyone experiencing depression needs the same treatment.
We want to understand the whole picture.
That includes your current symptoms, history, relationships, attachment experiences, trauma, losses, current stressors, nervous-system responses, coping strategies, strengths, and previous treatment.
We may look at questions like:
When does your depression get worse?
What tends to happen immediately before you shut down?
What do you start believing about yourself when you're depressed?
When have you felt that way before?
Are there emotions that feel unsafe for you to experience?
Are there memories that still feel emotionally “alive,” even though they happened years ago?
What happens in your body when you become overwhelmed?
From there, we can determine whether EMDR may be appropriate and what needs to happen before processing begins.
Our clinicians may also integrate EMDR with approaches such as IFS/parts work, Ego State Therapy, DBT skills, attachment-focused therapy, and other trauma-informed approaches.
You May Understand Your Depression and Still Feel Stuck
This is something we hear frequently.
“I know why I do this.”
“I've talked about my childhood for years.”
“I know I'm not actually worthless.”
“I know this shouldn't bother me this much.”
“I understand where it comes from. I just can't stop feeling it.”
Insight is valuable.
But sometimes insight alone doesn't change the emotional or physiological response.
That's one reason people become interested in EMDR.
Rather than only understanding the story, EMDR gives us another way to work with the memories, beliefs, emotions, and body responses connected to it.
EMDR Therapy for Depression in St. Paul and Minneapolis
If you're struggling with Major Depressive Disorder, EMDR may be one treatment option worth exploring—particularly when depression seems intertwined with trauma, attachment wounds, shame, difficult relationships, grief, chronic stress, or painful experiences from the past.
It doesn't mean your depression is “all trauma.”
It doesn't mean medication isn't important.
And it doesn't mean EMDR is going to erase every depressive episode.
It means we can become curious about what is contributing to your depression and whether there are pieces of it that can be processed differently.
At Sage Leaf Wellness in St. Paul, Minnesota, our therapists provide EMDR and trauma-informed therapy for adults throughout St. Paul, Minneapolis, and the Twin Cities.
If you understand your depression intellectually but still feel like your nervous system hasn't gotten the message, EMDR therapy may offer another way to approach healing.
Contact Sage Leaf Wellness to schedule a consultation and learn whether EMDR therapy for depression may be a good fit for you.
Source:
Shapiro, R. (Ed.). EMDR Solutions II: For Depression, Eating Disorders, Performance, and More. W. W. Norton & Company.