Depression: How It Develops and How to Work with It from a Gestalt Perspective

Text by: Sandra Zaimović, Gestalt psychotherapist

Depression rarely appears as a sudden break. It more often arises quietly, like a shadow that spreads millimetre by millimetre, until one day a person notices that they no longer feel life the way they once did. It begins with fatigue that has no clear explanation, willpower diminishes, days become monotonous, and the things that once brought joy now seem distant and out of reach.

In Gestalt therapy, depression is not seen as someone's “fault,” but as a sign that a person has been brave for too long, has carried what no one saw for too long, and has tried to be fine for too long while slowly fading inside.

How depression differs from burnout

Burnout and depression can look similar, but they arise from different places. Burnout is the result of long-term external exhaustion: too many obligations, pressure and responsibilities with no room for recovery, so the body “shuts down” to protect itself. Depression is more of an internal process: the result of suppressed emotions, unexpressed grief, conflict between what a person feels and what they feel they “must” do, and a loss of meaning and vitality. Burnout is a reaction to an overly intense environment, while depression is a sign that contact with oneself has weakened.

In practice, burnout is exhaustion that comes “from the outside in,” while depression is “from the inside out, into everything.”

Why depression arises: the quiet logic of body and psyche

Depression is often the result of long-term suppression of what once had to be suppressed. Many people grow up with rules such as: “Don't cry, you're not a baby,” “Don't get angry, it's ugly,” “Be strong.” And so sadness, anger, disappointment, and the need for closeness and support have nowhere to go, so they turn inward. In Gestalt we call this process retroflection: energy that was meant to move outward returns inward, as if the person were biting themselves from within.

Another reason arises when a person is left without support at the moments when they need it most. When there is no place to fall apart, they freeze. When no one is there to see them, they slowly disappear from their own field of vision. Depression is then the body's attempt to protect itself: to slow down, calm down, and quiet everything that is too heavy to carry at “high speed.”

There is often also a chronic inner conflict: I want change, but I fear the consequences; I need rest, but I don't believe I am allowed to stop; I want closeness, but I feel I am not worthy of it. A life lived between “I want” and “I must not” drains energy for years. At some point, the organism gives up the fight, and energy falls.

Depression is also the result of losing contact with one's own needs. When for years you live by other people's expectations, by tasks and obligations, without asking “And what do I need?”, life becomes narrowed, too constricted. In that confined space, vitality naturally weakens.

And finally, depression is often the quiet companion of unlived grief. When sorrow has no witness, it turns into weight, into greyness, into slowness. It is as if the body bends inward, protecting what never had the chance to be wept for.

None of this is weakness. This is being human.

How Gestalt approaches depression: slowly restoring aliveness

Gestalt therapy does not try to “fix” the person or force them to be positive. Depression is not treated by forcing optimism, but by restoring contact: with oneself, with the body, with emotions, with the environment.

The first step is to slow down enough to hear what is actually happening. In a safe space, therapist and client explore together how the body carries depression: where the heaviness is, where the tension is, where the energy is “trapped.” This restoring of sensitivity is the beginning of the return of aliveness.

Then space opens for the emotions that were suppressed. In Gestalt, these emotions are not analysed coldly; instead, one stays with them, fully present, gently and without pressure. Often beneath depression lie tears that were not allowed, or anger that never had a place to go, or fear that was held down for years. When these emotions are given their space, energy slowly begins to be released.

The work then focuses on contact: not only with the therapist, but also with one's own impulses: “What do I want?”, “What don't I want?”, “What drains me?”, “What nourishes me?”
These are questions that slowly restore the sense that life has colour, not just function.

Gestalt also often works through small experiments: allowing yourself to sit differently, to breathe more deeply, to say “no” to a single demand. These are not trivial things. They are the first movements in a world that has been too heavy for a long time.

When depression begins to ease

The general state does not change overnight. Happiness does not appear suddenly. What returns first is sensitivity: the ability to notice what is happening inside you. Then a small spark of desire returns. Then a flash of energy. Then the feeling that you can do something that was not possible a month ago. You feel wishes emerging. Plans take shape.

These are small, but enormous, shifts.

In Gestalt, we believe depression eases when a person reconnects with themselves, with the parts they had to silence in order to survive. When those parts find their voice, the depressive fog slowly lifts.

And what remains is not just the “absence of depression.”
What remains is something much deeper: the sense that you are back in your life, living it, at your own pace, with yourself at the centre. Aware of all you have come through.