Feeling depressed or anxious? The connection between unmet needs and our mental health

Laura Alfred
May 11
5 min read

Therapy offers a safe space to begin noticing and exploring your needs without shame or judgment.

As a relational psychodynamic therapist, I work with people who seek therapy for many different reasons. Some arrive in the midst of a crisis or life transition. Others are struggling with persistent anxiety or depressive symptoms. Many don’t feel confident or connected in their relationships. Others are grieving – the loss of a loved one, the end of a relationship, or the unfulfilled realisation of the life they had imagined. Often, people come with something less tangible: a sense that something feels off. They might say, "I'm not myself," or "I feel stuck" or "I can't seem to connect with the people who matter to me."

Whatever the entry point, there is often something deeper beneath these experiences: the quiet presence of unmet needs.

The needs we're born with

From the beginning of life, we rely on others to meet our physical and emotional needs. Humans need attunement, along with food, shelter and safety. Attunement means paying close attention to someone’s words and body language to get a sense of how they’re feeling and conveying an understanding of this. Infants and children thrive when caregivers respond with sensitivity to their cues, when they are comforted in distress, and when misattunements are repaired. No caregiver gets it right all the time, but when there is enough consistent care, we learn that our needs can be recognised and met. Another way of saying this is that we feel emotionally contained.

So, what happens when needs are misunderstood, ignored, or met with rejection? Many people grow up in environments where their emotional needs weren't seen or valued, or were made to feel ashamed for having them at all.

In more difficult circumstances, some people have experienced developmental trauma. Instead of being comforted or supported, they faced emotional neglect, unpredictability or mistreatment. In these situations, we adapt because we have to. We might learn to become overly self-reliant, constantly attuned to others' moods or disconnected from our own emotional needs. These strategies can help us cope in the short term, but they often come at a cost: the loss of a clear sense of self, difficulty trusting others or a deep discomfort with vulnerability.

Why it can be hard to know what we need

A common challenge people bring to therapy is difficulty identifying or expressing their emotional needs, such as feeling understood, respected, valued, connected, and having autonomy. However, meeting these needs is essential to wellbeing. A problem is that it can be difficult for us to ask for these things; or even recognise that we need them. The idea of having an inner emotional world, distinct from what others expect or need, might feel unfamiliar, especially if you grew up in an environment where there wasn’t much space for reflection or emotional expression. You might find yourself focused on others or attuned to their needs, while your own remain out of reach. Or you may have learned early on that expressing needs leads to disappointment, criticism, conflict, or rejection. So, staying silent feels safer, even if it leaves you feeling alone or unseen.

Over time, that silence can become second nature. You may start to feel uneasy or even guilty at the thought of having needs at all, as though needing something from others makes you weak, demanding, or ‘too much’. It might feel easier to withdraw, to cope on your own, or to quietly hope that others will notice what you need without you having to say it aloud.

The cost of this kind of adaptation can be significant. When emotional needs go unacknowledged and unmet, we often end up feeling disconnected from ourselves and from others. That disconnection can show up as anxiety, low mood, persistent dissatisfaction, addiction of various types or recurring difficulties in relationships. The very needs we’ve learned to hide can quietly shape the struggles that bring us to therapy in the first place.

Therapy as a place to reconnect

My approach to therapy offers a safe space to begin noticing and exploring these needs without shame or judgment. In the safety of a therapeutic relationship, we can start to identify old patterns and understand how they once were useful, and how they may now be getting in the way.

This process isn't about becoming dependent or overly focused on oneself. It's about making room for parts of our experience that have long gone unnoticed. It's about learning how to feel and how to trust that our needs are valid. It also involves making sure we are spending time with people who have a basic willingness to meet our needs and how to ask for these to be met.

As we explore what has been missing, we also begin to grieve. This grieving can be for the care we didn't receive, the safety we never had or the parts of ourselves we've kept hidden. The grieving process is not a detour from healing; it's part of the path. And as needs are recognised and held with compassion, many people find that the symptoms that once felt overwhelming begin to shift.

Bringing needs to the surface

Therapy isn't just about easing symptoms, though that should happen. It's about understanding what lies beneath them. Feelings like anxiety or low mood are rarely random. They often signal that something important is being overlooked or unmet.

In therapy, we begin to explore those underlying needs with care and curiosity. This exploration can be quietly healing, especially if you've rarely felt understood. Over time, it can lay the groundwork for meeting your own needs more effectively and relating to others in ways that feel more balanced and fulfilling. This includes recognising and responding to the needs of others – not by ignoring your own, but as part of building mutual, respectful relationships.

This work takes time. It asks for patience and honesty. But it can also bring something many of us have lacked: the experience of being responded to with care, and the growing ability to care for ourselves in the same way. From here, more satisfying relationships often begin to take shape.

Suggested reading and useful links

The Talking Cure: Psychotherapy in Outline – Gillian Straker & Jacqui Winship