March 15, 2009
Addressing Depression in Trauma Disorders
It is no secret that trauma survivors get depressed, and depression is the most commonly known and experienced mental health disorder.
Typical depression symptoms include:
- Suicidal thoughts, recurring death thoughts, death wishes
- Suicidal behavior and suicide attempts
- Self destructive behavior, self injury, self harm
- Feelings of worthlessness, guilt, self hatred, or not deserving to live
- Loss of energy, fatigue, excessive sleeping
- Little or no interest or pleasure in anything or anybody
- Inability to think, or to concentrate, or to make decisions
- Significant but unintentional changes in weight loss or weight gain
- Significant but unintentional changes in appetite
- For children, not making normal and expected weight gains and physical growth
For trauma survivors, depression can have layered meanings beyond the typical medical symptoms.
Repeated patterned depressions can be very much related to a specific or recurring trauma, or to a significant loss. For dissociative survivors with DID/MPD, the information detailing the specific loss or trauma may be hidden away or blocked off by dissociative walls. Someone in your system might know why you are feeling depressed, and they might know what the loss is, but the host / front personalities might not have a clue.
Do you have a pattern of depression occurring at the same time of year each year?
Think back through all the years. Do you have any hints that tell you how far back this pattern goes? Do you repeatedly feel the need for hospitalization at the same time each year? Do you find yourself struggling more than usual at the same time each year? Do you find yourself having thoughts of suicide or self-injury more often at a specific time of year? Do you know how long this pattern of depression been happening?
If you have Dissociative Identity Disorder, be sure to check inside and to ask your various inside parts what they have noticed as well. Some of your insiders might have a different awareness of patterns and events than you do.
For repeated patterned depressions, it is important to find the original starting point of this depression pattern. Once you do, you will get more clues as to what it is about.
My general approach to repeated depressions that follow a pattern is to “assume” that there is a trauma-based reason for it. Unless you have a better explanation, in terms of a bipolar type depression pattern, or a seasonal depression pattern, then quite possibly it is a trauma-based pattern.
Look around inside, ask around inside, to see if there is anyone that knows the depressed time of year to be a particularly bad time for them. While you are talking with your system, be sure to pay attention to the following ideas:
- Who inside feels the depression the most?
- Do you see anyone inside who is showing the depression in the way that they are sitting, standing, laying, not communicating, not being “their usual self”, etc?
- When you look at your internal system, who is showing / feeling the biggest list of depression symptoms?
- If you can’t automatically see an internal someone who is depressed, take a broader look at your internal world. When you walk around your internal landscape, can you find-feel-sense the center of it?
- Is there a place inside where the depression feels the most intense vs. the generalized depression of everyone (similar to finding the eye of a hurricane).
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Other trauma-related questions you can ask your insiders include:
- Were there any significant losses that happened at this time of year?
- Who in your system has experienced these losses? (Do not assume that everyone in your system is aware of the same losses!)
- Did you or anyone inside lose a child /children, or a close friend, or a loved one at this time of year?
- Are your feelings of grief and loss repeatedly surfacing as a type of depression?
- Was anyone inside specifically traumatized or abused at this point in time each year?
- What happened? What do you know about that trauma?
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For dissociative trauma survivors, a significant period of depression can be a very important clue that there is an unresolved trauma waiting to be addressed. If you have the room in your life to explore its foundations, and to address how the trauma issues are related to that recurring depression, you will be able to interrupt and resolve the depression itself.
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By:
Kathy Broady LCSW
