August 18, 2009
Depression and Dissociative Identity Disorder, part 2
Welcome to the second half of “Depression and Dissociative Identity Disorder”. The first seven tips have been previously posted. At this point in time, I will continue with the list of tips for how to specifically address chronic depression for trauma survivors with DID:
.
8. As the memories surface, feelings will also surface. Expressing genuine emotion is key to working through depression. Crying tears of grief, screaming out in anger, quivering in fear may not feel comfortable, but holding these very real and intense emotions deep within will create long-term depression. Allowing these emotions to come out safely and appropriately – even if years after the original point of acquiring these emotions – will help.
9. In the appropriate time, let other parts of your dissociative system know about the information that was held by the depressed parts. Overcoming the dissociative barriers by sharing that information between the system parts is critical in your long-term healing. The more that your internal system shares with each other, the more you all can work together towards healing. The full story line does not have to be shared immediately with everyone. However, keeping pockets of dissociated information will continue to create an underlying cause for chronic depression.
10. Your feelings will need lots and lots of processing time. Talk, cry, draw, write, vocalize what you are feeling as many hours and hours over time as you feel these feelings. If you have been holding your emotions in for years of time, it will take oodles of time for these feelings to be worked through. Talking about it once or twice won’t be enough. Pushing feelings back down into non-expression will create more depression. While it will be very new territory to learn how to express your feelings, it is a necessary step.
11. Learn new rules about the expression of feelings. For example, in the past, when you were at risk of being hurt by your perpetrators, you most likely learned that it was not safe to express anger towards those that violently abused you. And yes, in that time frame, when you were likely to express direct injury from your perpetrators, it was safest for you to push those angry feelings deep within. At that time, that was a good decision. However, once you are away from your perpetrators, and the risk of ongoing abuse is no longer prominent, it is both essential and ok to express anger at your perpetrators’ atrocious, criminal behavior. Your healing will require that you remember to adjust with your changing circumstances, including creating new rules for expression
12. Learn to direct your anger at an appropriate target, even if that means starting with a “generic” unnamed target. Talk with your therapist about the variety of anger-expression techniques that allow your anger to be vocalized without creating harm to anyone else. Learning to express your feelings does not give you permission to take it out on whoever is there. The more you can express your anger directly towards the perpetrators that harmed you, the more effective it will be. Likewise, misdirecting your anger towards the wrong target (ie: someone who was not responsible for your abuse or injuries), will only create more problems for you, and will harm a lot of innocent people in the process. For example, getting angry with your children or your therapist will not resolve the anger you feel towards your parents.
13. As a continuation of tip #12, be willing to learn specifically about transference, projection, displacement of emotion, etc. Survivors who have had years of repressed emotion due to duress and abuse will truly need to practice expressing their emotions properly, and will need to learn when they are misdirecting their emotions. All survivors that were not allowed to express anger directly naturally learned to displace any display of anger in sideward ways. Realize that you will continue to get this mixed up for awhile. Be very aware that you might first take your anger out on safer targets. These mistakes are to be expected, and not a “fault” of yours, but it is still your responsibility to learn more accurate skills. Making the mistake of blaming the wrong person will only add to your depression. It will leave the deeper feelings unprocessed, unaddressed, and unhealed, thereby creating the foundation for ongoing depression and pain.
14. Replace the years of trauma and abuse with your own preferred people and activities that you enjoy. Once your life is full of happier, more meaningful things, you won’t feel as depressed. This probably will not happen quickly or easily, and you might have to learn how to live again. It might feel like you are learning to live for the very first time. You might have to learn how to love, or how to experience joy, or how to play, or how to forgive, or how to explore, etc. The more you can fill your life with activities of your own choosing, the less depressed you will feel.
15. Be sure to encourage all of your insiders to have their own individual healing process. Let each of them work through their own traumas, their own feelings, and let each of them find new and more positive interests in life. As each individual part of you experiences less depression, the whole of you will experience less depression. If you let only some parts heal, the whole of you will still be affected by the parts that were not given the chance to work through their healing. Remember, as split and divided as you might feel, you are still all connected within the same one body and the same one brain. To truly overcome depression, all of your insiders need the chance to overcome their pain.
Depression can be very debilitating.
Healing your trauma issues will be fundamental to overcoming the effects of the chronic depression.
In other words, in my opinion, you will continue to struggle with depression if you have unresolved trauma issues. If your dissociative symptoms have a significant negative impact on your ability to function, the liklihood of your having a significant level of major depression (MDD) is also present.
It is true that there may be other reasons for your depression in addition to trauma. (Please note: those topics were not addressed in this blog).
However, it is safe to assume that if you have unresolved trauma issues, you will most likely have chronic depression. And, the less unresolved trauma in your life, the less depression you’ll experience.
So….. get to work on addressing your DID / trauma issues. You’ll feel better for it!!
__________
By:
Kathy Broady LCSW
Kathy Broady said,
August 18, 2009 at 6:31 pm
Checking to see if the comment section is working now…
Kathy Broady said,
August 18, 2009 at 8:10 pm
Well, I can see both comments, so … as far as I can tell, the comments are working.
I’m not sure what the issue was earlier…. ????!?!?!?
I’m just glad things seem to be ok now.
Post away, everyone!
juliewtf said,
August 18, 2009 at 9:31 pm
I am beginning to think that you can be depressed for so long,
that you don’t even recognize it as depression, just as a way
of life.
After hearing the word depression, directed at me several times,
by several people (with great disbelieve) I have started to wonder
if I might actually have depression.
Who would have thunk….
I also think that people have to remember there is a waayy beginning
stage for some, like me. First recognizing the depression, the spaciness,
the everything, long before they can address what to do with it.
Kathy Broady said,
August 18, 2009 at 10:02 pm
Juliewtf,
You have made a very good point. I completely agree — some people have been depressed for so very long, it’s completely normal / natural for them, and they don’t recognize that they are dealing with an actual mental health issue.
And yes, recognizing the depression one of the first steps in addressing the problem.
And just to be clear…
According to the National Institute of Mental Health, symptoms of depression may include the following:
* difficulty concentrating, remembering details, and making decisions
* fatigue and decreased energy
* feelings of guilt, worthlessness, and/or helplessness
* feelings of hopelessness and/or pessimism
* insomnia, early-morning wakefulness, or excessive sleeping
* irritability, restlessness
* loss of interest in activities or hobbies once pleasurable, including sex
* overeating or appetite loss
* persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
* persistent sad, anxious, or “empty” feelings
* thoughts of suicide, suicide attempts
I hope you feel better soon….
Kathy
Wounded Genius said,
August 19, 2009 at 2:14 am
(I think it’s post #1 where the comments aren’t working)
In response to the first part – I was on antidepressants before I started with a DID-specific therapist who advised me to come off them because they prevented me from “feeling” (on top of general splitting and alexithymia)
Any thoughts on this policy for DID people? It sounds like you think they are a *good* idea..?
WG
ljane5 said,
August 19, 2009 at 7:33 pm
Ugh! I’m on an antidepressant and I can still say I have every symptom you listed from the National Institute of Mental Health. I know, though, that I feel better than I did. I’m not wondering about whether or not life is worth living– at least not to the degree I was before. I do not feel quite so… black.
But, this just sucks. I am so tired of being in no-man’s-land. I can’t believe my past and I can’t not believe it. How do I get to some degree of acceptance?
Ljane
Wounded Genius said,
August 20, 2009 at 2:44 am
@ljane – are you on the right ones? None of them do very much for me… just shed loads of side effects…
No advise to offer on the acceptance thing, I’m a looong way from there.
WG
Kathy Broady said,
August 21, 2009 at 2:05 pm
Hi Everyone,
I am really not sure why the blog Depression and Dissociative Identity Disorder, part 1 is not accepting comments. I can’t figure out just what went wrong, lol. So if you have anything you want to comment about part 1, please feel free to add your comments here to the part 2 thread. It’s all one big article anyway, so… your comments will still make sense and are definitely welcome.
Sorry for the inconvenience,
Kathy
Kathy Broady said,
August 21, 2009 at 2:20 pm
Hi ljane5,
Thanks for your comments. I’m sorry to hear that your depression is so very deep — I do understand how miserable that can be. I’m not a psychiatrist, so I can’t comment on which med works best or any of that kind of psychopharm kind of thing. But as a therapist, I have some ideas. I think meds can only do so much, and from what I’ve seen, it is very very difficult to find the right combination that works for each person. They can help, but they can’t do everything.
I do think one of the important things to remember is that doing your clinical work — working thru’ all the hard stuff with your internal parts, and addressing the trauma, and sorting out the conflicts, and learning to express your feelings — all those kinds of things — are equally as effective, and in the long run MORE effective than medications. If the unresolved trauma issues stay there, all the medication band-aids in the world won’t remove or take away the effects of the trauma. So… maybe there is something more? new? different? you can add to your healing work?
Expression of emotion and just having the freedom to talk really makes a big big difference in the amount of depression someone feels. And when you are dissociative, this applies to the host and the inside parts too. Everyone will need the chance to express what they are feeling / thinking / remembering / experiencing, etc. If you have to hold everything in, it’s just going to keep adding more and more to the side of “needing to be” depressed. Freedom of expression lowers the “need to be” depressed.
So my first thought is to say….. talk more, more, more!!!
I’m sorry you feel so badly – it’s really not fun to be that depressed.
I wish you the best –
Kathy
Kathy Broady said,
August 21, 2009 at 4:40 pm
Hi WG,
Well… that’s a hard question, because I’m not sure that there is one correct answer for that. First let me give the disclaimer that I am not a psychiatrist or a medical doctor, so… my opinion is not based on any medical type expertise. But as a therapist, I do see the effects of medications, and I can speak to that kind of idea. I generally think, the fewer meds the better. And if someone can manage without any medications, that is good, simply because meds really do have a lot of negative side effects. Some of the negative side effects are very troubling, to say the least.
But those people with such severe depression that they are a suicidal risk, and survivors that have bipolar, will need their medication. Intense suicidal behaviors can too dangerous to be left to just talk-therapy, so using meds to at least help the person move away from that type of self-injury could be very important. People focused on suicide / self-injury are not going to be able to address much else in their therapy, so the quicker the person is at least safely stabilized, the better. So for me, it depends on how extreme the depression / bipolar is. Bipolar really needs to be medicated as it can just spiral out of control so quickly.
I am less inclined to support medication for anxiety, unless the anxiety is really creating problems in functioning in daily life. I think far too many people turn to anxiety-meds to avoid the feelings of life / memories, and if people are trying to medicate in order to “chemically create” dissociation, then that is not at all helpful.
Survivors and their doctors really have to remember that popping a pill to remove the symptoms isn’t going to heal their trauma wounding. Medicine can’t take away the fact that you were hurt, and that you experienced various effects from those injuries. Addressing the trauma is more effective in the long run than taking meds to try to squash things back down again.
That’s a quick reply – hope that helps.
Kathy
Wounded Genius said,
August 22, 2009 at 12:26 am
Hi Kathy,
Thanks for the reply. I guess with meds you can’t treat the whole system in one go – for example I have parts that are SI-prone/suicidal but treating that with meds deadens everyone. Also, some parts are more effected by side effects than others. At least with talk therapy, everyone gets the same consistent treatment
muffledones said,
August 22, 2009 at 5:16 pm
I agree with the comment on not knowing your depressed.
I have never scored NOT depressed on the beck depression test, not even close, even when I have felt I’m not depressed. ( think one time I actually WAS below severe though….)
Throw in different ‘parts’ and as usu its all the more confusing.
I am glad you posted about depression, cuz I keep forgetting that I need to address it.
But I s’pose….first I gotta learn how to feel, or let myself feel….
Thx
Kathy Broady said,
August 29, 2009 at 3:28 am
Hi muffledones,
Oh dear, it sounds like depression has become such a normal, everyday state of life for you that you that “depression” is just how life is. I’m sorry to hear that… Because, living a life with that much depression must feel very sad, or very flat… or just not so fun… If you could ever get not-depressed, you might be surprised at how life feels when you’re not depressed.
I have a guess tho’… besides with all the other stuff that you are keeping tucked inside… and keeping your feelings pushed down, and not allowing yourself to feel is going to cause / create / enforce depression. But being dissociative, I’d also guess that a lot of your feelings, or most of your feelings, are tucked away in some of your other parts. SO…. it goes back around to really really connecting to the other parts of yourself. The more you can and will talk to your parts, and the more you allow them to have freedom of expression, the more you will be able to feel, and in time, with enough expression, you will not feel so depressed anymore.
Depression is a complicated thing, so… it might be more involved than that for you – but this stuff might be one of the key factors.
Remember to let those insiders out to have a voice! Or listen to them from within. But talking together consistently and repeatedly – that’s a real key to lifting depression for dissociative trauma survivors.
Thanks for your comment, and I hope that you feel better soon.
Warmly,
Kathy
sammicans said,
September 27, 2009 at 2:10 pm
Hi Kathy,
I found your site and this particular blog to be helpful with my situation. I have been going to therapy on and off for the past eight months, dealing with CSA (Childhood Sexual Abuse) for the first time. It happened thirteen years ago, for a period of three years, and now that I’m a young adult, I decided to reach out and get some help for my issues. It wasn’t easy, which is a broad statement, but at the time, I didn’t think I had any issues to address, other than, I just needed to get somethings off of my chest. Therapy was going great and after eight months I decided to step away from counseling and manage things on my own. It wasn’t until a month into doing so, I started feeling very depressed, as in your blog, and I realized there were things I didn’t share with my therapist because it wasn’t affecting me at the time and it was embarrassing. I happened to be with a trusted friend at the time of my melt down, who talked with me about what it was I was holding onto and suggested I call my therapist and make an appointment to see her again. I have yet to see my therapist, but ever since I talked with my friend, which has been about two weeks ago, I have felt so emotionally “out of it” and in shock. I attempted to write in my journal the other night about my childhood, and I was overwhelmed with emotion, I had to stop writing. I have never been in this state in my life, I feel so numb and distant. I don’t know how therapy is going to go during my next appointment, but from reading your blog, I hope “change” will occur and I’m not either like what I was before therapy, nor in this state forever. I realize every person is different and working through emotions is a process, but I’m also a full-time student and working full-time. I have to focus at some point on my activities and hold down my job duties. I haven’t been given a diagnosis other than mildly depressed, I have tried an anti-depressant at one time, but I didn’t find it effective to help me work through my emotions. How do you feel about anti-depressants and the healing process?
Kathy Broady said,
October 11, 2009 at 5:15 pm
Hi Sammicans,
I am glad to hear that you have started to work on your healing. I think it takes quite a long time to work thru’ all the feelings, and emotions, and confusion, and “mixed-up-ness” that comes from being sexually abused. Sexual abuse affects so many more areas of the mind, soul, body, and social relationships than people may realize at first. The healing process is not a quick thing by any means… Important, yes, but it doesn’t go fast, especially not when there are other things in life to tend to (ie: full time work, full-time school, etc).
It sounds like you are still very much in the early stages of your healing journey…
Be kind and gentle to yourself – you’ve got a ways to go, and a lot of painful connections to make…
But healing also brings greater depth, and deeper peace, and a compassionate understanding for so many things in life, a solid resolution and stability…
It’s well worth the effort.
But yes, its a very hard and painful journey at times.
As far as medications go – I’m not a psychiatrist with direct medical training, so I would refer that question to someone with that kind of background for more specific answers for you.
As a clinical answer from my experience, some of my clients rely heavily on anti-depressants, and some refuse to touch the stuff. I think it really depends on the individual person, and how much they can manage their depression without falling too far in.
But one of the most important aspects of feeling better, and overcoming depression, is finding a way to express what has happened to you. Telling your story in whatever way it can come out — not having to hold in big heavy secrets, not having to hold in emotions that were locked away for years of time — those things will give you a kind of freedom that will make the biggest difference in your feelings of depression in the long run.
Keep at your healing journey – it’ll be worth it…
Warmly,
Kathy
multipixie9 said,
November 13, 2009 at 3:11 am
in your first post on this topic of depression you said it “follows you around like a warm blanket and a lifelong friend.” I gotta say I radically disagree with that. It follows me around like a bad case of lice followed by a sadistic mugger!!!!!!!!!!!!!!
I think I have probably been somewhat depressed for my entire life, things started out grim and never got much better. Depression never, ever felt comforting like a warm blanket, it always felt like something malevolent just waiting for me to slip up so it could overwhelm me and completely distroy me.
Sorry if this seems over the top, I just feel like depression has been one of the worst symptoms of my struggle to survive violence and ritual abuse and a whole lot more crap in my misbegotten childhood. BAH HUMBUG!!! I hate depression and wish i could get angry and yell a lot. GRRRRR!!!!!
deborah of pixies
Mona said,
November 14, 2009 at 9:32 pm
Deborah…I wrote this poem some time ago. Depression is certainly an old “friend” but not in a warm fuzzy kind of way. I thought you might relate to it.
Mo
Depression
He paces in the shadows,
wanting in
watching with cold, hollow eyes
for an opening
however small
where he can slip in
and with icy hands
burning on my shoulder
push me down and down
until the weight becomes too much
and I just want to sink
Into the earth
and become a shadow too.
Kathy Broady said,
November 15, 2009 at 9:19 pm
Deborah of pixies,
Oh dear! I’m so sorry to hear that your depression feels like a bad case of lice followed by a sadistic mugger! YIKES!! But then again …. it’s good that you were able to find a metaphor that is much more accurate for how it feels for you. I get your point tho’ — depression can be overwhelming, and it can destroy people’s lives, so… in that sense, I completely understand.
Your comment was not over the top – it is completely ok to say how things are for you. And frankly – I think that the more you could get angry, and the more you could yell out some of the stuff you are holding in, that might help bit by bit. Remember the saying… depression is anger turned inwards. Maybe that is particularly true for you????
I hope it doesn’t get you. Maybe yell at the depression itself? (not at yourself, at the depression that is following you around) … ???
Thanks for your post –
Kathy
multipixie9 said,
November 16, 2009 at 12:05 pm
Kathy you are very correct about my needing to be able to access the anger that must be there, rage really. The ones who abused me worked a lot of programming me to deny and disallow feelings – or the expression of feelings. They would continue to harm me until I accepted it with no outward sign of feelings.
I am grateful I am now beginning to cry and become angry. Anger in myself frightens me because as a little I wanted so much NOT to be like those evil people. Now I am desperate to begin letting these old toxic out. I’ve been letting my spouse verbally abuse me and it happened this weekend and I never truly saw it for what it is, but he goes on lengthy rants about my faults and tries to control me with fear. BUT, it is beginning to fail. I used to cry when he did it, now I just watch him. Today when I see my T I am going to ask to begin to do whatever it takes to STOP allowing him to disrespect me in our home. It’s so wrong of him to do it and me to take it! When he was gone Sunday, my feelings erupted and I let them go and yelled as loud as I could and just let all my feelings freak out and I am so proud of my insiders for doing that. Phil is behaving like a rotten ratfink and his actions anger and disgust me. (blowing big raspberry here ! )
Mona, Thank you for sharing your poem, you really expressed it very well. Someday I believe you and I will have good and beautiful things to express. I don’t believe this pain is all there is or is a forever place. We will do more than survive. Today lets just hang on together with all the other people working to recover from a horrid past.
I appreciate this forum Kathy and All of you who write in.
Deborah/Leslie
skyborn5 said,
December 6, 2009 at 7:03 pm
Kathy,
For me depression is still a relatively new concept. For most of my life I have either been manic or suicidal. Or not present. But last year I was actually completely stable and mostly integrated for the entire year. This year, however, everything has fallen apart. I have a lot of cats that I love more than anything and they all got sick with a disease that is supposed to be always fatal. I was very blessed and only lost 5 of them, plus a puppy to Parvo, but I cannot grieve for them because if I cry I can’t stop and that scares my cats and my dogs. Last year was the first time in my life that I actually wanted to live. This year I didn’t have a choice. I knew beyond a shadow of a doubt that if anything happened to me that all of my cats would be euthanized because no one else could afford to treat them. But now they are all getting well. By Christmas the last of them should be completely well. So my automatic reason to live will not be there anymore.
My sisters (alters) don’t cause me any stress. They try to alleviate it. I cause them stress most of the time. They are very caring and supportive and amazingly creative at thinking of coping strategies, but they have been doing it my entire life and they are weary and discouraged. Not suicidal, but running out of things to say to me.
I’m just sort of trudging through life right now. Doing chores. Going to work. Pretending like everything is fine. But it is very much NOT. And i don’t know how much longer i can hold it together.
Ria
Kathy Broady said,
December 10, 2009 at 2:50 pm
Hi Ria,
Welcome to Discussing Dissociation – it’s nice to hear from you.
I am sooo very sorry to hear of all the losses you experienced with your cats and dog. Pets are just so very important, and how heartbreaking it would be for you to lose so many of them. It sounds like you have a real tender heart for animals – are there some animal shelters in your area that could your help?? I know there are a lot of animals out there who could use the devotion and compassion you have for animals…
That much loss in one year is so very painful… and completely depressing…
I hope things get better for you soon.
Kathy
skyborn5 said,
December 10, 2009 at 6:57 pm
Kathy,
I think you must have missed about half of what I said. I AM a rescue. My rescue is called Healing Hearts. I have 18 cats, 3 kittens and 2 dogs here right now. More animals would be the last thing on earth that I need right now. I have spent my last pennies on getting all of my cats well from FIP and I am busy enough with my job, my graduate school and caring for all of my own animals, with my own medical problems. Since I’ve had FIP and Parvo at my house, I’m not even supposed to be touching other people’s animals. That’s one of many things that I find depressing. Even if I had friends, they could not come and visit because my house is so contaminated with highly contagious and highly fatal diseases. I plan to eventually replace everything – the carpet, the furniture, all of the cats and dogs’ things, and repaint the walls, to get rid of both viruses, but right now I am struggling to buy food for everyone. And putting up ads every place I can find online and in person to try to get my foster kittens and some of the healthy friendly adult cats adopted for Christmas. I could really use some people to volunteer to come and help ME, but no one wants to because of the Parvo and FIP.
Ria
Kathy Broady said,
December 10, 2009 at 10:26 pm
Ria,
OH! No, I didn’t understand at all that you yourself were already the rescue facility. But oh my goodness…. the additional explanation to all the complications of FIP and parvo certainly helps me understand more of what you’ve been going thru’. How overwhelming is that?!!! Maybe one day when your house is all spiffed up with the new stuff, you’ll feel all this a little differently, but yeah, at the moment, I can really understand how heavy all this is on you. The loss, the overwhelming cost, the feeling of contamination, the forced social isolation — all that — definitely becomes depressing.
I do know that sometimes helpers pay a very steep price for being willing to help others. Something doesn’t seem right about that, but it does happen.
I’m sorry that it is costing you so much…
You must truly care so very deeply for your animals….
I hope some good-hearted people are looking to adopt some kittens for the holidays!!
Warmly,
Kathy
skyborn5 said,
December 11, 2009 at 6:51 am
Kathy,
Right now I’m waiting on my last three sets of FIP test results, should have them back by Monday or Tuesday, and I am expecting them to be negative. Which will be wonderful for the cats…but not so great for me. Because I will have lost my automatic reason to live, which has been that I have to live so I can care for my animals because no other person or rescue has space to even foster them, much less treat them. But once they are all healthy, that is no longer an issue. And there’s just not really anything else holding me here. I have no friends, no real family, have never had a meaningful relationship with another person in my entire life. So what is there really to stay in this world for? Not much that I can see…
Ria
It’s all in my head « Wings over waters said,
October 22, 2011 at 5:13 pm
[...] Healing, Mental health http://discussingdissociation.wordpress.com/2009/08/18/depression-and-dissociative-identity-disorder… So I call in sick at work as I cannot face any of them right now. I can’t take any more of [...]