August 17, 2009
So you’re depressed, and you’re DID. That feels like a double whammy already, so what do you do now?
Depression and DID go hand in hand for many trauma survivors. They are not the same diagnosis, but can be closely knitted together.
When you are DID, you might have some parts that are depressed, while simultaneously having other parts that are not depressed. Dissociative walls and amnesiac barriers can separate the feelings / emotions / information that the depressed parts have, so that is different from what is known or felt by the non-depressed parts.
Survivors with DID can feel nearly crippled by the intensity of their depression. It follows them around like a warm blanket and a lifelong friend. Sometimes it’s hard for survivors to imagine life not depressed. The idea of being genuinely happy is a foreign concept that seems out of reach.
All too many survivors struggle with self-injury, suicidal feelings, suicidal thoughts, and suicidal behavior on a regular basis. The desire to die, or go away, or cease to exist, or quit, or sleep forever are common feelings for those that are depressed.
What to Do
Many depressive symptoms can be alleviated, or at least helped, with proper medication. If your depression feels too huge for you to manage on your own, or if your life is at risk by the severity of your depression, please make a doctor appointment at your very earliest convenience to discuss this option. At times, inpatient treatment may be warranted.
Various versions of talk therapy can be immensely helpful as well. Talking about your problems and expressing your feelings are important steps in healing, especially since depression is synonymous with emotions being pushed down and numbed into near non-existence. Addressing the traps in your life by problem-solving the double binds (where something looks like a lose-lose situation) and the things that feel impossible will help. Feeling stuck and helpless will only exacerbate your depression.
One of the key feelings to explore during depression therapy is anger. It’s commonly said that depression is anger turned inwards. Learning how to safely express your anger is essential to moving through the overwhelm of depression.
How This Applies to Those with DID / MPD
Many DID survivors have been depressed more years of their life than not. The overwhelming pain of severe trauma and the years of crushing family abuse create fertile breeding grounds for chronic depression.
There are a variety of specific tasks in treating depression for survivors with DID:
1. Find the parts in your system that hold the most intense depression feelings. You may or may not already know these parts. Some of the parts who hold the deepest depression may be tucked away deeply within your system.
2. Check about current day plans for self-injury and/or suicidal ideation. Be sure to know if you are at risk. It is important to have a solid awareness of how volatile these parts will be in acting out their feelings of depression and self-hatred. Create safety plans as necessary.
3. Ask questions about the preferred method of self-injury being used by these parts. There are hundreds of different ways to cause self-injury. The preferred methods used by various internal parts will very likely hold pertinent information about the life stories of these parts.
4. Pay attention to the patterns of increased depression through time. Are there certain times of year or certain days that are trigger points? What significance do these periods of time have? Are these dates or times anniversaries of particular traumas or difficult events? Explore these timeframes until you thoroughly understand what happened.
5. Learn more about the time when these depressed parts were originally split off and created. Ask about the starting point of these parts. Chances are, they were created during a very difficult time. The creation point will provide a great amount of information about who these parts are and why they are like they are.
6. Addressing the underlying trauma issues will be crucial in healing the depression. These parts will need to talk about what happened to them, what they saw, what they experienced, what they felt, what they believed, etc. Holding this kind of intense information deep within most certainly adds to and creates more depression. Find the courage to talk about your trauma. While it is enormously painful to address the cruelty you experienced during those traumatic times, letting this material surface and processing it effectively will help to alleviate your depression in the long run.
7. As these parts begin talking about what has been kept frozen and tucked inside, that will create movement, life, and energy. As painful as it is to address the trauma issues, it will also allow for new experiences to begin. With that comes the opportunity for something positive and healing to replace what has been stuck for years of time as traumatic and devastating.
*** Due to the length of this article, the second half of this list will be continued in my next blog post. Please come back soon to see the rest!
Do you have any comments or questions so far?
Kathy Broady LCSW