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PTSD And Depression – Is Trauma Locking Your Client In Depression?

Why lifting a traumatic memory brings rapid progress in your depressed client

Here are three reasons why unresolved trauma may tip someone into clinical depression.

1. High-stress levels

Depression rides off the back of anxiety and stress. All depressed people are pumped so full of the stress hormone cortisol that eventually they become exhausted, and feel hopeless and powerless. Without heightened stress levels in the body, there cannot be depression.

Sustained or chronic stress leads to:

  • elevated levels of cortisol (the ‘stress hormone’), and

  • reduced levels of serotonin and dopamine (the so-called ‘feel-good’ chemicals) and other neurotransmitters in the brain.

Unmanaged stress, particularly unresolved trauma, blocks the working of these chemicals which, among other things, regulate vital biological processes like sleep, energy, sex drive, and appetite, and also permit expression of normal moods and emotions. When the stress response fails to shut off and reset after a difficult situation has passed, it can lead to depression in susceptible people. All depression treatment needs to include relaxation training to help people bring down their stress levels. But feeling traumatized also results in another phenomenon that is often a key factor in depression.

2. Feeling helpless

People can survive any deprivations and stresses if they feel they can surmount them. It’s when people feel helpless that they feel hopeless. It's when people feel helpless that they feel hopeless We all need to feel we have some control over at least some parts of our lives. So feeling that we have no control, and are powerless and helpless, is hugely depressing. ‘Learned helplessness’ (feeling helpless when you’re not because you were helpless in the past) is a major feature of many depressions. This kind of learning makes people more susceptible to depression, and learned helplessness may have to be specifically ‘unlearned’ in treatment. When people are traumatized, their emotions also feel totally out of control. For all those years following that tragic crash, Sam would have felt emotionally vulnerable as different elements of life ‘pattern matched’ to her original trauma and made her feel powerless again. She hadn’t spotted this consciously, but the unresolved trauma made her more susceptible to depression.

3. Unfulfilled needs

Human beings depress when

  1. their innate human needs remain unmet over a long period, and

  2. they ruminate negatively about the hopelessness of those needs ever being met, thus racking up their stress levels ever higher.

If this situation continues long enough, people become emotionally and physically exhausted. (2) We all have needs to:

  • feel safe and secure day to day

  • give and receive attention

  • have a sense of some control and influence over events in life

  • feel stretched and stimulated by life to avoid boredom

  • have fun sometimes and feel life is enjoyable

  • feel intimate with at least one other human being

  • feel connected to and part of a wider community

  • have some privacy and time to privately reflect

  • have a sense of status, a recognizable and appreciated role in life

  • have a sense of competence and achievement

  • a sense of meaning about life and what we do. (3)

Continuing to be traumatized long after a distressing event makes us feel powerless and avoidant. But if we start to avoid things that might actually help us to meet our innate needs, such as company, intimacy or fun, we are at increased risk of depression. This is how trauma can block the completion of these needs and both cause and maintain depression.

It’s not always about trauma People depress for all kinds of reasons, and we should never assume that unresolved trauma must be a cause. Going off looking for ‘traumas’ that just aren’t there can make ‘therapy’ quite toxic for depressed people whose depression has a different cause. However, trauma is sometimes a major factor in depression, which is why

  • knowing how to correctly identify trauma and

  • knowing how to relieve it fast are vital skills for any therapist.

Read the full article here by Mark Tryrrell'sTherapy Skills. Great article.

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