Trauma is a Seed of Depression
September 3rd, 2010
By Cynthia W. Lubow, MS, MFT, Depression Topic Expert Contributor
Click here to contact Cynthia and/or see her GoodTherapy.org Profile
In my practice, people trace depression back to trauma most of the time. Emotional trauma is an overwhelming shock to a person’s equilibrium. This may mean getting attacked emotionally, physically or sexually, or witnessing such attacks. It can happen in war, rape, murder, accidents, and even well-intentioned medical procedures. It can also happen in single or repeated incidents of shaming or emotional/verbal attack. It can even happen when heart-breaking losses of any kind occur.
When people are traumatized, it often shapes something they believe about themselves or about life. These trauma-induced beliefs affect how people feel, and often cause depression. The belief may be “I’m never safe,” or “I’m unlovable,” or “I’m a monster,” or “love is dangerous,” or “I’m a failure,” or “I’m helpless,” or many others.
Sometimes the belief is based on something true at the moment of the trauma—like “I’m helpless” is true when a person is in surgery under anesthesia (brain functioning continues but thoughts are usually not consciously remembered—they can still affect us as if they were conscious), but beliefs formed during a traumatic event get stored without information about time. So “I’m helpless at this moment, only until the anesthesia wears off” becomes “I’m always helpless.” If this patient doesn’t get a chance to talk about the helpless feelings, and express the emotions around it, this patient may carry that belief into the rest of her/his life. It makes sense that people who believe they have no power to create the life they want would be depressed. It is trauma that turns that time-limited event of surgery into a part of people’s belief system and even part of their identity. This underlying belief can cause depression and helpless behavior indefinitely.
So the trauma-related belief can be part of forming a person’s personality. This is particularly likely if trauma occurs in childhood. This happens because the trauma-related belief is so painful that the traumatized person has to develop ways of coping with the belief. The methods for coping with the belief become a new part of who the person is.
For example, say a child watches his mother get mugged, and freezes in fear until it’s over. Perhaps in his child mind, he concludes that “I’m a coward.” Living with the belief that he is a coward is so painful that he decides he will deal with it by proving he’s brave. He does this by picking fights and engaging in high-risk behavior. These behaviors give him a euphoric feeling of self-confidence, and he gets some relief from the pain of the “I’m a coward” belief. The combination of that euphoria and wanting to avoid the shame feelings associated with the belief that he is a coward keeps him trying risky things.
He is new to taking risks, so he and others begin to think of him with a new identity. These behaviors in turn get him in trouble in school, and cause other kids in trouble to gravitate toward him, while the cautious kids avoid him. This makes it hard for him to do well in school and he develops an identity as a tough, street kid with crime rather than college in his future. This shapes every decision he makes–who he dates, what he does for money, where he lives, who his friends are—pretty much everything about him.
In situations where he might feel vulnerable or scared, he doesn’t dare show it, for fear of revealing himself as “a coward.” So when other traumatic experiences happen, he can’t express his vulnerable feelings, which keeps him from processing the trauma, causing each new trauma to cripple him further. When he does start to feel vulnerable, afraid or sad, he uses drugs or alcohol to suppress the feelings and give him the high of confidence again.
At some point, this man may realize he is depressed, perhaps when a friend dies of an overdose, a woman he loves leaves him, or he ends up in jail, or a hospital. At this point, unraveling his story to find what is causing the depression
will be complicated. The depression is caused by losing his friend/love/freedom/in-tact body etc, but it’s also caused by the drugs and alcohol, living a life that keeps him from reaching his potential, and by the self-hate that has developed over the years through taking risks despite serious consequences. But ultimately, the depression began when he watched his mother get mugged. When that is resolved, and he realizes he never was a coward, and that freezing was normal and even wise at that moment, he will feel much better. He will probably begin to feel free to redefine himself and make different choices for his life. But because of his reaction to the trauma and his reaction to his reaction, he will also have to unravel and replace all the aspects of his life and his self-image that were created by that initial belief that he was a coward, and by the feelings of shame that went with it.
Another example is a child who is sexually assaulted by an adult. That child may respond to the trauma with the belief that “I’m only worth something if I’m being used for someone’s sexual satisfaction.” It’s not hard to imagine that this child might become an adult who deals with this belief by being sexually available to many people she may not even find attractive, as a way of getting some temporary relief from feeling worthless. Being sexual with many people becomes part of her personality and identity, both of which would have been very different if she hadn’t been assaulted as a child. When this method stops working–maybe because she can’t find lovers anymore, or because she gets caught compulsively having sex outside her marriage and loses her husband–she may become depressed. She will be depressed about the recent changes in her life, but again, ultimately, the depression comes from the original trauma, and from the problems caused by trying to cope with the original trauma.
As complicated as these scenarios may seem, the origins of a given person’s depression can be even more complicated. Sometimes trauma isn’t involved in the origins of depression, but most of the time, with enough exploration, I can find the roots of depression in a trauma or traumas.
©Copyright 2010 by Cynthia W. Lubow, MS, MFT, therapist in El Cerrito, CA. All Rights Reserved.
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Comments
I am depressed right now and have been working with my counselor on this exact issue, trying to pinpoint exactly when this all kicked in. I would have to say that it happened right about the time when I was in a bad wreck a few months ago and could not work anymore. Not only was my way to make a living taken away but so was my sense of independence for a while. I am working my way back to where I was but I know it takes time to do that.
Deidre,
It sounds like you are on track, unless you have unresolved trauma from the accident. Having emotional trauma symptoms after a car accident is very common. You might consider being evaluated by an EMDR therapist. If the core of your depression is the trauma itself, and not just the temporary losses you experienced after the accident, having a few sessions of EMDR could make a huge difference! You can watch videos about EMDR at EMDRinAction.com.
There are many roots to depression, with traima being but one. It may be a bit irresponsible to allow patients with clinical depression to believe that they have to find something that they can pinpoint that led them to this state. For many people this is unknowable. There is nothing in particualr that triggers depression in many people other than screwed up body chemistry in many cases. These are things that can be handled through lots of hard work with a therapist. But to make people believe that there always has to be some kind of known trigger point is simply not true.
Absolutely, there are people who are just born with brain chemistry that is the chief component in depression. There are also people who will never know the reason for their depression. But when depression starts after having a “bad wreck,” or any other traumatic event, it’s very important to explore the role of the accident/trauma in the depression.
mom saw a huge accident years ago in which two people died.although she was not in a position to help them because they died almost immediatly,she blames herself for not having helped them even to this day.
whenever she reads or hears about an accident she trembles and starts crying often saying that she could have saved their lives.i do not think this is to serious an issue to take her to therapy.is there an alternative?
I’m no expert but I think you can have a heart-to-heart talk with your mom regarding what actually went on during the accident and how any help from her side would have been of no use because the people actually died immediately.
She can then be given time to think about this and hopefully she will understand that no help could have saved their lives and that sometimes things are just how they are, they do not change even if we want them to.
Thanks for that information Cynthia. I am going to talk with my current therapist about EMDR and how that could benefit me. I appreciate the tip.
Please tell me in short why people tend to remember these traumatic events more than normal rememberance. It seems like something different is happening in a person’s brain that makes this possible.
I would also like to know if the person is able to remember all the minute details of the event clearly. I just came across this blog, and am now inquisitive to know more. Thanks,
Leni :)
Revisiting and thinking about what exactly happened and going through the episode with a new perspective often shows a person what he or she missed seeing all the while. This will also, most often, result in the visibility of a solution that can help the person overcome the trauma and get back his or her normal life and stop thinking about the event after that.
Any time that you are faced with a harsh event or situation in your life it can throw you for a loop, get you off track. And for so many of us that has been when the seeds of trauma and depression have been planted, leaving many of us with years of therapy and working things out to get back to a happier and healthier place in our lives.
But this is do-able!! You can undo those seeds of trauma and weed out the bad and foster only the good again. It may not feel like you can but this is something that can be overcome.
Of course therapy is what I know best, so I may be biased, but M. Levinstein, I think your mother is suffering much more than she probably has to. If she has that strong a reaction that you see, she probably has other areas of suffering that you don’t see. I assume you and others around her have tried to reason with her, and have made no impression. I would strongly recommend her contacting an EMDR therapist. If this guilt is not connected to any previous guilt or trauma, you mother could be free of this suffering in a few sessions of EMDR. She owes it to herself to get this help. If she does have previous guilt or trauma getting triggered by this accident, EMDR can help that too–it just takes longer. Don’t let her suffer for decades with this, if you possibly can. It may be that she is punishing herself for her preceived guilt by not getting help. This is something she can work out with the therapist, if she just goes. Be sure the therapist has plenty of training and experience with EMDR. EMDRinAction.com is a good place to start looking for a therapist.
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