In my practice, people trace depression back to trauma most of the time. Emotional trauma is an overwhelming shock to a person’s equilibrium. Trauma might be linked to an emotional, physical, or sexual attack or witnessing such an attack. War, rape, murder, accidents, and even well-intentioned medical procedures might all lead to trauma. So can single or repeated incidents of shaming and other emotional and verbal attacks. Trauma can also happen when heartbreaking losses of any kind occur.
When people are traumatized, it often shapes their beliefs about themselves or life. These trauma-induced beliefs—such as “I’m never safe,” “I’m unlovable,” “I’m a monster,” “love is dangerous,” “I’m a failure,” “I’m helpless”—affect how people feel and often contribute to depression. Sometimes an individual’s belief is based on something that was true at the moment of the trauma: “I’m helpless” is true when a person is in surgery under anesthesia (where unconsciously-remembered thoughts can still affect us).
But beliefs that formed during a traumatic event are stored without information about what that means over time. So “I’m helpless at this moment” can become “I’m always helpless.” This underlying belief may contribute to depression and helpless behavior indefinitely. If this person doesn’t get a chance to talk about their helpless feelings and express their emotions, they could carry that belief into the rest of their life. It is trauma that turns time-limited events into a part of people’s belief system and identity. It makes sense that people would be depressed when they believe they have no personal power to create the life they want.
“I’m a Coward”
Trauma-related beliefs can be a formative part of a person’s personality, particularly if trauma occurs in childhood. The trauma-related beliefs can be so painful that the traumatized person has to develop ways to coping with the belief—and then the methods for coping 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, “I’m a coward.” Living with the belief that he is a coward is so painful that he deals with it by trying to prove he’s brave: 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 euphoria and the desire to avoid the shame of believing he’s 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. Risky behaviors get him in trouble in school, which means other kids in trouble gravitate toward him while 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 trauma-belief comes to shape every decision he makes and pretty much everything about him: who he dates, what he does for money, where he lives, who his friends are.
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 he experiences other trauma, he can’t express his vulnerable feelings, which keeps him from processing the trauma, causing each new trauma to incapacitate 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 he feels is caused by this most recent loss, but it’s also caused by drugs and alcohol, living a life that keeps him from reaching his potential, and 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, 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 his whole life has been based on the way he reacted to trauma and the way he continued to react to his reaction, he will also have to unravel and replace all the aspects of his life and self-image that were created by that initial belief and shame that he was a coward.
Another example: imagine a child who is sexually assaulted by an adult. That child may respond to the trauma by believing “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, who 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 of coping with trauma stops working—maybe because she can’t find lovers anymore, or 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 find the roots of depression in trauma.
© Copyright 2010 by Cynthia W. Lubow, MS, MFT. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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