What is the link between trauma and depression?
We now know that following a traumatic experience, depression and anxiety can commonly develop.
Other symptoms which may occur include unwanted intrusive thoughts, images or sensations that can occur in daytime, or disturb sleep at night. Many feel hyper vigilant, as if to guard against some unknown threat. Others may dissociate so as not to feel aversive emotions, and space out or go numb.
Unwanted intrusive thoughts and experiences are interpreted in a self negative way, making the person feel defective, such as the time a client told me: “I am a marked woman”.
And as a result, most people with psychological trauma find themselves avoiding situations which increase their anxiety, or remind them of aspects of their trauma.
What Causes Trauma
It is a fallacy to believe that only exposure to actual or threatened death, serious injury or sexual violence, can lead to trauma and depression.
Trauma and depression can result from a number of other life experiences – for example, children and adults can show trauma symptoms in response to yelling.
I have also seen trauma and depression as a result of severe workplace bullying, a messy relationship breakup, or from having experienced public humiliation or shaming.
Children who have experienced neglect, deprivation, or abuse of any kind, including sustained high levels of parental conflict, can suffer from a kind of developmental trauma process that affects adjustment in the young adult years (5). Many can’t remember much of their childhood; often they are left with feelings of abandonment and distrust, anxiety and depression. Some are ashamed to realise they feel excessively clingy or needy. By the time I see them as adults, many tell me they feel broken, or damaged.
Trauma can turn our view of the world upside down; frequently, the world no longer feels like a safe place.
Because traumatic emotions are painful they are difficult to process. Trauma can also impact us on a physical level, getting into our bodies. Because the trauma experience has not been processed fully, unexplained physical pains or symptoms may show up. Most of the theories today about what causes trauma put an emphasis on how we process our experience, and trauma is understood then as incomplete processing (1).
Treating Depression resulting from Trauma
The good news is that I have found therapy is very effective in restoring my clients to a normal life, no matter what has caused the trauma – from sexual abuse to violent or threatening experiences.
Treatment involves a kind of recounting the original trauma. I use Cognitive Processing Therapy (4), and Exposure processes (2) for this.
Initially I am looking for what a client has come to believe about themselves and others as a consequence of the trauma. This gently eases the client into getting in touch with unprocessed trauma at a level that can be tolerated.
Once this is done, the recounting shifts to a more emotionally focused mode, in which negative emotional experiences can be worked through.
Trauma also impacts our bodies. If a client is dissociated, and finds it hard to connect to their experience, or is very dys-regulated, maybe actively self-harming, or finding difficulty in controlling anger, I use body based psychotherapy (3) as well. This is completely safe, as it doesn’t involve any touch from me. This helps with dissociation and the regulation of emotions.
The aim of trauma therapy is that you feel emotionally well again, without symptoms such as anxiety, depression and dissociation. Instead, you should feel safe, empowered and in control, no longer avoiding certain situations – including relationships, and discover that there are goals in life that seem attractive once again.
Author: Paul Carver, Bsc, Msc, PG Dip Health Psych.
Paul Carver is a Psychologist with a very wide range of experience, focused on bringing the very best evidence-based treatments to his clients – including how to overcome psychological trauma and find emotional wholeness.
To arrange an appointment with Paul Carver, freecall Vision Psychology Mt Gravatt on 1800 877 924 or you can book online.
- Barlow, D.H., Ed. (2008). Handbook of psychological disorders. NY: Guilford.
- Foa, E.B., & Hembree, E.A. (2007). Prolonged exposure therapy for PTSD: emotional processing of traumatic experience. Madison Avenue, NY: Oxford University Press.
- Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: a sensorimotor approach to psychotherapy. NY: W.W Norton and Co.
- Resick, P.A., & Schnicke, M.K. (1993). Cognitive processing therapy for rape victims: A treatment manual , Newbury Park CA: Sage.
- Shapiro, R. (2010). The trauma treatment handbook: protocols across the spectrum. NY: W.W Norton and Co.