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The Trauma Recovery Blog

Traumatic Stress Injury

What Is

Depression

“Do you not see how necessary a world of pains and troubles is to school an intelligence and make it a soul?” 
― John Keats, Letters of John Keats

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Courtesy The Traumatology Institute

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Lost Connections by Johann Hari
Traumatic Stress Injury: What Is Depression?

It's normal for humans to feel sadness from time to time.  Anything can come our way to touch our heart, making us feel sad in response.  Some of us live with S.A.D. (Seasonal Affective Disorder).  With this particular form of depression, symptoms seem to be connected to the winter season for some.  For others, any change in season can bring on depressive symptoms that do resolve for the most part once the depressive time of year goes by and we're back in touch (it's said) with more rays put upon us by the sun.
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​In response to loss, grief is something to be expected.​  As we process any loss of a significant other in our lives, we can expect the denial of loss.  We can expect fits of anger.  We can expect we'll hope to bargain our loss back into life.  There may be a period of depression we go through with grief.  Ultimately, our grief works it's way through us to a place where we find acceptance.  

As painful as grief in the face of loss is, we can expect resolution of the emotional upset as grief does it's work.  We might not go through these five stages of grief in a linear way-from A-E.  But grief generally will resolve and heal, as we grow to allow grief it's time to do so.

Even a traumatic stress response that might initially depress us, with such depression coming on in the immediate aftermath of trauma, as it is with anxiety too and the immediate after-math loss of life's reference points for a time:

It's best that we consider such depression and anxiety in the after-math of traumatizing experiences as, 'a normal reaction, to extremely frightening perceived threats to well-being, that come at us in the form of abnormal human events'.

​Clinical Depression is what I wish to talk about here specifically.  This is a depression that lingers following trauma.  Clinical Depression is neither sadness nor grief.   This depression comes with intense sadness that sticks with us for too many days, months, or years without resolution. 

When clinically depressed, we feel helpless, hopeless, and there's a nagging, depressive sense of worthlessness that envelopes the one suffering clinical depression.  Depression wraps us like a sheet might wrap a body that is dead.  The feelings of worthlessness, and our inability to resolve the depression, puts a heavy weight upon our shoulders that no amount of positive talk to ourselves can lift.

Clinical Depression causes a very high-level of emotional, and sometimes physical, psychic pain.  When such feelings last for many days to weeks and keep us from living our best life, it's then that we see something more than sadness-more than grief.  Long-term (chronic) intense feelings of worthlessness is what I know my own 
clinical depression to be.

Depression as a clinical illness is relatively common.  The World Health Organization estimates that 300 million suffer with depression world-wide.  The W.H.O. also predicts that clinical depression will be the second-leading cause of disease world-wide by the year 2020. 

On it's own, clinical depression is a significant enough growing problem for humanity.  Recent studies suggest that over half of those of us living with trauma issues will also be struck with major depression.  When depression is an outcome of traumatic stress injury, with PTSD active along with depression:  This is said to be perhaps one of the most destructive combinations of conditions any human might face. 

The comorbidity between post traumatic stress disorder, major depressive disorder, and substance/alcohol use disorder is very common.  This is my own diagnosis.  It's a cocktail of issues I wouldn't pour as a drink to poison my own worst enemies. 

Depression stalls me in my tracks, putting me in a state of total despair often. 

PTSD does the opposite. 

PTSD is about hyper-arousal, where depression, as I've lived with it, is about numbing out and shutting down, sometimes to the point that I don't even want to get out of bed, let-alone, visit anyone or do anything productive with my day.

When both conditions are working at cross-purposes inside, it's often still near impossible for me to find relief.  It's the reality of the comorbidity of these issues running together that confused me in the beginning, and it's with these two issues running in sync that I gave-in to self-medicating with drugs and alcohol for relief of all the intense, emotional suffering and pain.  Giving-in to the need to self-medicate, ultimately morphed into the addictions I live with on top of PTSD and Depression today.

Because traumatic stress injury is the root cause of all my personal strife, I've accepted that each condition is with me now in a chronic way because my own stress response is out-of-whack, broken in fact.  I can have either an anxiety attack, or in social situations still my depression can take over.  When the depression takes over, I find myself in a state of dissociation-I'm in the room physically-but emotionally, I'm a million miles (with an inner-retreat) away.

It is this too-often 'lack of being present' that cost me my last important relationship.

I think that all of my illnesses are adaptations now.  Having adapted into a seeming state of being my own 'new-inner-normal', I think that biologically and psychologically these illnesses come with intent to protect me from further traumatizing harms.

This is how I've made sense of it:  Traumatic stress experiences (too many) changed how my brain functions in response to stress-making now any stress seeming again like trauma.  It's due to repeated traumatization over many years, injuring my brain with every one (without right help granted along the way) that's generated what I see as an adaptation.

It seems my brain LEARNED what in life is to frighten me to near-death.  This learning from my paramedic work went into memory under the fuel that is traumatic stress in the body.  As an outcome of learning via this fuel, the traumatic memories, as Aphrodite Matsakis shared in her pioneering work with trauma years ago, are, for me, super-learned memories that even with treatment are now difficult to undo.

It seems, and an email exchange with Dr. Robert Sapolsky (stress expert) confirmed:

With the trauma memories super-learned, my own brain shifted in both structure and function.  Having super-learned that which I must be deeply frightened about, my brain still has difficulty undoing the learning, and has still a bit of  a time re-learning in a way that puts those trauma-memories of my own to bed-into long-term memory, rather than still in short-term memory, where such past experiences, traumatizing or otherwise, actually in the brain belong.

The loss, and restoration roller-coaster ride on the train of functioning is still what these conditions put me through:  Remissions are all I wish for these days.  My own remissions continue to be hit-and-miss.  I'm in one again right now for all of my issues.  As I hope I've made clear in other posts, I'm no longer naive enough to believe anymore that any achieved remission will stick. All it takes is the right 'trigger' that ignites painful memories, and my own sense of remission can vanish in a flash.

Frustrating?  Yep, you bet it is.  I'm getting to a place where I can accept that this is simply what it is.  But, yes, I'm frustrated over my conditions still more often than I am not.  I'm hopeful that others reading here can relate.

I'll say it again:  I'm one of many who didn't get the help I needed for all of this mess of conditions early enough.  That's made my own recovery long, arduous, and painful.  I've had remissions of depression and substance use, only to be bombarded then with feelings of anxiety off the scales. I've had experiences of remission of the anxiety, only to have depression fire-up to complicate my living anyway.

Releasing the trauma from my body has only been accomplished in part, unfortunately (I had best success using Eye Movement Desensitization and Reprocessing Treatment with Self-Regulation Therapy combined).  Given my situation today, living in abject poverty, access for either treatment right now is still a barrier. 

I wish it wasn't, but it is what it is.  If I've advise for this poverty issue, it's towards policy-makers, compensation systems, and our Canadian Universal Health-Care system these days.

To quote, again, Dr. Jonathan Douglas, a personal mentor, "When right help is given, people can get well.  When right help is denied, or a case (trauma-induced) is mismanaged, people can not get well."

I'll quote here again too, British MP and advocate for mental health care, Norman Lamb:

"It's not only morally wrong, it's economically stupid for governments to not put mental health care and treatment on the same tiers as physical health care and treatment."

Why 'morally wrong'?  Because these are all legitimate illnesses, and society continues to stigmatize the mentally ill, which stalls right movement on the part of politicians hoping to maintain a base to keep their own bums-warm in our Parliaments and Legislatures (It's said that upwards of 46% of Canadians still consider the mentally ill as making excuses).

Why, 'economically stupid'?  Because as we continue to ignore issues of mental health, homelessness is rising; prisons are filling up; poverty is getting deeper; domestic violence is up; and most tragically, suicide is on the rise in Canada, as it is around the world.  It's economically stupid to ignore mental health issues, deprioritizing the conditions compared to how we address physical health, because, one-way-or-the-other:  The society PAYS for the negative outcomes of mental illnesses regardless.

Suicide is ALWAYS an outcome of depression driving one to even consider taking oneself out.  It's these issues of mental health we've frankly ignored for far too long, that will be the over-riding health-issues every society on the globe will be dealing with before long: 

As shared above, by 2020, the world health organization has determined that depression alone will be looked at as the CAUSE of much human disease.  We ignore these issues now, and we're accepting a fate that I don't believe we need to face, quite frankly, at all.

We now know that not all traumatic stress injuries result in PTSD.  Not all such injury results in depression necessarily either, when the incidents that traumatize are rightly intervened towards at the time of injury.  When we're supported from the time of injury forward, the outcomes that equate to mental health struggle need not happen. 

I'll preach, therefore, to my own last breath that anyone who's been harmed by those things in life we consider traumatizing, get help from a trauma-informed clinical helper as soon after the traumatic stress experience as is possible.  It's never too-late unless one ignores the opportunity for recovery entirely.

I was originally injured (traumatic stress) only 11 months into my career as a paramedic in BC.  Clinical depression showed up first, as I was vulnerable to depression.  I accept that where depression is concerned, I was predisposed in developing it.  It's said the body gives out at it's most vulnerable places.  For me, I was vulnerable to depress, both genetically, and for other good reason:

I spent years being intensely bullied in child-hood.  From primary school through to graduation night, I felt as though I may as well have grown up in a prison yard.  There's a family history in my world of both depression and Substance/Alcohol Use disorder.  These are my own vulnerable places, and on-cue, when traumatized as a paramedic, clinical depression was the first issue to show up.

I do believe we carry perhaps a genetic predisposition to such things.  But I've also come to believe that illness happens due to the imposition of long-term stress, or short-term traumatic stress cascading the brain and body with stress-hormones and other physiological chemistry in a way that catalyses the onset of these illnesses. 

I do believe that some of what we deal with is about nature (genetics). 

I also believe that regardless of any genetic predisposition to any disease, it still takes an environmental influence (nurture-or lack thereof) to activate any genetic coding that rings inside the tune that becomes our struggles with illnesses, both mental and physical, I believe, need a stimulus outside the body of some sort to ignite.

For both mental health and physical illnesses:  There may be gene-markers that point to the illnesses themselves that we could find with genetic testing.  But, I now believe, without the environmental influence to 'switch on' the genetic code, we're not destined to develop any illness simply because we might carry a vulnerability generated by family history and genetics. 

Genes are switches.  Traumatic stress turns-on the genes that express the illnesses of mental health we deal with.  Environmental/social factors, such as bullying during brain-development periods, trigger too the genetic-expression of the illness we call, clinical depression.  (Here's a study that discusses this take).

As I started feeling depressed short-years after starting work as a paramedic, I recalled that Id suffered depressive episodes as a younger man.  So when depression showed up again in 1994, enough that I was losing myself behaviourally, I did, for  a time, think that the work had nothing to do with me being depressed. 

Feeling worthless, and feeling lost, turning to the medical system only provided drugs to deal with the depression.  Which, really didn't help all that much.  I threw herbal medicines at it too.  Not even in combination did these medicines put my symptoms of depression to rest.  They were maybe slightly diminished, but that's the best any medications have ever done for me.

My doctor in 1994 didn't connect the dots.  He asked zero questions about the work.  He conducted no trauma-history to diagnose depression then.  In fact, I've yet to have any physician or psychiatrist conduct a trauma-history taking using any of the assessment tools I'm familiar with today.

Prior to signing up, I was actually more mentally and physically healthy than I'd ever been in my life before.  I'd soul-searched and put to rest much of my past, including my bullying experiences, having sought some help following the loss of my Dad to cancer a couple of years prior to starting work with the ambulance service. 

Just prior to starting my career, I'd grown in a huge way.  I stopped using drugs then, and stopped drinking.  I was eating right and was exercising regularly.  I'd taken up again learning to play guitar.  I joined a band with friends.  Started singing.  I took up scuba-diving and was feeling so good about myself, when the opportunity came to sign up to serve, I jumped at it as an opportunity for further growth.

Prior to my ambulance service, I felt as much like myself as I feel right now in remission.

That's what trauma does to us:  It confuses us so deeply, without right help many errors are made.  Including errors in diagnosis when are physicians are ill-informed and conduct no history.

Thus, again, this is why I preach still the need for specialized care when trauma is the core issue, causing all that we might later express as these illnesses, depression, PTSD, Compassion Fatigue, and Substance/Alcohol Use Disorders. 

My doctor missed the trauma early in my diagnosis in 1994.  Why?  Because he didn't know enough about trauma, and he didn't connect any dots by asking right questions to determine the actual history that brought me into his care.  He threw pills at me, which was all he had to treat me with.  Pills that are still with me, as getting off of them now is extremely difficult. 

Anti-depressant medications cause all kinds of symptoms when we choose to try taking them back out of our lives once they've taken hold inside.  That said, when I've tried eliminating them in past remissions, I learned the hard way that they ARE helping at some level.  So, for now, I continue with these medications.  For others, that's something best discussed with your trauma-informed clinical helpers and family physician.

By 1994, five years into the work, I'd been hit with traumatic stress numerous times. 

First, with a gruesome scene (11 Month's into career).  A suicide by rifle, near witnessed.  That was a scene for a green-horn of absolute horror.

Secondly, I'd attended the unnecessary death of a child.  Again, by rifle.  The little person was shot in the belly, playing with a gun.  The child died on us shortly after reaching the emergency room at our local hospital. 

Third, I'd attended to a crazy-scene following a murder on main street in our sleepy little town-a stabbing that because someone had started CPR, we were required to continue.  The scene was madness-fear caused me to toss the patient's brother out of the back of my ambulance at one point. 

I was then hit again with another murder.  Shortly after that, I was again hit with a suicide of a friend-a colleague, in fact.  A nurse I'd known since she was a kid.

I spoke of these calls when I entered into spiritual counselling.  But there too, the helper wasn't informed about trauma.  For my own generation of first responder, there was NOTHING done to inform us enough, nor was there right interventions available through most of these, my most traumatizing experiences on the job.

I completed a survey of potential other traumas I went through over 16 years of inner-self-destruction recently.  By the time I'd finished the survey, the count, for me, a small-town, rural, so-called part-time paramedic, topped 1500 + traumas in the work, each one ALONE could have been pointed to as the cause for me of major depression and PTSD in 2005 when I couldn't do it for another minute. 

By then, my life was in ruin.  The response of the employer and our compensation system (no help) simply finished off my marriage. 

I'm not alone and only share this towards others so that you too know you're not alone as well.  For the generation of first responders that were the first bunch to hit the wall, put up our hand for help, and  who had that help denied: Our stories aren't really that much different from one another's. For those in the general population who are dealing with trauma issues and these illnesses, I want you all too, to understand that you're not alone.

It's really within only the last five years that I've seen this society finally responding towards trauma and these conditions in a way that accepts the facts.  Too-little, too-late for some of us.  But, right on time for others coming up behind.  Help is much more readily available and our systems are slowly waking up to accept the full reality of traumatic stress injury, PTSD, Depression etc. 

We've moved an inch forward this past five years, but we've now still a very long way to go.  Miles, in fact, before I'll be personally satisfied that the world now gets it as deeply as many of us who've survived now do.

I digress again.  My writing mentor is going to get her yard-stick out.  So, I'll put myself back on track before she does.

Depression:  Nature or Nurture (both, in fact) is a very real problem for those of us who've suffered traumas in life.  Adverse Childhood experiences are correlated to the onset of depression in the traumatic-experience's immediate time-frame, but also as an outcome that presents in later adult life. 

Addiction we know is often correlated with Adverse Childhood experiences of trauma and neglect. 

Depression and PTSD walk often hand-in-hand. 

Depression and Substance/Alcohol Use walk hand-in-hand as well.

For some of us, we end up dealing with all three.  Comorbidity is common, and when a trauma history isn't properly conducted as part of the first diagnosis, mistakes are made.  With these mistakes, recovery is impeded.  Too many times with active clinical depression the outcome is horrific: 

We're losing far too many precious lives to suicide as too-many succumb to the negative thinking about ourselves that make up all of depressions constant lies inside.  I no longer believe that PTSD alone is responsible for suicides.  It is depression that carries this out as one of depressions most hideous, self-abusing, violent, full-of-lies about our worth decisions.

I survived my own suicide attempt in 2015.  I went there as depression and substance use, combined with PTSD, stole away all my remaining hope for a time.  It was an impulsive decision.  One I'd not make again.  Because, there is no need to die-once we get in touch with depression for what it is-a liar-beyond-the-worst-of-liars, hideously picking away at our being, tragically from the inside out.

Advise?

I really don't dare.  I offer my own experience.  It's now the most precious gift I have to offer the world.

What do I do when depression comes around to haunt me as though I'm worthless these days?

I thank Depression for showing up again to remind me how precious my life is-a life precious by virtue of the fact that I breathe.  I thank my depression for reminding me of this fact, every time now that depression tries to take over my own mind, body, and spirit.

YOU ARE A PRECIOUS HUMAN LIFE.

If you are depressed to the point of suicide, ever?  Call 911.  Call a crisis centre.  Call a friend you trust, or family member and don't let the liar dictate anything to you with it's own bullying judgments and the condemnation that depression can generate with so much negative thinking.

YOU DESERVE LIFE.

"You will have life, and you will have it to the full." ~ Yeshua.

Why these words?

Depression makes comparisons.  Comparisons to others as it picks away at the human soul in my experience.  Depression compares who we are, against any others we see as doing 'better than' we in life.  It compares too, the person WE WERE, depression free, to the depressed-self we've become. 

Depression's symptoms use these tactics as though it (depression) is an entity, and that entity has but one, final goal: 

To take us out.  Tragically by our own hand.

Don't let it win.  That's the only advise I feel credentialed enough, via lived-experience, to give.

Follow This Link For More About Depression from The Mayo Clinic.

Follow This Link To Studies About Depression.

Johann Hari's Take on Depression, as he's done with addiction, aligns with my lived experience where both are concerned. 

Follow this Link to Amazon, and consider giving Mr. Hari a read.

Depression?  It's  like a demon, frankly.  A lying, fool of a demon-hoping to convince us that we no longer matter.

"I thank you, Depression, for once again reminding me of my own precious, wild, yet extremely wonderful life."

When it howls at you?  Try those words.  For me:  Depression HATES it when I speak to it like that.  And, more times than not lately, as depression hears that even a demon can be loved, it retreats back into the dark, where depression (clinical) belongs.

See the Links Below to Access Trauma-Informed, Clinical Care.
  • BC Association of Clinical Counselors
  • BC Psychological Association
  • Badge of Life Canada-Therapists (For the rest of the country).

Below, as well, there are a couple of videos that discuss depression to ensure we can be best informed.

Knowledge is Power, I'll say again.  The more I learn about the illnesses I carry, the less mysterious they become, the less mistakes I make in walking through my own recovery.

Future Learn offers this Free Online Course: Covering Depression, Anxiety, and Cognitive Behavioural Therapy Techniques.

Depression hopes to kill.  Don't allow it to carry  out it's scheme.  Help is there now-even our physicians are up to speed where depression is concerned.

In seeking help, consider doing these self-assessments, and take them to your family doctor and care-providers to ensure your own trauma-history doesn't go by them and missed:
  • Self Assessment Tools: Share Results With Your Family Doctor

Be Well.  Recovery is possible.  Restoration is possible.  Learning to manage symptoms is an education well-earned.

"All we have to fear, is FEAR (of seeking help) itself." ~ FDR

Follow This Link To The Next Page: What Is Addiction?


Darren Michael Gregory: Curator-The Trauma Recovery Blog.

You Are Not Alone: Help Is Available: Follow the Links Below to Find a Trauma-Informed Care Provider in BC

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Find Trauma Informed Family Clinical Counselors Here
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Find Trauma Informed Family Clinical Psychologists Here

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More About Traumatic Stress and Depression

The Science of Depression


Understanding Trauma: How Stress and Trauma Cause Chronic Pain, Anxiety, Depression, & PTSD
Wellness and Performance.Com



Robert Sapolsky on Depression


“The more confident and appreciative of who you are, the less hold depression has over you.” 
― Omoakhuana Anthonia

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Disclaimer: These materials and resources are presented for educational purposes only. They are not a substitute for informed medical advice or training. Do not use this information to diagnose or treat a health problem without consulting a qualified health or mental health care provider. If you have concerns, contact your health care provider, mental health professional, or your community health centre
Darren Gregory © 2018. All Rights Reserved
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