C-PTSD and Depression
Don't Fight It. Embrace It!
February 11, 2021
Today’s episode is about depression, Major Depression to be exact and the role it has played in my life and how it is entwined deeply into the fabric of C-PTSD and PTSD. You can’t have these conditions and not be depressed. I hope today’s podcast helps some of you to ease your load a bit and take steps towards healing. It’s late and I’m tired and it’s good enough.
I found Psycom.net had a nice approach to how Major depression is defined and treated. There is a ton of really good information throughout their website. It is definitely worth the effort.
If you are curious about the workings of Major Depression, Very Well Mind has some good stuff. You would be surprised as to all what is going on in your brain when you have depression.
Here’s the Wikipedia page for the Feeling Good Handbook. This book revolutionized the treatment of depression and anxiety disorder and has been proven to be equally as effective as medication for the treatment of these conditions.
And finally, here is the straight scoop about suicidality. Here is where you are going to find out how to know if someone you know is having suicidal ideation and what you can do about it. Great information.
C-PTSD and Depression
Don’t Fight It, Embrace It!
February 11, 2021
Hello and Welcome to Out of My Mind in Costa Rica. I’m your host Ray Erickson. Today I am talking about depression because you cannot have PTSD or C-PTSD without depression. It’s a package deal and nobody knew they were signing up for it. Depression has been a lifelong component of my life and it has taken me decades to learn how to recognize it early and intervene in a way that actually helps. This will also probably not be the only time I feature depression on Out of My Mind in Costa Rica because, like me, you probably need repeated exposure to good information.
Here’s a brief update regarding communication with my wife. Even though there has been some communication, she has not responded, specifically to the email I sent a couple of weeks ago. This is not a good sign, but as part of my efforts to heal myself, I am not taking this personal, not like I did in the past. In fact, I could site literally dozens of dozens of experiences where I had been triggered by something she said or done, but all that would be is whining and if you are going to heal, you must stop whining about the unfairness, injustice and misunderstandings that have occurred in your life. You must take responsibility and whining about things does not help.
Depression has been a big issue in my life because each time I became triggered, the depression followed. For years this went on and I had no idea what was happening. I didn’t know I had C-PTSD. I just knew something was going on. I tried a number of psychotropic medications to address the symptoms including, but not limited to: Imipramine, Dexedrine, Wellbutrin and Seroquel. I was thinking the main problem was Attention Deficit Disorder and the Doctor was thinking Bipolar. Looks like we were both wrong. This was a really difficult time. My relationship was going down the tubes and nothing seemed to help me to control the angry outbursts.
Even though depression was a huge problem, the bigger problem was the explosiveness that occurred with increasing regularity. Sure, I had all of the symptoms of depression, but I would muscle my way through the depression not knowing the problems were due to PTSD. Complex-PTSD didn’t exist, medically, in those days. This was especially difficult. I was in the mental health field. I was in private practice and I was the Co-Coordinator for the local chapter of a professional social work association. I was a madman running around pretending I was doing fine. I can’t count the number of clients I would see when I was more depressed than they were. Fortunately, the very act of being there for someone, acted like a short-term antidepressant and I could, for that 50 minutes be focused on their needs. There were other days when I needed to cancel all my appointment and go back to bed.
Eventually, the depression began to break down my ability to function. In addition, an underlying aspect of my development included an insecure attachment style, Therefore most of the depression I experienced came about in response to my failures; whether it was academic, professional, or interactive with the people I loved. There was always an external reason to explain why I was depressed. I would crash and, in a day, or so, life returned to “normal” until the next triggering event. I want to be clear here, I was rarely triggered while in the act of profession interaction. All of my triggers were within my personal relationships, in particular, my love relationships.
But depression wasn’t always a result of having failed in one form or another. Depression would creep up on me even at the most joyful of times, as if I felt I didn’t deserve to be successful or the belief that I was a fraud would creep in. Afterall, how could a person who never had children be able to help parents who were struggling with their children? This self-doubt also infiltrated my mindset when it came to my book, Ten Tips to Tame Your Teen. Who’s going to buy a book written by a man who’s never had children?
But it’s a wonderful book backed by more than 40 years of working teenagers and families. It is filled with expert observations and wildly effective interventions delivered with sincerity and compassion. Heck, the Kindle version is free on Amazon. Check it out. Sometimes, while listening to music, an audio chapter will que up and I listen to it. I know it sounds narcissistic, but it’s just really good stuff and I keep telling myself that I need to publish the audiobook, but...life intervenes and that has yet to happen. Maybe soon. It depresses me that the book has not had greater recognition and if I know how to correct that I would.
Social workers are not natural marketers. We are a humble lot, and we are uncomfortable tooting our own horn. This is why we need so much help if we want to reach a large audience. We have everything going for us, education, experience, and an ability to communicate complex ideas into an easy to understand and acceptable message. It’s our nature. Social Work is not a choice, it’s a calling.
Social workers are born out of crises and I am no exception. I was born into an incest family. Talk about a vortex of crises, these families take the cake for crisis. One of these weeks I will go into detail about my family, but for now, let it suffice to say, that the seeds of depression were sewn into the fabric of my subconscious as a child. I say this because for much of my childhood, I lived in a dissociated state where my world mirrored the world of Beaver Cleaver, the 1960’s sitcom. Thank God. I really hate to think about how bad depression would be in my life had I not dissociated from what was really going on in my family.
There are two basic types of depression. Intrinsic and Extrinsic. Intrinsic depression arises from internal conditions, whether it is nutritional, hormonal, or due to an imbalance of brain chemistry. Extrinsic depression is a response to an external stimulus whether it is the lose of a loved one, a job loss or a failed attempt of some sort. Extrinsic means from the outside and intrinsic means from the inside. Oftentimes these two types of depression team up and one leads to the other, but regardless of what comes first, the problem is still depression, and depression is dangerous.
Let’s take a closer look at how psychiatry views depression as described in the Diagnostic Statistical Manual or the DSM V. According to the DSM depression is defined as the following.
Depression DSM-5 Diagnostic Criteria
The DSM-5 outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.
To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.
The above was taken from Psychcom.net and the link is provided in the episode description.
Wow, that’s a boatload of stuff going on when someone is depressed. This is what goes on when I am depressed. The DSM calls it Major Depression, with an emphasis on the term Major. Everyone experiences bouts of depression. Life can get downright depressing. There needed to be a distinction between what most people feel as a natural response to certain life experiences and the kind of depression that steals your life and devours your soul. Therefore, the term Major is added to Depression to stress that this is not your day-to-day depression. This was something much more powerful and destructive, this isn’t just a down day, it is Major Depression.
There are many websites out there with tools you can use to determine if you have ever had major depression or if you are currently experiencing major depression. The one I like to use is from a book by Dr. David Burns, MD, called The Feeling Good Handbook. This book was published in 1980 and became the foundation for Cognitive Behavioral Therapy, one of the most effective psychological tools in modern psychology. CBT is just as effective as medication was for alleviating depressive symptoms. It was also a mainstay in my private practice and work with teens and families. If you are experiencing the symptoms of depression, then CBT is a great place to start. I encourage you to add a little CBT to your treatment regimen and see how it goes.
When it comes to C-PTSD, depression is like a kick to the groin after I’ve been triggered. Speaking for myself, major depression or what I will simply call depression always occurs following a triggering event. Does that happen to you? I would bet a dollar to a donut that you too have depression after being triggered. So, what is it about being triggered that also triggers depression? For me it’s a dumptruck of guilt and shame following the out of control anger I feel when triggered. I am deeply ashamed which opens the door to depression.
I can only speak to my experiences with depression and if my experiences resonate with you, then hopefully my efforts to deal with depression will also resonate with you and you will give them a try. One of the reasons I have tried to avoid situations where I could be triggered is, in part, due to my fear of the depression that I know will follow. I could be triggered for 2 hours and for 2 days I am clinically depressed, and, on many occasions, my mind would be flooded with self-damning suicidal thoughts. This is not a particularly good investment of energy.
Every time I am triggered, my blood steam is infiltrated with a hormonal cocktail that sends me through the roof and over the top, regardless of the situation. My response is 100 times what would be considered a normal response to the triggering event. Suddenly, before I can even think, chemicals such as Cortisol, Epinephrine, Norepinephrine and Adrenaline are injected into my system. All of these chemicals are basically “uppers” which means it is like snorting 5 lines of methamphetamine. I am zooming, clear headed and laser focused. You don’t want to argue with me at these times. Just like you wouldn’t argue with an outraged 6-year-old boy.
And just like the meth addict, there is a letdown once this chemical cocktail has subsided. There is a vacuum of sorts that get created in the mind and neurotransmitter hormones such as Dopamine, Norepinephrine and Serotonin are released into the bloodstream, lowering the body’s resistance to depression and mood regulation in general. I become severely depressed and my initial response is to shut down and withdraw. So I do.
This used to be a place of shame but now, after many years of experience, seeking solutions and gathering information, I realize that this is a natural state one experiences in the face of trauma. That’s a relief, I thought I was going mad, but it turns out it is perfectly natural to feel depression in the aftermath of being triggered.
Talking about depression is not easy for anyone, me included. It’s very personal and very painful and besides, most people do not know how to respond to someone with depression, but the good news is there are lots of websites out there that will help you to understand depression from a medical perspective. Out of My Mind in Costa Rica is not here to do that. I created OOMMCR to be your voice. To speak for those who are struggling with depression as a result of complex trauma and PTSD.
So, here we go. First things first. Depression is serious stuff. Don’t minimize it or belittle yourself for being depressed. I know this is easier said than done and I can hear your doubting self-talk, right now, telling yourself, this is all bullshit. What does he know about my depression? I don’t know about your depression, but I do know about depression and I know what helps to alleviate depression from being the scary monster that it may have always been for you. I want to turn on the bedroom light and show you that there is no monster under the bed and it’s OK to feel safe and secure in your own skin.
Feeling safe and secure in our own skin is a cornerstone of wellbeing. There are many paths to this state of mind and that is exactly what it is. Depression is a state of mind and when you change your view of depression, it no longer can hold power over you. I am not saying depression will pack its bags and get on down the line. No that is not likely to happen. What will happen is over time, slowly, there will develop a lessening of the impact that depression has on your life. First you choose not to fear it and the, you choose to embrace it, not in a “I give up,” mentality but embrace it like an old friend who has been keeping watch over you all these years.
Part of the struggle people have with depression is their natural urge to fight the depression, to go to war with depression through denial, rationalization and a host of other cognitive errors, because that is what depression does. It distorts your perception of what is real and triggers your brain to focus on your powerlessness. You are not powerless. When I realized I was not powerless over the depression that always flooded my senses following a triggering event, but I could actually act in ways that open my mind and body to accepting depression as a natural response to a triggering event. I no longer had to fight. I could go with the flow and this has made all the difference.
Accepting depression as part of the healing process has changed my life. Oh, yeah, I still get depressed whether or not a trigger is involved. Hell, the mere thinking about depression triggers an impulse to walk up to that edge, look over it and ask myself, should I just end it all? This frees me to accept depression as part of my life. It no longer defines my life. I am not fighting with it. I am allowing depression to be a natural part of my greater self. Part of my own story and a part of how I learned to take care of myself. I have replaced the self-loathing and the self-hatred with self-acceptance and self-love. I’m not perfect at this, but I don’t expect to be perfect at mood regulation. But I do notice I am making progress, slowly, but surely.
The depressive episodes are less frequent, they are less intense, and they are shorter in duration. I call it the Judo approach to managing depression. Under no circumstances do I recommend you do any of this stuff without first consulting with a qualified health care worker to determine the type of depression you are experiencing and what the best approach is for you, at that moment. If you are experiencing any suicidal ideation, the first step is to see a specialist. TODAY. Not tomorrow or when you feel better, but TODAY. Got it! Call 911 and don’t think twice. It could just save your life.
People with C-PTSD and PTSD generally have a pattern that includes alternating bouts of anxiety and depression and oftentimes settle into a tolerable level of both. Most of us function pretty well most of the time, but sometimes, you just need to step back. Put your phone on Do Not Disturb, put on your best pajamas, and go back to bed. Let the world be the world. It will survive without you for a day or two until the depression has passed. There is no shame in stepping back and taking a time-out. You have earned it and you deserve it. So, take it, God Damnit! Tell you family you are going on a vacation from the world and not to bother you until you are ready to re-engage. It may be hard to do this, but it is a critical step towards truly loving yourself.
True love means complete acceptance and true love needs to include you. This is not in the least selfish or narcissistic or lazy. It is an act of true self-love when you accept all of yourself. Not just your upside, but your downside as well. As terrible as it is to feel burning pain of major depression, it is much more dangerous to ignore it. That pain is not going away until you tend to it and that means you need to look at it. To examine it, to understand its purpose in your life. Ask for the help you need, it’s an act of courage.
Reach out to people you love. They love you too. Tell them what you need from them. Most people who don’t experience depression do not know what to do with depressed people. You know what you need, tell them. They will be relieved and feel good knowing they are helping and you will feel their support which is like a magic pill with depression. It is pretty hard to be depressed when you are surrounded by people who genuinely love and support you to your core. That, my friends, is some of the good stuff in life and if you want the good stuff in life, then you must be willing to go for it and it might just mean you have to be straight with your friends and help them help you by telling them what you need from them. Nobody can read your mind.
I also encourage to sit, quietly with the depression and in your mind, step back, as if you are a scientist or an independent observer of your life. Just look at it. Where is it located in your body? What thoughts are associated with the feeling of being depressed? What is the origin story for the depression? How old is the depression? What lies beneath the depression?
These are some of the curious questions that cross my mind when I am depressed. The answers vary over time, but there is a root source for everyone’s experience with depression and that root cause, in most cases, is abandonment in one form or another. Somewhere, sometime at an incredibly vulnerable age you experienced the futility of life, even if it was for a brief moment, but that moment was indelibly etched upon your brain, literally and that image, for better or worse, is the image that binds you to the depression you feel. So, who was that child and how was that child impacted by their experiences of utter and complete abandonment?
These questions are not to be taken lightly. They lead you into the deep and dark areas of your psyche and if you are like me and you have a curious nature then you will explore that darkness because you have the desire to know your true self. What greater purpose in life is there? You don’t need to do this yourself. I’m here for you. The people you choose to let in are there for you as well. So, go ahead, dig in and dive deep. Your true self is waiting to make your acquaintance. When you understand the role, depression has played in your life, you have an opportunity to rewrite the script and give your life a new focus, one that is healthy and filled with love and abundance.
We all have our own journeys that we do completely on our own. The world we build within us is reflected in the world around us, so it is up to me and it is up to you to be the difference maker in our lives. Don’t be the victim, be the victor. Even though it may sound like a load of bullshit, go ahead, and put yourself first. Love yourself first until the love begins to ooze out of your pores and you are one with life again. Optimism beats pessimism every time depression rears its ugly head. Stop fighting depression and start understanding depression.
I don’t know what else I can say, at least for today, I believe I may have said enough. Hopefully, enough to motivate you to actively engage with your inner world. Get to know it and make friends with it. Your true self is a pretty nice person.
Thanks for listening and if you don’t mind, take a moment to make your voice heard. Comment or review Out of My Mind in Costa Rica on those platforms that allow that sort of thing. Also, I am sure that all of you know someone who may benefit from my fucked-up life so please share OOMMCR. You may just be saving a life.
Also be sure to take a peek at the episode description and check out the websites I have found that will give you a bit more information about PTSD, C-PTSD and Depression. So, until the next time.
Be Courageous. Be Strong and Be Kind. I’ll catch you later. Bye.