It is no secret that trauma survivors get depressed, and depression is the most commonly known and experienced mental health disorder.
Typical depression symptoms include:
- Suicidal thoughts, recurring death thoughts, death wishes
- Suicidal behavior and suicide attempts
- Self destructive behavior, self injury, self harm
- Feelings of worthlessness, guilt, self hatred, or not deserving to live
- Loss of energy, fatigue, excessive sleeping
- Little or no interest or pleasure in anything or anybody
- Inability to think, or to concentrate, or to make decisions
- Significant but unintentional changes in weight loss or weight gain
- Significant but unintentional changes in appetite
- For children, not making normal and expected weight gains and physical growth
For trauma survivors, depression can have layered meanings beyond the typical medical symptoms.
Repeated patterned depressions can be very much related to a specific or recurring trauma, or to a significant loss. For dissociative survivors with DID/MPD, the information detailing the specific loss or trauma may be hidden away or blocked off by dissociative walls.
Someone in your system might know why you are feeling depressed, and they might know what the loss is, but the host / front personalities might not have a clue.
Do you have a pattern of depression occurring at the same time of year each year?
Think back through all the years. Do you have any hints that tell you how far back this pattern goes? Do you repeatedly feel the need for hospitalization at the same time each year? Do you find yourself struggling more than usual at the same time each year? Do you find yourself having thoughts of suicide or self-injury more often at a specific time of year? Do you know how long this pattern of depression been happening?
If you have Dissociative Identity Disorder, be sure to check inside and to ask your various inside parts what they have noticed as well. Some of your insiders might have a different awareness of patterns and events than you do.
For repeated patterned depressions, it is important to find the original starting point of this depression pattern. Once you do, you will get more clues as to what it is about.
My general approach to repeated depressions that follow a pattern is to “assume” that there is a trauma-based reason for it. Unless you have a better explanation, in terms of a bipolar type depression pattern, or a seasonal depression pattern, then quite possibly it is a trauma-based pattern.
Look around inside, ask around inside.
Check to see if there is anyone who knows the depressed time of year to be a particularly bad time for them.
While you are talking with your system, be sure to pay attention to the following ideas:
- Who inside feels the depression the most?
- Do you see anyone inside who is showing the depression in the way that they are sitting, standing, laying, not communicating, not being “their usual self”, etc?
- When you look at your internal system, who is showing / feeling the biggest list of depression symptoms?
- If you can’t automatically see an internal someone who is depressed, take a broader look at your internal world. When you walk around your internal landscape, can you find-feel-sense the center of it?
- Is there a place inside where the depression feels the most intense vs. the generalized depression of everyone (similar to finding the eye of a hurricane).
Other trauma-related questions you can ask your insiders include:
- Were there any significant losses that happened at this time of year?
- Who in your system has experienced these losses? (Do not assume that everyone in your system is aware of the same losses!)
- Did you or anyone inside lose a child /children, or a close friend, or a loved one at this time of year?
- Are your feelings of grief and loss repeatedly surfacing as a type of depression?
- Was anyone inside specifically traumatized or abused at this point in time each year?
- What happened? What do you know about that trauma?
For dissociative trauma survivors, a significant period of depression can be a very important clue that there is an unresolved trauma waiting to be addressed.
If you have the room in your life to explore its foundations, and to address how the trauma issues are related to that recurring depression, you will be able to interrupt and resolve the depression itself.
I wish you the best in your healing journey.
Warmly,
Kathy
Copyright © 2008-2021 Kathy Broady MSW and Discussing Dissociation
Medicine has never helped me. Nothing really helping me. I feel it’s my own fault I’m just bad and have a bad attitude.
My psychiatrist suggested I go for DBT training. I hated the little I did while in the hospital.
Kathy do yo think it can be helpful?
Anyone have any experience with this?
Hi Linda,
First of all, thank you for bringing this article up to my awareness. I learned a lot from it (a lot that I needed to heard right now).
I wanted to jump in here because I know that Kathy is super busy with P4 conference stuff so I am not sure if she will have the time to respond and I wanted you to know that you have been heard.
I have not experienced DBT training or have heard of anyone who has. So, I cannot speak to the particulars of this kind of program or how useful it might be with DID. I am relying on an understanding that, if your psychiatrist suggested it, it must be a safe approach for you and your situation.
I can say that I have remained open to all treatments ideas suggested to me over the past eight years in therapy. A few have been misses but several have been incredible healing experiences. I have a new T now (my old T retired this past spring) and she has suggested several new and different approaches for me (family systems approach, EMDR and neuro feedback). I am open to at least trying all of her suggestions. I figure that, if she feels that they are safe for me, what do I have to lose by trying. At this point, I feel confident that I will say no if I am feeling that they are not helping.
Bottom line for me, I am willing to try (almost) anything if it helps my healing process.
This does not answer your specific question I know Linda but it is all that I can offer.
ME+WE
09/18/21
Thanks, ME+WE
I appreciate your response. I’ve been diagnosed with DID for 40 years (and still go through denial at times-“mine doesn’t seem to follow the norm) I’ve tried a lot of things in those years. Also the first 10 years I was in hospitals a lot even 3 months in a DD unit in Colorado (I live in CA). I’ve been tried on nearly every medicine with no help. I was in a DID hospital in Baltimore in 2018+2019 BAD! We did DBT 2x a week there I hated it! Partly because of the therapist that led it. I had a great therapist but, they wanted to get me to interact with my parts but no one identifies themselves and seem to want to remain secret. We have no communication with others except occasionally with writing. My therapist hasn’t worked with DID before me and I tried to keep it down for stability. He’s learning from me! He suggested my working with a DID therapist. That may be a good idea, but working with a trauma therapist just kept me young fearful and needy… getting worse for nearly 3 years! I finally quit with her even though she kept telling me “you’ll never be ok until you deal with all your trauma” I believe she would have let me die rather than agree she was harming me not helping me. She tried IFS, my parts were discounted with that. She did some EMDR and quit I’m not sure why! So I’m apprehensive to go into something else because I don’t want another bad experience like that! My psychiatrist has worked with complex PTSD, but not DID. I’ve read DBT isn’t recommended for DID. So I don’t know🤷♀️ I think my biggest concern is my clutter/hoarding. That is causing us the most despair. Again, Thank You for responding. I definitely feel Heard😊
Sept seems to be a bad time for us. This year we are in the Special Care Unit of a psych hospital in Brisbane having a programme of 12 ECT treatments. We tried twice to suicide in a standard ward so got transfered to SCU. Anyone have experience of ECT with a DID system? So far still feel suicidal but have only had four treatments so far. Cheers Bruce
Every year in April, we still get this way, especially jodie, although we dont know why yet.It doesnt usually happen to me, caden. But for some reason this year it is hitting me hard. I can barely move from the weight i feel is on top of me. Maybe its because there is no school right now, and my work has always been my identity, or all the disappointments we have been through recently, or maybe its because we are trying to internally connect with each other more, not sure. But its bad. I feel useless because things that usually work on the inside kids are not working. I dont know.
Maybe i am just getting in touch with my extreme laziness side,
I’ve had bouts of depression/depressive feelings every year for the past 34+ years and it’s always around “holidays”, always around stuff that is supposed to be nice and cozy.
I wish it was, but even if my surroundings are nice and cozy i don’t feel that way.
Since i’ve started fb and got “fb memories” being shared with me i can find out it indeed is exactly around the same time i get depressed/depressive feeling or become suïcidal.
Life just doesn’t seem to work out the way i want it to be.
i still wish we could figure out why october be such a terrible month for us. it be so bad but we dont even know why.
One of the biggest questions for us is.. is it trauma caused depression or illness caused depression. Living in a body with a chronic condition (type 1 diabetes) and a mental health condition is a double whammy.
Not sure if it’s one condition or the other, or both?
Been feeling particularly low recently and it seems to be worsening. Not sure what to make of this because it could be both.
?
Wish we had more levels of ways to help when we live in a sick body…..
I think severe depression is our biggest obstacle. There are tons of things we want to do, and we never get bored, but getting off the couch to get things done when everyone would rather jist try to sleep… Thats hard. Their depression keeps getting worse, and nothing seems to help. Its also made their self esteem go from low to non-existant lately. I like to be busy, but all they feel like doing a lot of the time is laying on the couch with their dog and staring into space. Motivation is an issue.
Reblogged on Transparent Honesty – One Strong Soul.
Reblogged this on Transparent Honesty-One Strong Soul and commented:
Great informational read right here.
This IS a very well written article, had never known about you or your work until today. Kind of funny, it is almost 90 days later & this just hit the spot. Thanks a lot for speaking intelligently & not even a little patronizingly with PTSD sufferers.
Very well written article. Informative and interesting. Your blog is always a pleasure to read. Thanks.
Yu/stan/kema
Its lots of reasons.
Reblogged this on Discussing Dissociation and commented:
Depression often hits hard around the holiday season.
How are you feeling? Is depression snuggling up to you??
This article can give you lots of things to think about …
I hope you feel better soon.
Warmly,
Kathy
evre yere in april jo try to kill hersef we dont no why
and in october we do no why
we dont no why bout april
this be may now and we dont no why it dont be geting beter thow ushally in summer her start to do betr but not this yere
but 3 pepol in ar famle die this munth mabe that be why
“but I do think that dissociative systems that have had a lot of medications / druggings through the years have some uncanny abilities to control medication effects.”
yep, for sure. like that med is sposed to knock you out… really wanna bet, says an insider. not happening.
for once, you’re actually asking questions i know the answer to Kathy.
One thing i wonder about though…because people keep saying we have a chemical imbalance, thats why we need meds. But, me and mae are the only ones who are really depressed. why would it only affect me and mae if it was a chemical thing, right?
We have certain times of the year the depression is the worst. October is the worst time. January/February isn’t very good either. Most of the rest of the time i can at least handle it. The times we’ve been in the hospital, its been…February, March,…um… February. Stuff happened at those times of year the most often. i don’t know if everyone else inside knows about it. i don’t talk about it much. they might see the flashbacks. and i know for sure mae doesn’t talk.
jo
@ Kathy – thanks – great response. I understand that you’re not a prescribing physician but I am still interested in your input. In my experience, the prescribers look at the surface and say – here are pills. My T is non-prescribing and happens to dislike meds though she did not express this when i was on them. As it turned out, being on meds was sending parts of the system to sleep most of the time so the work has been more… “interesting”.. since I came off 😉
Well, eye of the hurricane hit home Kathy, and so if there is an eye of the hurricane, and she bears almost all of it almost all of the time and we have to let her vent or else we are in real trouble, and all she does is cry and suffer pain and loss it seems like, well then . . . nevermind . . . or maybe you do have ideas . . . we feel like we are on the right path . . . . she needs and is starting to have company during her bouts and the joy of the other littles is starting to reach all the way down to her during trancey times . . . or othe r times too, but . . . there is no end in sight for her and her need to grieve and suffer . . . . older parts are starting to feel with her at times . .at times . . instead of becoming her so to speak . . . but . . it is desperately hard work . . and good heavens . . . re the questions on antidepressents . . they saved my life once upon a long long time ago. I remember waking up one morning the tenth day on Tofranil and my goodness the black cloud was gone and I was so so MAD. But mad was good because it was SOMETHING. So now it’s years and years later and I’m still on things. Some new things too and off of old things . . we are all so very complex and this stuff is clearly neurobiological a great deal of the time . . . so for me, right now, even though I don’t get stuck in her staying out depressions, we still are affected by it and I just won’t even worry right now about still being on them. I wake up to feeling her and hurting and knowing I don’t want to DO this day, so I can’t imagine not working with this poor affected brain of mine and giving it some help. Well, that’s me, very briefly, for now. healingone
Fascinating stuff as always.
Kathy, I’d like your opinion on the use of anti-depressants in treatment of DID – among non-psych docs there is a tendency to white-wash with anti-depressants.. what are your thoughts on the affects this has on alters? especially non-depressed ones? and the system as a whole?
I have some personal experience of this but would be interested in your opinion.
Hi BTC,
Another tough question! Anti-depressants. hmmmmm. Well, “they say” that anti-depressants are supposed to help, right?! I am a strong believer in medication for people with bipolar, but it seems that for people who struggle with depression, finding the right medication is a very difficult process. (Including for the depressive episodes for bipolar too). Some meds are more effective than others, the side-effects are often difficult to live with, the “right meds” vary from person to person and it is a very frustrating, painfully slow process in finding the right mix.
SO. I don’t really like medication because it is just so difficult to find the right combination, but I do believe that sometimes the brain just needs some extra help to get out of those really really depressed places. **Please note** I”m not a prescribing physician, so I’m only speaking about my observations as a therapist, not based out of medical training. **
I do not think – not for a second – that DID can be treated with medication alone. There’s no resolving trauma issues with “here, take this pill”, so any doctor that is down-playing the importance of genuine talk-therapy is not doing you any favors! As people heal from their hurts and their wounds, their need for medication should decrease.
I’ve read / seen how some parts of a dissociative system can be allergic to things differently than other parts in their system. I would have to assume that could apply to medications as well.
I’ve also heard that it is more effective to have the depressed parts actually take the medication. Now – I really don’t know if that makes a difference or not, but I do think that dissociative systems that have had a lot of medications / druggings through the years have some uncanny abilities to control medication effects.
SO! With that in mind, yes, I suppose it is quite possible that different alters can have very different responses to the same meds…
Just some thoughts –
Kathy
Kathy, do you think this applies to certain times of day, or certian days of the week?
I have been noticing lately that early afternoon of some days seems to be a difficult time for us. We are more likely to feel depressed then, or just sad, or other emotions. Also seem to have the most time staying present/having controlled switches then. Seem to rolodex a bit more.
Any thoughts?
Hi Gobbies,
Good question. Ummmmmm. There could be a lot of different factors involved here. Hitting a depression at a particular time of day could be related to nutrition, fatigue, medication, system changes, etc. Keep an ongoing record of the various responses you are having (and what happened right before that), and over time you might find a more specific pattern emerging.
I think fatigue is a really big factor in how easily someone starts to switch, ie: the more tired you are, the more likely you could rolodex and be emotional. It’s not that simple, of course, but it is something to watch for. For some multiples, the more tired they get, the harder it is for them to stay adult. Not sure if that applies to you, but it would be worth thinking about.
Tough question. Thanks.
Kathy
OK, this is Weird. I do not generally struggle with depression, but this posting tonight is particularly timely for just alot of reasons.
Its also just helpful that you write all these questions to ask inside.
Thank you for writing this posting, glad I checked in tonight.
Hi Dollswise,
I’m glad my questions are leading you to think! As far as I’m concerned, for DID, the key to healing is talking with your internal system. I’m so glad you are talking to your inner parts about these things!
And… I hope your depression is getting better…
Kathy