Can Trauma Lead to Depression?
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Trauma is a strong physical and emotional response to a terrible or life-threatening event, such as a natural disaster, accident, or sexual assault. When someone experiences a traumatic event, their brain and body often go into survival mode. In the short term this can lead to symptoms like shock, intense sadness or anger, anxiety, or emotional numbness.
Prolonged trauma responses that last well beyond the time of the trauma can be seen as a hypervigilant and overfunctioning nervous system that is always on edge and preparing for fight-or-flight to save the person from danger, explains Kelsey Latimer, PhD, a licensed psychologist who treats depression and PTSD in private practice in Stuart, Florida. “That is exhausting to one’s system over time and can lead to physical and mental burnout,” she says.
Although many people will recover and return to their normal daily life following a trauma, others go on to develop other health issues, such as depression, according to the American Psychiatric Association (APA).
In addition, some people who experience trauma go on to develop post-traumatic stress disorder (PTSD), which research shows is also closely linked to depression.
Why Trauma Can Lead to Depression
So, why does trauma sometimes lead to depression?
“When you are subjected to adverse life events or trauma in general, your body attempts to adapt to it in the form of a combined physical and emotional response,” says Eric Chaghouri, MD, a licensed psychiatrist in Los Angeles.
Some people may initially respond to trauma by feeling stunned or disoriented or have difficulty processing what happened, according to the American Psychological Association (APA). Once these initial reactions wear off, people may experience many different types of thoughts or behaviors, such as depressive symptoms like sadness or grief or other intense feelings. They also may not feel like interacting with people, per the APA.
More research is still needed to better understand the relationship between trauma and depression, but certain factors may make you more prone to developing depression after experiencing trauma, one study shows. They include:
- Younger Age “Younger patients, especially those who experienced trauma, are prone to depression because [some] have yet to learn coping mechanisms and their young minds aren’t yet able to adapt to brain chemistry–altering trauma,” explains Dr. Chaghouri.
- Female Gender There are higher rates of depression among women who have experienced trauma and those who have experienced multiple traumatic events, says Chaghouri. Women are twice as likely to be diagnosed with depression than men, and 2 to 3 times more likely to be diagnosed with PTSD than men, due to reasons including that women are more likely than men to experience certain traumas (such as sexual abuse or assault) that frequently lead to PTSD.
- Self-Medicating Trauma Symptoms With Alcohol Misuse of alcohol is a risk factor for depression, according to Mayo Clinic. It’s also a potential complication of PTSD, per Mayo Clinic.
- More Types of Trauma Experienced
- Trauma Symptoms That Interfere With Their Ability to Function
How PTSD and Depression Overlap
Most people who live through trauma will experience a temporary period of difficulty coping and adjusting to life in the aftermath. But some people who experience trauma may find they can’t stop thinking about what happened.
If you’re experiencing trauma symptoms that persist for over a month and interfere with your ability to go about your day, you may have PTSD, according to the APA. Approximately 1 in 11 people are diagnosed with PTSD in their lifetime, per the APA.
The symptoms of PTSD, according to Mayo Clinic, include:
- Intrusive Memories These are recurrent and unwanted thoughts, memories, or distressing dreams associated with the traumatic event
- Avoidance Symptoms People with PTSD may avoid people, places, and things that remind them of the trauma, as well as trying to avoid thinking or talking about it.
- Negative Thoughts and Feelings People may start to feel bad about themselves, may blame themselves for what happened, may not find pleasure in things they once enjoyed, may stop trusting people, or may feel detached from family and friends.
- Arousal Symptoms These changes in physical and emotional reactions may include being on high alert all the time, startling easily, having difficulty sleeping, irritability, or having a short temper.
Although they are two distinct diagnoses, symptoms of major depression and PTSD can overlap and sometimes you can be diagnosed with both, per the aforementioned research. Depression is 3 to 5 times more common in people with PTSD than in people without PTSD, according to the National Center for PTSD.
Overlapping symptoms between depression and PTSD, according to the National Center for PTSD, may include:
- Irritability
- Trouble sleeping
- Problems concentrating
- Loss of interest in activities you used to enjoy
- Social withdrawal
“Sometimes it can be difficult to differentiate between the two,” says Chaghouri. “However, what’s unique in patients with PTSD is that there is a hallmark symptom of reliving the traumatic experience or having flashbacks, avoiding the environment or circumstances by which the event happened, and being always on edge, which can lead to agitation and violent outbursts.”
Whether someone with trauma goes on to develop PTSD, depression, or both depends on each person’s unique risk factors, Chaghouri explains. Some people may be more or less likely to develop depression based on their coping mechanisms, resilience, and personal support systems, he says
“Those who have preexisting mental health disorders can experience more intensified symptoms of depression or PTSD,” Chaghouri adds.
How to Cope With Trauma and Depression
If your symptoms impact your day to day life, or you find that you can’t function like you did before the trauma, you should reach out to your doctor or a mental health professional for help, says Chaghouri.
Psychotherapy (aka “talk therapy”) and antidepressant medication are the most effective treatments for depression, according to Mayo Clinic. For PTSD, the main treatment is psychotherapy, but may also include antidepressants or anti-anxiety medication, per Mayo Clinic.
“I recommend cognitive behavioral therapy (CBT) to my patients with depression and PTSD because it aids them in processing their thinking in a way that helps them understand and cope with the traumatic experiences,” says Chaghouri. CBT is a type of talk therapy with a goal of changing unhelpful thinking and behavior patterns to more constructive ones.
For PTSD, CBT is usually done alongside exposure therapy, a type of therapy that allows you to safely face memories or situations you find alarming so you can learn to cope with them, per Mayo Clinic.
Along with therapy and medication, some complementary approaches that could help improve your symptoms include:
- Mindfulness This form of meditation is a simple but powerful tool that can help bring you back to the present moment when you’re experiencing a flashback or calm your body when you’re feeling anxious, according to the National Alliance on Mental Illness. It can involve exercises like deep breathing or smelling something with a soothing scent, for instance.
- Resilience When it comes to managing both trauma and depression, resilience — the ability to adapt to challenging life experiences — can be very helpful. One way to build resilience is by developing effective coping strategies — such as journaling, building a social support system of friends and family, or reframing negative thoughts — to manage your symptoms.
- Exercise Regular physical activity can do a lot of good for anyone’s mental health, including people with depression, trauma, or PTSD. Exercise has been shown to lessen symptoms of depression and anxiety. Most adults should aim to do 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise each week, as well as muscle-strengthening activities at least two days a week.
*If you are experiencing thoughts of death or suicide, please reach out to your local emergency department, crisis line, or call the Suicide & Crisis Lifeline by dialing 988.
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