Thursday, November 17, 2011

Unresolved Trauma Looks Like......

Regions of the brain affected by PTSD and stress.
Image via Wikipedia
As I work with individuals who have experienced different forms of abuse and trauma in their lives, it is clear that unless they have really worked at it, the trauma is still affecting them in ways they don't recognize or connect with it.  Many people enter the counseling process without even realizing they have been traumatized.  They just think whatever has happened to them is part of life and they have moved on.  However, sometimes the negative patterns they find themselves in, can often be residual effects of abuse, neglect or traumatic experiences.

      It is important to understand that trauma is different for everyone.  It differs from abuse in that trauma is described as the long term effect of abuse.  One of the main principles to understand when dealing with a traumatized person is that it is the person's experience of the event, not the event itself, that is traumatizing.  It is our perception of what has happened or is happening, as well as our interpretation of what that means for the future which determines our experience.  That perception creates a lens that we see life through from that point on.  If the traumatic perception is strong enough, we begin to develop coping mechanisms to help avoid running into that experience in the future.  Traumatic experiences that have gone unresolved can affect our response patterns and can initiate spontaneous triggers that put us into fight or flight responses if the experience is strong enough.  Often I have clients report that they can't think, remember or recall information when they are under certain stressors or anxiety.  Some individuals think they have ADD but after going through EMDR therapy and resolving the traumatic emotional chemistry, their confusion, distraction and/or lack of focus goes away.  

      There are some obvious indications that a person is dealing with unresolved trauma; such as self harm, suicidal thoughts and feelings or addictions to drugs, alcohol, gambling, sex etc.  However there are some things that may not seem as defined as these behaviors.  For example, not being able to tolerate intense emotion may be a sign that a person has unresolved trauma in their lives.  The original traumatic event as perceived by the person initially may have brought on an intense emotional response.  Therefore it would be reasonable to conclude that anything that feels like that again would be significantly difficult to bear.  Often when children go through something that is traumatic to them, they dissociate from the memory and/or the feelings because it is simply too intense for them to process.  However, whether we are aware of memory or not, the experience is recorded and when we experience something that feels similar to the event, we may have a reaction.  

      Being unable to commit in relationships, fear of commitment, being unable to bond....these are symptoms of unresolved trauma.  Additionally, fear of conflict can be the result of never seeing conflict resolved.  This can be very traumatic for a child, which can lead to becoming an adult without the conflict resolution skills needed to deal with the many situations we face in life which involve conflict.  Without those skills, conflict can be a very scary situation and cause the adult to again experience those childhood anxieties that came when they were involved in or heard conflict that went unresolved.  

Cover of
Cover of Molecules of Emotion
       Emotions and memory are chemistry within the body.  According to Candace Pert, in Molecules of Emotion, our emotions are biochemical and effect our bodies down to the cellular level.  When this chemistry goes unresolved through our natural processing mechanisms, it has the capacity to be triggered again and again by whatever feels similar to the original event.  That trigger can be sight, sound, smell or touch.  When triggered, the original chemical formulation is again dumped into the body and we experience the event again.  The good news is, this chemistry can be resolved; thus resolving the reaction and allowing the brain-body connection to return to normal.  

      Other reactions that may be attributed to unresolved trauma have to do with chronic belief systems about self worth.  The person may believe they are bad, have no value or are unimportant to others.  They don't see themselves as worthy of being loved.  They may also take on excess responsibility, believe that everything is their fault or apologize for their behavior more than is appropriate.  Depending on what age the child experienced the trauma, these behaviors may have caused the person to become stuck in a stage of development known as ego-centrism.  Simply put, during this stage of a child's development they believe that whatever happens around them happens because of them.  This is why we have learned to tell young children that their parent's failed relationship is not their fault.  During this stage, children can believe that if bad things happen to others around them, it is their fault somehow.  Carried into adulthood, this manifests in control, being overly responsible, perfectionistic behavior and even what we know to be Type A behavior.  Of course, not all Type A behavior is the result of trauma, but when trauma exists in the background of a Type A personality, it is worth looking at.

      In my next post, I'll explore some of the other symptoms of unresolved trauma.  If you recognize any of these symptoms and they are causing problems in your life, you may want to seek the help of a professional counselor who is skilled in trauma therapy.  Having a support network around you is very helpful as you take on these issues.  Just remember, there is hope and there is help to move beyond these things.  Explore the possibilities today.  

   

Thursday, October 27, 2011

Depression Looks Different in Men and Women

Human Experiences, depression/loss of loved oneImage via WikipediaIn working with depression, counselors and clients alike have seen the symptoms of depression to be the same across the board.

Depression has several different criterion - at least the depression that we are familiar with.  Major Depressive Disorder is characterized by one or more Major Depressive Episodes that are not consistent, but a person can be diagnosed with Depression if they have had one or more episodes.  An episode consists of:
  • at least 2 weeks of depressed mood or loss of interest
  • accompanied by at least four additional symptoms of depression as follows:
    • markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
    • significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day
    • insomnia or hypersomnia nearly every day
    • psychomotor agitation or retardation nearly every day
    • fatigue or loss of energy nearly every day
    • feelings of worthlessness or excessive or inappropriate guilt nearly every day
    • diminished ability to think or concentrate, or indecisiveness, nearly every day
    • recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
Other forms of depression are Dysthymic Disorder which is characterized by at least 2 years of depressed mood for more days than not and then the Bipolar 1 and 2 Disorders which cycle between Depressive Episodes and Manic Episodes.  With regard to Bipolar, these diagnosis are more complicated than what I have described, but this post is not about Bipolar, it is about depression so I am  not going to go into these in detail.

Depression is not about just having a down day.  I often describe it as having a dark veil over your life that you can see through, but it colors everything.  It is a state of mind rather than a passing mood and it is not something that should be ignored.  Often depression is characterized as a condition that you can just buck up and get over without any help or support.  That is not true.  Having a down day or a blue mood can be overcome by changing your thoughts, getting more sleep or engaging in social activities.  True depression is more complicated and difficult.  Depression is a condition of the brain, whether it is a shrunken hypothalamus or an imbalance in brain chemistry.  Since we can't live outside our brains, when our chemistry is out of balance it is extremely difficult to overcome this without help.  Telling someone with this condition to just pull themselves up by their bootstraps and get on with life is the worst thing to do.  I would encourage anyone with depression to seek out a doctor or a naturopath for assistance with this condition.  

Often individuals who have gone through abuse in their lives are susceptible to depression in their lives.  Chronic inner conflict can be a major contributor to the body's ability to remain in a balanced state.  Can a person be depressed without going through abuse?  Yes, absolutely.  However there can be others sources of inner conflict such as being in a relationship where you aren't able to be yourself, working and/or living in a very controlled environment, alcohol or drug use, disease and medications to name a few.  Living in our area, we are now going into the winter months and many people are affected by Seasonal Affective Disorder which is a Disorder that comes on when sunlight is limited.  

However, the symptoms of Depression are now being categorized differently for men and women.  Here is the list for you to look at:

                       Female Depression                                                    Male Depression

  1. Blame themselves                                                          Feel others are to blame
  2. Feel sad, apathetic, worthless                                        Feel angry, irritable and ego inflated
  3. Feel anxious and scared                                                 Feel suspicious and guarded
  4. Avoids conflicts at all costs                                            Creates Conflicts
  5. Always tries to be nice                                                   Overtly or covertly hostile
  6. Withdraws when feeling hurt                                          Attacks when feeling hurt
  7. Has trouble with self respect                                          Demands respect from others
  8. Feels they were born to fail                                           Feels the world set them up to fail
  9. Slowed down and nervous                                            Restless and agitated
  10. Chronic procrastinator                                                  Compulsive time keeper
  11. Sleeps too much                                                           Sleeps too little
  12. Trouble setting boundaries                                            Needs control at all costs
  13. Feels guilty for what they do                                         Feels ashamed for who they are
  14. Uncomfortable receiving praise                                     Frustrated if not praised enough
  15. Finds it easy to talk about weaknesses and doubts         Terrified to talk about weaknesses and doubt
  16. Strong fear of success                                                   Strong fear of failure
  17. Needs to "blend in" to feel safe                                      Needs to be "top dog" to feel safe
  18. uses food, friends, and love to self medicate                   Uses alcohol, TV, sports and sex to self-med
  19. Believe their problems could be solved only                    Believe their problems could be solved only
          if they could be a better (spouse, co-worker                  if their (spouse, co-worker, parent, 
          parent, friend)                                                               friend) would treat them better.
   20.  Constantly wonder, "Am I loveable enough?"                 Constantly wonder "Am I being loved 
                                                                                               enough?"

Comparing this list, the two sides look very different.  Additionally, the symptoms Mr Diamond lists for male depression are symptoms that are often attributed to other disorders, anger problems, personality disorders and trauma disorders.  I believe that there needs to be continued research into this so that depression in both sexes can be diagnosed accurately and treated appropriately.  In domestic violence situations and abusive relationships, men tend to display many of these symptoms as do women.  

If both parties in a relationship are depressed, it stands to reason that the relationship would suffer.  There would be little energy coming from either side as well as few internal resources available to work at the problems that would inevitably appear.      

How should a person deal with someone who is depressed?  First of all, don't tell them to get over it, cheer up or just snap out of it.  They can't and that creates more hopelessness.  Patience is a good start.  Often being bright and cheery around a depressed person can be hurtful to them because they can't reciprocate.  Listening to them, supporting them, helping them with daily activities is a good start.  If the person needs supplementation or medication, a trip to the doctor is in order.  Some individuals are leery of antidepressents, however these medications have their purpose.  If an antidepressant is prescribed, it is always wise to stay in touch with your doctor and never just stop taking them.  Anti-depressants require 6 weeks to reach appropriate levels in the bloodstream and they are started in stages and stopped in stages.  Keep in touch with your doctor about how you feel because they will help you decide whether you are being given the right medicine at the right dose.  

Natural remedies for depression can include exercise.  30 minutes of exercise 3 times a week has shown to be very therapeutic for people who suffer from depression.  Other remedies are St. John's Wort, SAM-e, 5-HTP which is a serotonin enhancer, L-Tyrosine, improving diet by looking for food allergies to wheat or gluten, corn or soy.  Improved sleep habits are important for improving mood as well.  It is always recommended to consult with a professional before taking any supplement.

I encourage all my readers to participate in good self care.  Toxic relationships have a dramatic effect on the psyche as well as health problems.  Don't suffer through another day of depression without taking some steps to move forward.  Life without joy or happiness is a hard place to be and no one should be in that place very long.