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PTSD, Trauma & Depression by Tracy Latz, M.D.
Depression is a common problem that can occur following trauma. It involves feelings of sadness or low mood that last more than just a few days. Unlike a blue mood that comes and goes, depression lasts 2 or more weeks. Depression can get in the way of performing activities of daily life, make it hard to function and can cause you to lose your passion for living. It can affect eating and sleeping habits, ability to concentrate, and your confidence or self-esteem.
How commonly does depression follow trauma?
Depression affects almost 1 in 10 adult Americans yearly. Depression is a frequent symptom that occurs following trauma. For instance, a survey of survivors from the Oklahoma City bombing revealed that 23% reported depression after the bombing as compared to 13% of survivors who reported having depression before the bombing. Depression is frequently experienced in people diagnosed with Post-Traumatic Stress Disorder (PTSD).
What are the symptoms of depression?
Real depression differs from feeling sad in that with a clinical depression the sad, blue, depressed mood or lack of interest in usual hobbies or interests must last for at least 2 weeks and must be accompanied by at least 3 to 4 of the following: significant weight loss or gain, sleep disturbance (increased or decreased), agitation or decreased motor activity, fatigue or loss of energy, excessive feelings of worthlessness or inappropriate guilt, concentration difficulty, and recurrent thoughts of death or suicide.
How are depression and trauma related?
Depression can either “come from out of the blue” or it can be triggered by stressful events such as divorce, loss, or a trauma. Difficulty coping with painful experiences can often lead to intense sadness or depression. Veterans returning from military conflict or a war zone, for instance, may have painful traumatic memories and feelings of guilt, shame or regret about their experiences; they may have sustained physical injuries or witnessed loss of friends. Natural disaster survivors may have lost loved ones, their home/communities, or may have been injured. Survivors of physically, sexually or mentally abusive relationships or situations may begin to feel that they can no longer trust other people. These types of experiences can lead to both depression and PTSD.
Many symptoms of depression overlap with the symptoms of PTSD. For example, with both depression and PTSD, you may have trouble sleeping or concentrating. You may not lose interest in activites and pursuits that you used to find enjoyable. You may isolate your self and avoid interactions with others. Irritability can be a symptom of both PTSD and depression; and it is possible to have both clinical depression and PTSD at the same time. Many of the treatments for depression also work for PTSD due to this overlap in symptoms.
How is depression treated?
There are many treatment options for depression. You should be assessed by a healthcare professional who can decide which type of treatment is best for you. In many cases, milder forms of depression are treated by counseling or therapy. More severe depression is treated with medicines or with both therapy and medication.
1. Exercises For The Mind and Body:
–Move! Walk, run, bike, or go to the gym. Any physical activity should help move your energy (externally and internally) and the more often you get off the sofa or chair the better.
–Practice yoga, tai chi, or qigong. Dance around the room in figure 8′s, and/or wave your arms and move your hips in figure 8′s. Do the ’3 Thumps’ every morning (see our demonstration videos). Studies in recent years have clearly shown that yoga can elevate GABA levels in the brain and may act as a protection to the brain against stress and depression.
–Use EFT (Emotional Freedom Technique) to tap for your symptoms of sadness or anxiety (watch our free EFT demonstration video if you need a refresher in the procedure or tapping points).
–Meditate or use guided imagery (our guided meditation CDs are designed to assist) to diminish sense of abandonment, powerlessness, feeling unlovable, fear of the unknown, heartache, guilt, shame, anger or resentment. Massage therapy or acupuncture to free stuck or excess energy in your meridians can also be helpful.
2. Light therapy: In light therapy, also called phototherapy, you either go outside during bright daylight hours or sit a few feet from a specialized light therapy box or full spectrum plant light, so that you’re exposed to bright light that mimics sunlight.
–Artificial light therapy mimics outdoor light (must include a full spectrum of light) and appears to cause a change in brain chemicals linked to mood by stimulating the pineal gland. This treatment is easy to use and seems to have few side effects. Certain hardware stores such as Lowes or Home Depot have full light spectrum lamps in the garden section. You don’t have to spend a fortune… to feel or see the light.
–Dawn simulation is another light treatment, a dim light goes on in the morning while you sleep, and it gets brighter over time, like a sunrise.
3. Medications: Some people with depression and PTSD benefit from treatment with antidepressants, especially if symptoms are severe. They include:
–Serotonin Specific Reuptake Inhibitor (SSRI) Antidepressants. Antidepressants commonly used to treat seasonal affective disorder include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro). SSRI medications address the symptoms of depression and anxiety with associated insomnia, excessive worry, and decreased appetite.
–Norepinephrine Reuptake Inhibitor (NRI) Antidepressants (Bupropion). An extended-release version of the antidepressant bupropion (Wellbutrin SR or XL) may help prevent depressive episodes in people with a history of seasonal affective disorder. NRI medication is helpful for depressive symptoms with associated low energy level, poor motivation, and increased sleep.
-Serotonin and Norepinephrine Reuptake (SNRI) Antidepressants. Medications in this class include venlafaxine (Effexor, Effexor XR), duloxetine (Cymbalta), and desvenlafaxine (Pristiq). SNRI medications address the symptoms of depression and anxiety with associated excessive worry, low energy level, and poor motivation.4. Counseling:
4. Counseling (individual, marital or family) is another option to treat both PTSD and depression. Psychotherapy (cognitive behavioral, insight-oriented, brief solution-oriented) can help you identify and change negative thoughts and behaviors that may be contributing to depression or anxiety. You can also learn healthy ways to cope with symptoms of anxiety/depression and manage stress. EMDR (Eye Movement Desensitization and Reprocessing) is a form of individual psychotherapy used specifically to process traumatic memories to reduce their intensity and allow people to develop more positive, adaptive coping strategies.
5. Nutritional and dietary supplements used to treat mild depression/anxiety or poor concentration/focus symptoms of SAD include:
–St. John’s wort. This herb has traditionally been used to treat mild depression and anxiety. Be sure you are taking a pharmaceutical grade and that it does not conflict with medications you may be taking.
–SAMe. This is a synthetic form of a chemical that occurs naturally in the body. SAMe hasn’t been approved by the Food and Drug Administration to treat depression in the United States. However, it is used in Europe as a prescription drug to treat depression.
–Melatonin. This natural hormone helps regulate mood. A change in the season may change the level of melatonin in your body. Some people try taking melatonin supplements, but discuss this with your health care provider first before doing so as it may be contraindicated with certain medications.
–Omega-3 fatty acids. Omega-3 fatty acid supplements have been shown to relieve mild depression or anxiety symptoms in some studies. Sources of omega-3s include fatty, cold-water fish, such as salmon, mackerel and herring. Flaxseed, flax oil and walnuts also contain omega-3 fatty acids, and small amounts are found in soybean and canola oils.
–Huperzine. Huperzine-A is a plant alkaloid derived from the Chinese club moss plant, Huperzia serrata (a member of the Lycopodium species). In China, huperzine extract has been used for centuries to treat various ailments such as swelling, fever and blood disorders. During the past few years, Huperzine has been studied extensively for its potential in treating dementias such as Alzheimer’s disease. By reducing the activity of acetylcholinesterase, Huperzine A may help to reduce the breakdown of acetylcholine and may help preserve or even restore memory. While recent studies have shown that taking Huperzine A may help to relieve dementia symptoms and appears to enhance general mental functioning (poor concentration and focus) when it was taken consistently for as little as one month; more research is needed before Huperzine A can be recommended for either dementia or general memory improvement.
6. Additional tools and techniques (specific meditations, energy medicine techniques, qigong exercises, stress reduction tips, etc) for transforming depression, anxiety, guilt, shame, powerlessness or other obstacles, situations or circumstances which might be causing you to feel ‘stuck’ can be found in our best-selling books titled SHIFT: 12 Keys to Shift your Life and Shift: A Woman’s Guide to Transformation by Tracy Latz, M.D. and Marion Ross, Ph.D. (available on Amazon in hardback, paperback and on Kindle), videos, DVDs and CDs. In short, you do not have to silently suffer with PTSD or depression.
It is important to know that both PTSD and depression are real, defined issues for a large number of people and that professional help is available and should be consulted if you become suicidal or consistently feel that life is not worth living. Severe depression should be taken seriously as it can be a life-threatening illness. Help is available if you find your self in a deep dark hole from which you cannot escape- contact your primary care physician, local mental health center, local hospital, therapist, psychiatrist, or pastoral counselor for further assistance.
What can I do about feelings of depression?
Depression is a clinical condition that can make you feel exhausted, worthless, helpless, hopeless, and sad. These feelings, if intense, can make you believe that you are never going to feel better. You may even think that you should just give up and that “ending it all” will make it better for both you and your loved ones. Some symptoms of depression, such as low energy level or lack of motivation, can also make seeking treatment a seemingly insurmountable mountain to climb. Such is the illusion of depression…
It is extremely important for you to know that these negative thoughts and feelings are part of depression. As you begin to receive treatment for your mood, your thoughts will change and not seem so dark and hopeless. When in the deep, dark hole of depression it seems like you will never see the sun again when in fact the sun is still there if you can get assistance with peeking up over the rim of the hole.
If you think you might be depressed, you should seek help from family, friends, coworkers, clergy, counselors, physicians, suicide hotlines, crisis centers, etc. Here is a list of simple things you can do that may improve your mood:
Reach Out! Talk with your doctor or healthcare provider. Talk with family and friends. Spend more time with others and get support from them. Don’t close yourself off.
Take part in activities that might make you feel better. Do the things that used to bring you joy before you began feeling depressed. Even if you don’t feel like it, try! There is a good chance that you will feel better after you do. “Bring the body and the mind and mood will follow….”
Engage in mild exercise.
Set realistic goals for yourself. Break up goals and tasks into smaller ones that you can manage.
Sending you all Loads of Love & Light!
Tracy Latz, M.D., M.S. -along with Marion Ross, Ph.D. we are ‘The Shift Doctors‘
About the author: Tracy Latz, M.D, M.S., Mh.D. is a highly respected Integrative Psychiatrist with over 20 years of clinical experience in treating SAD, depression, anxiety and Post-Traumatic Stress Disorder. Dr. Latz is a gifted speaker, teacher, seminar leader, metaphysician, author, intuitive, and has served on associate clinical faculty with the Department of Psychiatry at the Wake Forest University Medical School. She is Board-Certified in General Psychiatry, holds certifications in Mind-Body Medicine from NICABM, Medical Qigong, holistic healing, and is currently in private practice in Mooresville, North Carolina.
Marion Ross, Ph.D, Mh.D. is a transpersonal psychologist, metaphysician, holistic healer, author, and holds Mind-Body Medicine certification from NICABM. She has successful private practices in France and the U.S.
**The Shift Doctors (Tracy Latz, M.D. & Marion Ross, Ph.D.) are available for keynote talks, classes, events or for seminars (1/2 day or up to 2 day) on personal transformation, team-building, motivation, anger management, intuitive development, or collaboration for private groups, conferences, corporations or corporate events. Contact them at email@example.com or find out more about them at www.shiftyourlife.com .