Part II of a Six-part Trauma Series. Trigger warning: This is a difficult topic. Some examples of trauma with depression will be eluded to without details in order to set a scene for clarity and relatability.
Skyla sits and stares out the window of her small apartment. She watches as the trees blow from side-to-side, in uniform rhythm. These days, staring at nature is the only way she can calm the noise in her head and body.
She does not know how long she has been sitting there. Time does not seem to hold the same meaning it used to. Nothing does, really. In fact, Skyla does not even know who she is anymore. “Bubbly,” “jubilant,” “a lover of people and life,” – all ways her friends and family would have described her, but that was before. Before the assault, she was wide-eyed and trusting. Before, she felt strong, confident, and energetic. Now…well, now she is a shell.
The alarm goes off at the same time as it does every morning, but she has learned to simply ignore it and go back to sleep. The aching in her body and the guilty yelling in her mind eventually push her out of bed, but not too far. The window is where she lives now, with the birds, plants, and clouds her only friends. She does not know if things will ever get better, and every day she cares less. Over and over, in her mind, she hears the questions, “What has happened to Skyla? Where did she go?”
Not everyone who has experienced a trauma is diagnosed with PTSD. For people like Skyla, the result may be depression. Rather than triggered by flashbacks or nightmares, for example, some people may experience tearfulness, loss of pleasure, withdrawal, irritability, or feelings of hopelessness, helplessness, and worthlessness. After a trauma, a cascade of neuro-biological events can occur, resulting in mental and physical (body memories) preoccupation with the trauma. This can overwhelm a person, creating intense fatigue and making the performance of even the simplest of daily tasks feel like scaling a mountain.
Think about it. You may well imagine the internal dialogue Skyla is likely battling. There may be, “what ifs,” “if onlys,” “whys,” and “what’s wrong with me?” self-talk. Then, there’s the fatigue. She is so very tired. From the very first day when she woke up in the hospital, her whole body has ached. She had always been so active. Who would have ever guessed that only six days of laying around would make her muscles feel this weak and atrophied? The mental, emotional, and physical fatigue feel too much.
It is more than the body pain that has deflated her, though. She struggles to explain what is going on inside of her. Some things simply have no words. She knows (in her left brain) that the trauma is over, and she is “fine” now. She knows her friends, family, and coworkers are safe and would never harm her. Even so, her right brain and body did not seem to receive that same message. She feels on edge with all people and she cannot explain why, not even to herself.
At first, everyone was so supportive, but now they do not understand why she “still” struggles. After all, she received care right away and all of them were there for her when she needed them. No one ever judged her, and they even caught the man who hurt her. Surely, she should be feeling better, not worse, after all this time. Skyla knows this is how they feel. She finds all the chirpy clichés they have begun to hurl at her untenable. She has stopped returning calls and e-mails. She has even quit her fitness classes. Her isolation propels her into an ever-descending downward spiral. Everyone is at a loss for what to do.
Despite what she thinks, Skyla is not alone in this. Depression is common after trauma.
If you, or someone you know, can resonate with Skyla, there are some things that can help. Here are some ideas to get you started.
Small Steps Matter. If you fell and broke your leg and needed a cast and physical therapy, you would likely understand that your first step toward healing would not be to jump right back into your typical level of activity. In fact, you may not even be able to make the most basic of movements at first. You would innately know that you must make small steps toward recovery. Maybe you would need to spend an entire week doing nothing but ankle flexing activities, for example. This might be frustrating, but it is doubtful you would think something is wrong with the fact that you cannot “go back to normal” right away. It is no different after a trauma, except that it is not just your body, but your brain, heart, and spirit that need rehab. Just as with purely physical recovery, small steps are steps. Making your bed. Brushing your teeth. Saying hi to a neighbor. Cooking a small meal. All these things, when building atop of one another, end up in healing. Every day, set small, attainable goals. Do them and then celebrate them. Work is work, no matter the content – it all counts!
Find a Tribe. Mom, dad, siblings, friends, spouses – all the significant others in our lives may not be able to understand what we are going through, and therefore not have the tools they need to help us. Their presence in our lives is no less important because of this. The difference comes with function, not importance. For instance, you probably wouldn’t talk as deeply to your family and friends about your work as you would your coworkers, right? Like with this, after a trauma it may be particularly helpful to find and talk to others who have had similar experiences. The name for this is coterie. A coterie is group of people who “get it”. MOPS, AA, and support groups are examples of coteries. You need to know you are not alone. Find others who understand.
Depression is Not a Character Flaw. Trauma is injury to every part of you; body, mind, spirit, and relationships. No one would ever accuse a car crash survivor of being lazy because they don’t go back to work after three days. Neither are you lazy (or, fill-in-the-blank on whatever unhelpful adjective is used to describe your process). People can see a cast and stitches, therefore, they understand that healing needs to happen over time. Trauma, at a certain point, is invisible. Once the outward scars abate (or become “white noise”), people have no way to gauge progress and therefore forget or refuse to allow for the changes that continue internally. Do not jump on the self-abasement train. Trust yourself. You know your efforts. People will see eventually. Keep going until they do.
Depression after trauma can feel like a downpour after a flash flood – problem on top of problem. Rising after such a fall takes time, stamina, effort, and support. If you are hurting, reach out. You do not have to do this alone and you do not have to make a complete about-face in one fell swoop! If you, like Skyla, feel as if your life has been reduced to the size of a single window, call The Center • A Place of HOPE. The Center is recognized as one of the top centers in the world for the treatment of depression. Caring professionals will walk beside you and offer support and guidance as you find your way to the other side of the depression mountain!
Written by Hannah Smith, MA LMHC CGP, Group Therapy Training & Curriculum Consultant for The Center • A Place of HOPE. As a Neuroscience-informed, Licensed Therapist and International Board-certified Group Psychotherapist, Hannah’s passion is to see people reach their potential and find lasting, positive change. The Center is located on the Puget Sound in Edmonds, Washington. It creates individualized programs to treat behavioral and mental health issues, including eating disorders, addiction, depression, anxiety, and more.