If the external environment continues to reflect the abusive patterns of the past rather than replace them with constant support and encouragement, the old feelings will probably come back.
First we’d like to take a brief look at a disorder that is related to depression (some say it’s the next step along the continuum of mood disorders in severity). Posttraumatic stress disorder (PTSD) has become much more prevalent in the wake of the terrorist incidents of September 11, 2001.
PTSD and Depression
PTSD was only accepted as a separate psychiatric disorder as recently as 1980. It was first noticed among veterans after World War I but was only taken seriously as a distinct illness after the Vietnam War. The disorder was “post-traumatic” because the symptoms—including increased anxiety; avoidance of stimuli associated with the event or events; agoraphobia; vivid dreams related to the trauma; and frequent recall of the past experience—would frequently appear some time afterward.
Interest—and even more controversy—surrounding PTSD soared when a number of researchers began to notice that the same symptomatology was evident in survivors of rape, natural disasters, auto accidents, and childhood abuse. Some, more traditional, psychologists declared that PTSD didn’t exist and that it was simply a misdiagnosis of other disorders. Yet by the mid-1990s, PTSD was found to affect nearly 8 percent of the American population, making it one of the most prevalent psychiatric disorders. Since then the numbers have gone up considerably.
Not everyone who experiences traumatic events develops PTSD: only 30 percent of Vietnam veterans became sufferers of the condition. What distinguishes people who get PTSD seems to be that they were victims of previous traumas.
Research and Bob’s experience of working with Vietnam veterans point out that early trauma predisposes the sufferer to the disorder. The later incident (war, rape, or witnessing a violent crime) provides the trigger in a process known as “retraumatization.”
Millions of television viewers experienced retraumatization when they witnessed jets slamming into the World Trade Center buildings over and over again in the aftermath of the terrorist attacks of September 11. Incredible as it may seem, according to the psychiatric bible Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, watching such events can be as traumatic as being a victim. According to a study carried out by Prof. Roxane Cohen Silver of the University of California at Irvine and colleagues, more than 17 percent of the U.S. population living outside New York exhibited signs of PTSD after September 11. The majority of those who fell victim were women and those with a history of depression.
We ourselves noticed that many of our students and clients exhibited PTSD symptoms after September 11—even those in Australia. Again the same pattern emerged—those who had a prior history of abuse or trauma and who suffered from depression were more likely to develop PTSD or its close cousin, acute stress disorder.
Recent neurological studies confirm that PTSD and depression are very similar in their effects on the brain. Moreover, the two disorders share a number of symptoms, including a tendency to avoid social contact, to suffer from nightmares associated in some way with traumatic events, and to be hypervigilant.
The point here is not to quibble about diagnostic criteria—labels have never cured a person of anything, and in some cases simply make matters worse. But it seems to us that not only do many depression sufferers probably have some form of PTSD, but thinking in these terms helps clarify the nature of depression itself.
(extracted from) Creating Optimism: A Proven, 7-Step Program for Overcoming Depression, Based on the popular Uplift program, written by Bob Murray Ph. D., and Alicia Fortinberry, published by Mcgraw-Hill