PTSD Depression and The Various Levels of Dissociation

When suffering Complex PTSD or PTSD, depression is going to show up somewhere down the line. It is one of those symptoms that is almost always present with a post-traumatic state.

It is important to realize that a depressive state is both a symptom and an effect of post-trauma. Depression is often perceived and treated as a stand-alone mental/emotional illness.

The Nervous System Responses and Depression as a PTSD Symptom

There are various ways of looking at depression when examining the symptoms of PTSD.

While going through trauma, your adrenals and nervous system get geared up for survival into fight or flight mode. Once the traumatic experience or episode has passed, your circumstance or personal mindset may not have been sufficiently capable of integrating and containing that high nervous system and emotional energy charge, and, as a result, you remain stuck at “ON.”

Over time, you run out of energy resources. You will start to get allergies and have a sensitivity to various foods; also, the possibility of asthma attacks, chronic pain, hormonal imbalances, and a break down of the immune system.

From being stuck at “ON” for too long, you will eventually flip over and get stuck at “OFF.”

While going through trauma, your adrenals and nervous system get geared up for survival into fight or flight mode. Once the traumatic experience or episode has passed, your circumstance or personal mindset may not have been sufficiently capable of integrating and containing that high nervous system and emotional energy charge, and, as a result, you remain stuck at “ON.”

Your energy freezes and becomes dormant. From a state of being hyperactive and continuously on the alert, you move into a dissociated state where you feel numb and depressed.

When you are hyperactive, the sympathetic branch of your nervous system is running on overtime. Now the parasympathetic branch of your nervous system is in overdrive. And this can result in lethargy, depression, low blood pressure, constipation and other digestive issues - to name but a few.

Furthermore, you will move between those two states of; hyper-activation (ON) and hypo-activation (OFF) and along with that, the emotional responses.

PTSD Depression Symptoms from a Dissociation Perspective

Depression acts as a safety valve, after having been hyperactive for a more extended period.

It is, unfortunately, also where you can remain stagnant and immobilized for too long.

Although, however, "yucky" a PTSD depressive state feels, it can, and often is a preferable state to be in, compared with feeling too much continuous emotion.

It is not that you don’t have energy, and therefore are depressed. It is the other way around - in that your energy is invested in being in a depressed state, consciously or unconsciously - to survive.

Once you become aware of PTSD depression from this perspective, it renders that state more accessibly fluid, and perhaps gives back a sense of control, as opposed to being a victim of depression, to working through it.

How to Possible work Through PTSD and Depression

You either fully identify with depression and dwell in it, or fight it to stave it off for some time; but whenever you lose hold of your vigilance you might just slip back into it.

Having read the above, and knowing that depression follows suit after anxiety or any another emotional activator, let us see if we can listen to that numbness, that tiredness, lethargy, depression, and disconnection without reacting to it.

To be attentive to it, so that the energy from the depressed state slowly starts to move back into awareness and observation.

What will happen is, that while you do that, you will start to feel more 'your familiar self' again and will notice that emotional activation, which preceded the depressed state. It often is anxiety, but it could be any other emotion for you.

Go gently back and forth between connecting and disconnecting with it and, as you did with depression, do the same with this emotional state that you encounter. Can you listen to it, hold it, not allow yourself to go into thoughts and memories of it, but coming back to the feelings which are presenting themselves.

Working with emotions will be a continuing process of moving back and forth, between negating thoughts of blame, shame, self-reproach, allowing oneself to be vulnerable and to feel through the different layers of emotional residue.

Through attention to these hyper-- and hypo responses of the nervous system, the emotional residue is being transformed into resilience and awareness. There is no other way around it, but to go directly through it!

  • Do you want to reduce anxiety, hyper-vigilance, and being “ON” alert constantly?
  • Do you want to move out of a dissociated, fatigued and depressed state?
  • Do you want to work with anger and reestablishing boundaries?
  • Are you interested in sleeping better, having better relationships, and being able to live a normal life?

I have created The Trauma Care Audio Guided Meditations which address the most fundamental insights into the processes of trauma and dissociation and how you can work through them.

  • Nancy says:

    This is so true and I’m in the building resilience phase (Yay!)! After literally years of lethargy and apathy and hating every minute of it I finally thought to myself perhaps this is my new normal and I need to accept it. When I stopped judging the lethargy as bad and started to just allow it, I finally turned a corner. I am feeling somewhat like my old self again! Starting to find things to be interested in and having the motivation and energy to participate in them (hiking lately).

  • stephen says:

    Thank you so much for your post . So important to understand the dynamics of our depression .Fighting it doesnt work . Excepting and observing takes the edge off . I must say that I must be left alone to understand this and try to get in the middle of the boat and i do spend sometime in Hypo-Activation.Thats life and if im left to go through it and talk myself through it .Im fine .Really appreciate your post .Great to be given insight .

  • Lorraine says:

    Thanks Roland

  • Petra says:

    These are very interesting thoughts and for me a new way to see it. Thank you for sharing. It seems to me like a good way to process “the unspeakable” ..

    • Yannick says:

      Wow! I have had lots of EMDR therapy, read
      Books and articles and NO ONE has ever mentioned the reason the body goes into a depression!! Although I am over the hump, this mystery is now solved with this short blog post. Thank you so much.

  • Pauline says:

    How does the neglectful parent , who is also a victim in the cycle heal herself and her kids post separation when abuse escalates? It seems the supposed neglectful parent can be targeted through the children harming them more. Struggling to cope with guilt versus over compensating for marrying an abusive person is a huge role while trying to deal with ones own mental health as well as that of the children.

  • Shirley says:

    Wow my psychology degree never taught me this but it makes a lot of sense – thank you.

  • Mary says:

    I’d like to first thank you for writing this insightful blog. I don’t know what your credentials are, but I will definitely be trying to look up info on you and and books I can get in paper (hard) copy, or articles I can download to my Kindle.
    Long story…..I’ll shorten it. Buried three of my children. The last one in the most unspeakable way a parent can lose a child, almost 15 years ago. Divorced in the last year and now unable to work. Unbelievable pain every day, now diagnosed with RA, Raynauds Phenomena, OCD, Anxiety, Depression, ADHD & ADD & Insomnia. I have, what I think are very well trained, experienced, compassionate and sometimes confused as to the best treatment for my symptoms (because it is difficult to know which is aggravating/causing the other)- psychologist & psychiatrist.

    Your blog gives feedback to what they have stated many times!

    Something clicked after reading this!! THIS IS ME!! THIS IS MY LIFE!!! I AM STUCK! I saw a psychologist about six months ago who did “sand therapy” with me and I was horrified by what I saw in the way of self perception….. I please EVERYONE else before myself. (Did I mention my abusive childhood?) In summary, I was told the front part of my brain had been badly damaged by the amount of time I have been in this “state of mind.”

    I will be looking up/downloading/purchasing some of your work. I’d like your opinion on where I should start…… Anywhere? Something specific? Thank you!

  • Sara says:

    Is it possible that you can be ON and OFF In different contexts in your life? I feel I am ON at work and OFF outside of work, I work in trauma informed environment have to work really hard around transference due to still being in journey in my own recovery, when out of work find hard to get out of bed or even leave house, am looking at going back into therapy again but was thinking about these trauma responses in terms of my own work/ home life

  • Ruth says:

    Hi, Roland – and thank you. I am living with c-ptsd for over 20 years now, and ended up getting a diagnosis of cronic fatigue, with ptsd on the side that occationally (frequently) reactivates. I suppose I am one of many that are misdiagnosed this way. After reading your blog here, I had a good revelation. I do have questions that I am not comfortable asking here. Can I send you a mail with my one big question? I am ok with it if you feel the need to protect your privacy, and will still follow this blog 🙂 Have a nice day!

    • Roland says:

      Hi Ruth. Thanks for your message. Unfortunately, PTSD starts impacting body and mind across the spectrum and chronic fatigue is a common symptom of post-trauma. Please do write me a private message.

  • Terry Wall says:

    Hello looking for support and advice I am strongly coming to believe that my ptsd is co morbid with borderline personality disorder

  • Michael Turaj says:

    this is a very good article, precise and to the point. Off and On button makes a lot of sense, so does whne it says its not like you dont have energy but that your energy is invested in being depressed, which is so true in my case. t says instead of fully identifying with depression or fully fightin it to stave it off for some time, it says “we can listen to numbness, that tiredness, lethargy, depression, and disconnection without reacting to it” adn then says being attentive to it the enegery from the depressed state slowly starts to move back into awareness and observation” but how? There seems to be a step that i am missing here. Can you please elaborate on that, perhaps with concrete suggestions? thank you!

  • Giorgio says:

    Thank you Roland!

  • Diane says:

    Glad to have found this article it explains a few things I didnt know, thank you

  • Shaun says:

    Has hit the nail completely on the head for me. What an excellent explanation. Am beginning to understand my cptsd and trying to learn to live with it.

  • Min says:

    Im only just now starti g to really dig i to my depression, anxiety and deal with my PTSD. I have been reading as much of your blog posts as I can absorb. So one or 2 a day. Thank you for sharing this! I’m starting to understand myself better and this has been so eye opening.

  • Mista Wasis says:

    I can share from a First Peoples perspective as a 60s Scoop who was a permanent Crown Ward until 21 to which I underwent various treatment included the myriad of pharmaceuticals. That said also inner child journeying, t was an old couple, a wizard and a true healer that told me after a ceremony that next time I see them remember something good about your childhood and share that, it was difficult as my journey of repatriation to my proud peoples a family of nations a nation of families, the House People, The Iron Nation, The People of the Snake Plains until that time was to always share trauma hurt and anguished pain as part of healing or government of the Canada(GoC) Health Canada initiatives or what is now in the public via media Canadas secret ‘Medical Intelligence Branch,’ eugenics and other psychological operations experimented on foster children some even sold thru the Adopt Indian and Metis(AIM) out of Saskatchewan coincidently some 2000 files records and identity of Indigenous Foster Children sold thru this program for example. I am going to work with this in our ancient customs and will work to incorporate this new wonder of science, psychology and sociological studies with our ceremonies, some of which have taken multi-personalities and fashion them as spirits or animal clans and to take all that is good of each one and live and thrive with it and as such have witnessed the miracle of both western and Indigenous Medicine flow as one in the hearts, minds and spirits of those in need, keep up the great work it is firms like yourselves that will offer the solutions and answers for all our futures, you are angels in human form 🙂

  • Barbara Haworth says:

    For the first time , I have a glimps if hope , like a tiny pin prick of light at the end of a very long tunnel
    I had resigned myself to the fact that I was drowning and waiting for the end , going through hi to low which I felt with by disassociation from everything and everybody
    Just when I think I’m in some form of control, something always happens beyond my control and sets me right back till the thought of the end of this life is not a only the only way , but a blessed relief, it’s a very calming peaceful feeling
    Then I think of my children (adults now) and while I’m needed (I feelit’s getting less and less) I can’t move on
    From what I’ve read so far , you may be my only hope of a way back and a normal life and an end to feeling like an observer with no control
    Thank you x
    ( I have no family/friends to turn to and would not know how to talk to anyone as I’ve successfully secluded myself for more than 3 years )

  • Rosie says:

    I wish doctors understood this. I’ve always been treated for depression, with no consideration of the reasons behind it

  • Shea says:

    How would you handle PTSD combined with complex DID.

  • Jennifer says:

    Thank you for your efforts. It so important to make these discussions more common especially when there is not enough support surrounding crisis intervention and recovery from it. It describes my process perfectly after I lost my son and what I learned is you can’t fight what your mind wants to do but allow it to happen and then find a way to alleviate the stress so you have good days among the bad. It is still difficult and exhausting when multiple stresses happen all at once but I try to ask myself what do I need to learn about myself from this.

  • El says:

    27yrs on and my night terrors and paralysis are worse than ever, I experience real pain and full colour so it’s as real as waking. I used to stay awake for days because I was too scared to sleep but this makes it worse as does sleeping on my back and tiny triggers or cruelty. Day time panic attacks and depression, I’ve tried facing it and ignoring it believe me.I come across as happy go lucky + it has made me kind and empathetic. Sorry but you cannot help me and maybe would could cause more damage.

  • June Bellamy says:

    The best article which describes the process and the way through it. Ive been there done exactly this. Only because I was training in Mindfulness at the start, I was on medication and knew the benefit of support this would bring. And then intense self compassion training got me through the back end of vulnerability,coupled with deep awareness. Psychotherapy was an unknown missing component and luckily I had the foresight to reach out. This was my winning combo. NB note: there is no time line! Each persons journey will be different. Day by day. Just work this process!

  • Tanja says:

    Such a timely article for me! Thank you for that Roland.
    For years i struggled with anxiety/panic attacks that began somewhere in my mid teens, and through a series of events crescendoed into daily torture by my late 20’s. From there feelings of unreality/being in a dream (dissociation) only grew. A few bouts of depression thrown along the way with feeling incapable of emotion and I developed allergies, asthma, during my 20’s then IBS, struggling with fatigue in my late 30’s and 40’s, on top of everything else. Now in my 50’s I’m beginning to consider a PTSD as my main cause of issues.

    I’ve gotten better at working through depressive episodes, realizing my stressors. But I was never able to connect that feeling of unreality during my panic attacks (which often makes those worse), or the hyper sensitivity of my senses (i.e sudden overwhelming fragrances causing full blown panic) to this.
    I have good years and bad years. I am attacking my issues with diet, vitamins, and of course also mentally and emotionally, as well as spiritually. The only diagnosis aside from obvious physical issues I’ve received was GAD (generalized anxiety disorder) which IMO is putting it mildly.
    I’ve always thought in order to suffer from PTSD one had to have experienced an extreme event, such as rape or war etc.

    I believe this topic is not being addressed or considered by many in this way. Thank you again Roland, for speaking out about these things that are hard for us to express amid the confusion that often come along with our roller coaster times.

  • catherine tolbert says:

    Can I have PSTD depression while never in the Armed Forces? I have been diagnosed with major Depression with psychotic features (Hallucinations) My co-workers frequently made fun of me for it.

    • Roland says:

      Any form of shock that you have not been able to process can contribute to PTSD. With longstanding and ongoing Post-Traumatic Stress, you might actually be dealing with complex trauma. Pls have a go through the resources here on the web.

  • Ali says:

    This has really helped me try to understand why my twin sons are ‘stuck’. 6 years after their father’s sudden death and we don’t seem to have moved forward one step resulting in totally switching off from the outside world (they haven’t left the house for over two years). I’ve asked them to read your blog and hopefully some of it might hit home. I just sometimes think they want to remain hidden from life !!

  • Justanother Earthling says:

    Thank You. *Information/Knowledge is ”power”. Thank you.

  • >