Trauma-induced depression tends to be resistant to traditional antidepressant medications and includes symptoms beyond just sadness, low energy, and feelings of worthlessness or hopelessness. Depression which results from trauma includes intrusive and disturbing thoughts, flashbacks of the traumatic episodes, emotional detachment, numbing, social withdrawal, and persistent feelings of guilt or shame. These depressive symptoms are more severe and long-term than depressive symptoms which are not linked to traumatic experiences. Trauma-induced depression results from either chronic trauma or complex trauma. Chronic trauma includes prolonged exposure to distressing situations, such as ongoing domestic violence, bullying throughout childhood, or continuous emotional abuse from either a parent or romantic partner. Complex trauma includes exposure to multiple and repeated experiences of emotional and/or physical abuse, emotional neglect, or growing up in a chaotic, unpredictable, toxic family environment. Complex trauma almost always leads to long-term depression, which is accompanied by an inability to form healthy adult relationships, persistent self-doubt, and a deeply fragmented sense of self. Trauma-induced depression is extremely difficult to treat. However, when you revise your perceptions about your childhood or adolescent trauma as something which happened TO you and NOT something which DEFINES you, you can begin to recreate your sense of self and to let go of your shame and insecurities.
Ketamine therapy has been increasingly utilized in outpatient settings to provide hope and relief for trauma-induced depression survivors. The approved form, esketamine, has been proven effective in its ability to act on glutamate receptors, which are key brain pathways responsible for managing the brain’s trauma memories. Esketamine targets hyperactive neural circuits and helps trauma survivors to actually begin to form new present-oriented, healthier narratives which release them from the fear and debilitating depression which has often existed for years. Esketamine differs from traditional antidepressant medications, in that it creates more rapid relief from depressive symptoms, such as within 24 to 72 hours. Esketamine has also been found to be especially helpful in reducing the dissociation, anxiety, panic, and even suicidal ideation from trauma-induced depression. Esketamine received approval from the FDA largely due to its ability to promote the growth of new synaptic connections and the rewiring of trauma-affected brain areas, such as the amygdala, the hippocampus, and the prefrontal cortex.
The amygdala triggers the brain‘s natural alarm system. For instance, when you experience a traumatic event, long-term emotional abuse, or multiple traumatic events, your brain’s amygdala has learned to live in crisis mode. The amygdala’s overactive fear and anxiety responses are the building blocks of long-term depression. The hippocampus is the brain’s memory structure and receives the most severe damage from traumatic events, in that it loses the ability to store and process information correctly. After experiencing a traumatic event or even ongoing emotional abuse, a person’s hippocampus often cannot separate safe events from the dangerous or painful events which have occurred. The prefrontal cortex regulates your emotional responses to all external events, particularly decision-making, goal-setting, problem-solving, and stress management. Traumatic events cause the prefrontal cortex to have extreme difficulty in managing threats which are transmitted from the overreactive amygdala. Trauma-induced depression is often characterized by the “freeze” response, which includes dissociation, social isolation, paralyzing phobias toward interpersonal relationships, and a perception of yourself as basically inadequate and flawed.
What many people do not understand is that trauma is very difficult to treat, because the brain’s ability to process memories and emotions has been pervasively debilitated in several crucial areas. Neuroscience research studies are still pursuing greater knowledge about how trauma stays within one’s subconscious and conscious memory systems, as well as how to reverse the effects of trauma. Symptoms of trauma occur on a continuum, based on the severity of the traumatic experience(s), how an individual perceives these events, the amount of social support in the individual’s life, and the subsequent life events which may add to or perpetuate the brain’s faulty wiring system. A major goal of trauma therapy is establishing a sense of security and comfort within yourself and within your significant interpersonal relationships, rather than being in crisis mode. Another important goal of trauma therapy is learning self-regulation, self-reflection, and maintaining healthy relationships. The most significant treatment areas for survivors of trauma are the pervasive sense of being disconnected from others during daily life, trust and abandonment issues in relationships, severe difficulty with emotional regulation, and frequent mood instability.
Neuroplasticity, which is the brain’s capacity to form new neural networks, has been greatly supported by clinical trials using esketamine therapy. When traumatic childhood or adolescent memories are wired into your brain, you CAN learn, through motivation and hard work, to surrender these painful visions and to replace them with new, empowering visions of who YOU are and CAN be. You have the power to destroy old narratives. If you are an adult who has experienced developmental trauma, you may require at least 6 months of trauma therapy to learn the tools for processing and getting control of the trauma triggers and the associated effects upon your thought patterns and emotional states. Effective trauma therapy focuses upon cognitive reprocessing, which can be frightening but which is integral to creating real changes in your behaviors, thought patterns, and emotional regulation.
