Major Depressive Disorder/PTSD

Roland

MyPTSD Pro
I’ve been depressed for two weeks, maybe more, maybe less, hard to keep track. I have PTSD from childhood trauma, and major depressive disorder. At first, I shrugged mdd and gad off as “Well PTSD has depression and anxiety, why do I have a whole two separate diagnosises for these?”. But lately, with my life NEAR perfect, started the job of my dreams (Sign language interpreter in elementary school) and I’m engaged (I will get married in about six weeks), you know, this depression isn’t related to my life at all. Not that it ever really was, but man I get blindsided when I get depressed. It’s the whole don’t eat, don’t sleep, drink too much coffee (free serotonin/dopamine), suicide ideation (no actual intention or desire just intrusive thoughts of killing myself), feeling numb, empty.

So what I mean to ask is how does MDD play off of PTSD?

I did notice that this past week was my dad and grandfather’s birthdays, (my dad abused me). Also March is historically a rough month for me, in past Marches I’ve been suicidal/elevated self harm, was fired, lots of triggers/flashbacks surrounding. Oh the f*cking elephant in the room that I somehow forget every year, I was molested in March as a child (timeline is likely screwed, my sister’s birthday is 03/27, and I know it was around the time she was born but I don’t know when the first time was out exactly details, since I was three years old) but I typically get flashbacks in March of being molested, so I have assumed whether true or false that that was when I was molested. It’s also common apparently. Did you know the most likely time of year for people to kill themselves in April?

Anyways, any insight would be appreciated, I’m drowning.
 
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So what I mean to ask is how does MDD play off of PTSD?
Yeah - this is the landscape I live in. I'll be able to share more in the morning, but I wanted to at least let you know that you're absolutely not alone in navigating this.

It helps me to always note how much of the depression I'm feeling is situational, vs. always with me. If I can identify something as predominantly situational - as in, I'm depressed about a specific aspect of something - and it doesn't seem to matter whether it's a present-day work situation, or a bigger picture thing, or even when it's about aspects of PTSD...situational for me feels like it's connected to my PTSD symptoms. It's existing in the shadow of the MDD, but I can try and compartmentalize it, somewhat. Manage it cognitively.

But when the depression is simply in me and all around me....when I can tell that it's operating as my identity - that's the stuff that I can't CBT or DBT my way out of. I can't challenge the thoughts, because of how real they are.

That stuff, the MDD - the only thing that can make a dent in it is my medication. Or treatment protocol; I had good results with TMS for awhile.

Ketamine is most certainly keeping me alive, these days.

I've come to understand that - for me, anyway - it's rather textbook the way it works. If the medication can pick me up just a small bit, then I can bring in other tools to build resilience and maybe even eventually, actually build new pathways that work properly.

If my medication isn't sufficient, it becomes almost impossible to manage on my own. Actually, I shouldn't say 'almost'. The truth is, I cannot manage it on my own, at that point.

Being able to feel these differences DOES actually help me overall - it's less....disorienting, I guess is how I'd describe it.
 
Yeah - this is the landscape I live in. I'll be able to share more in the morning, but I wanted to at least let you know that you're absolutely not alone in navigating this.

It helps me to always note how much of the depression I'm feeling is situational, vs. always with me. If I can identify something as predominantly situational - as in, I'm depressed about a specific aspect of something - and it doesn't seem to matter whether it's a present-day work situation, or a bigger picture thing, or even when it's about aspects of PTSD...situational for me feels like it's connected to my PTSD symptoms. It's existing in the shadow of the MDD, but I can try and compartmentalize it, somewhat. Manage it cognitively.

But when the depression is simply in me and all around me....when I can tell that it's operating as my identity - that's the stuff that I can't CBT or DBT my way out of. I can't challenge the thoughts, because of how real they are.

That stuff, the MDD - the only thing that can make a dent in it is my medication. Or treatment protocol; I had good results with TMS for awhile.

Ketamine is most certainly keeping me alive, these days.

I've come to understand that - for me, anyway - it's rather textbook the way it works. If the medication can pick me up just a small bit, then I can bring in other tools to build resilience and maybe even eventually, actually build new pathways that work properly.

If my medication isn't sufficient, it becomes almost impossible to manage on my own. Actually, I shouldn't say 'almost'. The truth is, I cannot manage it on my own, at that point.

Being able to feel these differences DOES actually help me overall - it's less....disorienting, I guess is how I'd describe it.
I’m stubbornly anti-psychiatrics, but then again coffee releases serotonin and dopamine and when I’m depressed I can drink up to three cups in a day. So it’s odd how you subconsciously “medicate” anyways. Sometimes I wonder if I should reconsider my stance on psychiatrics. Idk. It’s nice knowing others deal with this shit too, because as I said my life is practically perfect. I may be doing too much, but no real reason to be depressed. **sigh**. Also don’t know what to do to get out of it other than wait it out.
 
If my medication isn't sufficient, it becomes almost impossible to manage on my own. Actually, I shouldn't say 'almost'. The truth is, I cannot manage it on my own, at that point.
This is kinda where I am. The only time meds have helped is at crazy-high doses (like 4-5x the normal recommended high). The side effects at those doses are not tolerable, and I've experienced long-term effects from a couple.

It helps me--a little--to identify what is the PTSD and what is the depression. I work on the PTSD stuff, and as that eases, I only have to deal with the depression. That's still a lot because I really have not found anything to help long enough to make a difference, and meds just are no longer an option for me.

I've also started to notice, as @joeylittle mentions, what is situational vs what is clinical. I've learned to work with the situational so that its incidence has decreased, which I suspect helps the overall picture.
 
This is kinda where I am. The only time meds have helped is at crazy-high doses (like 4-5x the normal recommended high). The side effects at those doses are not tolerable, and I've experienced long-term effects from a couple.

It helps me--a little--to identify what is the PTSD and what is the depression. I work on the PTSD stuff, and as that eases, I only have to deal with the depression. That's still a lot because I really have not found anything to help long enough to make a difference, and meds just are no longer an option for me.

I've also started to notice, as @joeylittle mentions, what is situational vs what is clinical. I've learned to work with the situational so that its incidence has decreased, which I suspect helps the overall picture.
That’s definitely a good point, that clinical depression **isnt situational** it’s just odd because this is the first time for me it hasn’t been also situational.

The scary thing is, that March has hardly begun. Like, it’s only going to get worse from here before it gets better.
 
I’m stubbornly anti-psychiatrics, but then again coffee releases serotonin and dopamine and when I’m depressed I can drink up to three cups in a day. So it’s odd how you subconsciously “medicate” anyways. Sometimes I wonder if I should reconsider my stance on psychiatrics. Idk. It’s nice knowing others deal with this shit too, because as I said my life is practically perfect. I may be doing too much, but no real reason to be depressed. **sigh**. Also don’t know what to do to get out of it other than wait it out.
I’ve had some bad experiences earlier with psychiatrists, however then got put onto one who actually looked at me as a person not just cluster of symptoms to label, the ones I didn’t have great experiences with were all older and unwilling to acknowledge I had trauma and in my case my challenges and symptoms stemmed from that. Most I’ve encountered in the last 5-10yrs have been better. Also, I had years without a psychiatrist and my GP managed any antidepressant medication just as well if not better.
Regarding the time of year, I often get rocky around certain anniversaries of one off traumas, particularly a major couple in December many years back and the heightened ptsd symptoms I often get around that time, even if everything else is going great, often alternates with exhaustion from the high panic levels and then in the exhaustion I get down for fear of facing the next bout of panic/flashbacks/etc whilst trying to function. It’s got worse the last few years since my Nana died as I usually spent the holiday period with her for sometimes 6-8wks (my son included when he came along) , and the biggest Dec trauma happened when I was in a different country to her so I don’t have that rock with me. She was a constant even from a different country and helped buffer mum’s behaviour and narcissism, now I also have to deal with my mother during a time I’m reliving one of my worst traumas, and we usually have to try and up treatments during that time (as much as holiday leave allows for).
I guess I’m saying they probably exacerbate each other at times of triggering anniversaries, and that maybe your GP could be someone to discuss meditation options with? I had to try a few before I found something that helped without serious adverse reactions, yet some of the first ones I tried helped others I know so unfortunately that aspect is presently mostly trial and error, but once you know what helps for you it can make the world of difference; like as been said, the meds for me tweak things enough that other strategies and therapy etc can work and help.
 
I’ve had some bad experiences earlier with psychiatrists, however then got put onto one who actually looked at me as a person not just cluster of symptoms to label, the ones I didn’t have great experiences with were all older and unwilling to acknowledge I had trauma and in my case my challenges and symptoms stemmed from that. Most I’ve encountered in the last 5-10yrs have been better. Also, I had years without a psychiatrist and my GP managed any antidepressant medication just as well if not better.
Regarding the time of year, I often get rocky around certain anniversaries of one off traumas, particularly a major couple in December many years back and the heightened ptsd symptoms I often get around that time, even if everything else is going great, often alternates with exhaustion from the high panic levels and then in the exhaustion I get down for fear of facing the next bout of panic/flashbacks/etc whilst trying to function. It’s got worse the last few years since my Nana died as I usually spent the holiday period with her for sometimes 6-8wks (my son included when he came along) , and the biggest Dec trauma happened when I was in a different country to her so I don’t have that rock with me. She was a constant even from a different country and helped buffer mum’s behaviour and narcissism, now I also have to deal with my mother during a time I’m reliving one of my worst traumas, and we usually have to try and up treatments during that time (as much as holiday leave allows for).
I guess I’m saying they probably exacerbate each other at times of triggering anniversaries, and that maybe your GP could be someone to discuss meditation options with? I had to try a few before I found something that helped without serious adverse reactions, yet some of the first ones I tried helped others I know so unfortunately that aspect is presently mostly trial and error, but once you know what helps for you it can make the world of difference; like as been said, the meds for me tweak things enough that other strategies and therapy etc can work and help.
Sorry for taking so long to reply! It’s great that you found a psychiatrist that’s helpful for you, as well as treatment. I’m sorry about your grandma, it’s hard to cope with things like that, losing that sense of support. Idk as I said, I’m stubbornly anti-psychiatrics by premise, but when I really think about it, I self-medicate with coffee, milkshakes, looking for that serotonin, dopamine, melatonin. In some ways it’d make more sense to get medications. I’ve only recently realized just how much I’m like a rat seeking that brain chemical hit to lift me up.
 
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