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Psychological Trauma and Its Surprising Link to Depression

This entry was posted in Mental Health on by .
Medically Reviewed Fact Checked

Last Updated on February 24, 2022 by Carol Gillette

Psychological Trauma and Its Surprising Link to Depression

Alternative to Meds Editorial Team
Medically Reviewed by Dr Michael Loes MD

The common phrase “scarred for life” began popping up in English literature back in the 1850s—long before any modern understanding of mental health existed in the public consciousness. Its common usage and meaning have long been linked to mental and emotional distress. The concept of “psychological trauma” is essentially synonymous with this notion of “emotional scarring.”

As information evolves, we see a significant overlap of symptoms after a traumatic event or a series of them that include depression, anxiety, and others, and these can be long lasting and extremely debilitating. This overlap can be confusing for practitioners who strive to diagnose clusters of symptoms and label them with accuracy. It may be that a diagnosis of depression could more accurately be observed to be a long lasting reaction to trauma, because these symptoms do overlap in many persons. A study published in the Multicenter Journal of Psychiatry Research found that patients who had been diagnosed with MDD had the most severe PTSD symptoms of all participants.1 And to simply attempt to elevate one’s mood with prescription drugs is destined to overlook the actual psychological factors underlying one’s depressed state. Even more concerning, it will shortcut other treatment choices that may have been more effective. Researchers analyzing vast numbers of PTSD cases found psychological processing significantly more effective than pharmaceutical treatments. Even though guidelines for PTSD treatment recommend against medications such as benzodiazepines, about 30%-76% of PTSD patients still receive them. But patients diagnosed with depression are recommended to take benzodiazepines, resulting in a significant treatment controversy.2

While prescribers continue to debate drug-based treatment options, we shall look here at more holistic answers that can free a person not only from prescription drugs, but non-drug-based treatments that can be implemented to actually resolve lingering effects after psychological trauma.

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What Is Psychological Trauma?

A psychologically traumatic event is a situation or occurrence that is so stressful, scary, or difficult to process that it results in long-term damage or disturbance to your mental state. Common ways for this damage to manifest can include stress (as in post-traumatic stress disorder), anxiety, depression, withdrawing from social contacts, and even addiction as a result of self-medicating.

It can be difficult to pinpoint exactly what causes psychological trauma in an individual patient because the potential causes are so varied and personal. Any unpleasant, intense, or frightening experience can result in psychological trauma, but the same sort of trauma can also be the result of less dramatic events.

For example, someone living with a narcissistic partner skilled at gaslighting might never experience an intense sense of physical danger or even participate in a blow-out argument. Yet, the long-term pattern of emotional abuse and manipulation might still result in psychological trauma, along with all of the self-doubt, depression, anxiety, and trust issues that go with it.

Physical endangerment or serious illness, especially to the point that one believes their life is in jeopardy, is another common source of psychological trauma. Trauma, in general, can be thought of as both a mental and physical condition. Making distinctions between psychological and physical trauma is not necessarily useful because any experience that is traumatic in the medical sense is very likely to have a lasting psychological component. As we stated earlier, life and health are holistic endeavors — embracing physical, mental and spiritual factors that can either ricochet off one another, or become harmonized and orderly.

How Does Psychological Trauma Affect Mental Health?

Enduring psychological trauma can follow many cataclysmic events both physical and emotional, or a combination of these factors, and can affect mental health and emotional well-being in a lot of different ways.

emotional scarring affects mental healthSomeone who has been psychologically traumatized or “emotionally scarred” may exhibit one or more of the following:

  • Depression — one of the most prevalent reasons for seeking treatment in PTSD cases 3
  • Anxiety and panic attacks
  • Nightmares or sleeplessness
  • Paranoia/extreme vigilance/elevated startle response
  • Anger and defiance
  • Eating disorders
  • Inability to work, loss of focus
  • Loss of hope, lack of vision for the future
  • Inability to regulate emotions or lack of emotional response
  • Drug abuse or alcoholism

Equally important to understand is that mental and physical health problems are often found intertwined in those suffering psychological trauma, especially over the long term.4 Health is, as previously mentioned, a holistic endeavor, and we are physically and emotionally hardwired for survival. For that reason, psychological trauma can sometimes be so severe that it cascades out into biophysical symptoms–either directly or through long-term secondary effects — such as lack of sleep or unhealthy habits used as coping mechanisms. Psychologically traumatized patients sometimes report having panic attacks or similar symptoms, including a racing heart, elevated blood pressure, shaking, or difficulty breathing.

What happens to the fine-wiring of the brain during psychological trauma (and after) remains a matter of continued research and discussion among neuroscientists. To explain it very generally, traumatic events can impact either gradually or instantly into a sort of hyper-vigilant “survival mode.”

If you’re familiar with the concept of “fight or flight,” you already have a basic understanding of your instinctive trauma response. The results of this response, however, can have far-reaching implications that linger well after the traumatic situation has ended. This hyper-vigilant trauma response may become indistinguishable from paranoia, panic disorder, or various anxiety disorders. A psychologically traumatized person may have great difficulty trusting people or situations. As a coping mechanism, a person may also repress harmful memories in response to trauma, to protect against constantly reliving your traumatic event in the short term but also makes it difficult to process your experience and find closure. Drugs to dampen emotional responses may play a role in arresting an intolerable crisis. However, pharmaceuticals used long term can act as a barrier to full and embracive psychological healing after trauma.

Who Is at Risk For Psychological Trauma?

Each day carries with it some risk that we will experience a traumatic event — some of these upheavals can blindside us beyond what could ever be expected or be prepared for. The world can be a dangerous, scary place, and it’s nearly inevitable that we’ll all experience traumas of various magnitudes in our lifetimes. Loss, worry, and accident are unfortunate universal truths of the human experience. There are, however, certain demographics are disproportionately linked to traumatic events within the general populace.5

  • Children. Traumatic events experienced during childhood have been statistically linked to a greater risk of behavioral and physical health problems.
  • Drug and alcohol users. People with substance use disorders and other at-risk populations have a statistically significant link to traumatic experiences.
  • Women. Violence against women is extremely prevalent in the United States, with one in three women reporting having experienced some form of abuse. Enduring violent outbursts from a partner is a clear example of a psychologically (and physically) traumatic experience.
  • Disabled people: Both people with physical and mental disabilities and people with chronic and mental illnesses have a statistically significant link to trauma. This group can include a significant number of unemployed persons and those who lack financial means or other support mechanisms to access effective healthcare for substantial periods of time. Patterns of trauma sometimes persist throughout the life of the individuals in this population.

Psychological Trauma Warning Signs

Psychological Trauma Warning SignsA healthcare professional can give an accurate diagnosis for psychological trauma and its related conditions, but there are several indicators you can watch for yourself if you suspect you are suffering from the effects of psychological trauma. Remember that post-traumatic responses can be immediate, delayed, acute, or prolonged and that they may change over time.6 Post traumatic stress can manifest in some persons years after the event, though this is relatively rare. The most common post-traumatic responses, as given below, are also the ones that tend to lessen with time, especially given support and proper treatment.7

  • Sadness
  • Anger
  • Anxiety
  • Trouble focusing
  • Sleeplessness
  • Fixation on the traumatic event

If these symptoms worsen or become more extreme over time, intervention by a healthcare professional may be necessary. Other serious, post-traumatic responses that may warrant contacting a healthcare professional include:

  • Constant or recurring feelings of fear or dread
  • Frequent crying
  • Debilitating lack of focus
  • Illogical feelings of anger or resentment toward others
  • Chronic nightmares
  • Social isolation due to avoiding people, places, or situations that trigger traumatic memories

Post-traumatic responses in children can be very different. In addition to the usual signs of depression and anxiety, you might look for things like:

  • Chronic bed-wetting in previously potty-trained children
  • Reduction or suspension of verbal communication
  • Frequently play-acting or drawing the traumatic event
  • Needy or clingy behavior with trusted adults

Teens are another matter altogether. Their active hormones and developing brains may be an impediment to processing trauma effectively. Depressive symptoms have been found to be particularly prominent in unresolving and untreated PTSD after trauma in the adolescent population.8 Trauma responses in preteens and teenagers can also manifest in particularly unpleasant ways.

  • Disrespectful and abrasive behaviors, such as disrupting classes or meetings.
  • Irrational guilt at having survived the traumatic event.
  • Self-destructive behaviors, threats, or fantasies.
  • Threats of violence or revenge against the perpetrators and perceived enablers of the trauma.

Physical trauma responses can also be present in some cases. Physical manifestations of psychological trauma often indicate a serious case that would benefit from professional intervention.

  • Headaches
  • Sweating
  • Elevated blood pressure
  • Upset or aching stomach/loss of appetite
  • Racing or irregular heartbeat
  • Chronic fatigue
  • Nervous or twitchy sensations

What Does Psychological Trauma Lead To?

There are many serious long-term consequences linked to unresolved and untreated psychological trauma and post-traumatic stress. They are often complex and interrelated — resulting, in turn, in feedback loops of bad habits and bad feelings exacerbating one another. These consequences can include:

  • Drug abuse. Traumatized people abuse drugs at a greater rate than the general population. Numbing emotions through self-medication has been a popular option among distraught humans since the dawn of civilization, but the health and social consequences of excessive drug and alcohol consumption can rapidly make matters worse.
  • Hopelessness. When someone experiences a traumatic event in which they almost die (or believe they almost died), they may fixate on that event to the exclusion of all other thoughts. They may believe it’s inevitable that the same trauma, or a similar one, will befall them again, and any action they might take is therefore futile. This fixation on one’s own defencelessness makes it impossible to plan for the future or develop a positive outlook for days to come.
  • Unemployment. When you consider the effects of depression or drug dependency and combine them with a sense of hopelessness, it’s no surprise that people who’ve experienced psychological trauma may have difficulty holding a job. This is another complex factor that can result in a dangerous spiral because depression can lead to unemployment, and unemployment can subsequently cause depression.
  • Poor physical health. The combined lack of sleep, nutrition, hope, and resources that may stem from psychological trauma can quickly snowball into illness and injury if not treated in a timely and effective way. Similar to the relationship between unemployment and trauma, failing health caused by depression and trauma will itself become traumatic and depressing.

The Difference Between Trauma and Depression

Is trauma the same as depression? No, but as we’ve explored, the two are often interrelated in complex ways. Depression is typically a longer-term response to trauma. In the traumatic moment and immediately following, the traumatized person may actually be in a highly anxious, energetic, hyper-focused, or even agitated state.

Living with the aftermath of the traumatic event (and the fear, doubt, anger, or guilt) day after day is what leads to eventual depression and hopelessness. Depression and hopelessness then lead to further issues. You can use “trauma” as a noun to refer to the traumatic event itself. Depression is not trauma but an emotional response to the overwhelm of trauma which manifests in some persons more than others. The despair and hopelessness of a depressed state can also lead to behaviors that increase the risk of experiencing additional trauma.

How Do You Recover From Psychological Trauma?

How Do You Recover From Psychological Trauma?

Treating psychological trauma with non-drug-based therapies has been shown most efficacious in studies out of South America and Mexico as well as the US and internationally.9 Many people are not aware that such services exist, with such a wide variety of treatment options that do not involve drug therapy. No two people’s path to recovery is ever the same, so some models of the healing process will naturally apply to some patients more than others.

What Are the Indicators of Trauma?

The ADAA (The Anxiety and Depression Association of America) has published a private, self-assessment that can be helpful to identify certain indicators of symptoms relating to past trauma.10 In no particular order, they may include:

  1. Trouble sleeping
  2. Repeating episodes of emotional distress or disturbing dreams
  3. Flashbacks
  4. Loss of interest or joy in life
  5. Unusual outbursts of anger
  6. Avoiding situations because they may trigger past events

Treating Psychological Trauma

Psychological trauma and its many related conditions may respond to various types of therapy. Which therapy works best will depend on the individual being treated and the nature of their psychological damage.

The American Psychological Association (APA) 11 strongly recommends four specific types of therapy for patients suffering from post-traumatic stress.

  1. Cognitive Behavioral Therapy (CBT) interventions are focused on the complex relationships between thoughts, feelings, behaviors, symptoms, and the difficulties of living with post-traumatic stress. All four types of APA-recommended therapy are forms or subcategories of CBT.
  2. Cognitive Processing Therapy (CPT) focuses on helping patients move past unhealthy habits and beliefs that are contributing to their trauma and slowing the recovery process.
  3. Cognitive Therapy is another method of identifying, and modifying the negative thoughts and behaviors that interfere not only with the patient’s recovery but also their ability to function in day-to-day life.
  4. Prolonged Exposure guides patients in a gradual journey to confront and process trauma-related memories and feelings. By slowly and systematically facing their trauma-induced fears, the patient is able to overcome the trauma with confidence and a sense of security.

The APA further recommends three other types of psychotherapy on a conditional basis, meaning these methods may be effective for certain patients but should not be administered in all cases. There have been some positive outcomes reported that use these methods to treat psychological trauma, but the evidence for their efficacy is not as strong as with the various CBT treatments.

  1. Brief Eclectic Psychotherapy draws on elements of CBT but focuses on the relationship between the patient and therapist and puts special emphasis on eradicating feelings of shame and guilt.
  2. Eye Movement Desensitization and Reprocessing Therapy is a unique process that requires the patient to briefly but deliberately focus on their traumatic memory while also being subjected to bilateral stimulation in the form of eye movements. This is meant to reduce the intensity of the traumatic memories and thereby subdue the emotional response.
  3. Narrative Exposure Therapy focuses on establishing a narrative that allows the patient to take ownership of their own life story and put their trauma into some sort of useful context. Non-traditional methods of therapy such as equine therapy and art therapy are not explicitly endorsed by the APA, but many of them have also shown promise in helping people manage depression and other long-term trauma responses.

Unfortunately, pharmaceutical companies have aggressively attempted to promote the reliance on medication to treat conditions like PTSD, whereas the mental health experts advise non-drug protocols like CBT as a preferred and more effective first line treatment.12,13 Medication should only be used to treat psychological trauma as a last resort for patients who do not respond well to other types of therapy. Anti-depressant and anti-anxiety drugs can be extremely powerful, and many have the potential to build chemical or emotional dependence in the user. Medicines that are habit-forming or prone to abuse may be particularly dangerous to persons experiencing depression or other post-traumatic stress responses.

Alternative to Meds Center’s Holistic Treatment for PTSD, Depression, Anxiety, Insomnia

Holistic Treatment for PTSD, Depression, Anxiety, InsomniaFor nearly 2 decades, Alternative to Meds Center has helped clients overcome mental health challenges with safe tapering methods and holistic alternative routes all aimed at recovery of natural mental health. We invite you to review our services overview page and become familiar with the types of therapies used successfully in our inpatient recovery programs.

1. Gros DF, Price M, Magruder KM, Frueh BC. Symptom overlap in posttraumatic stress disorder and major depression. Psychiatry Res. 2012 Apr 30;196(2-3):267-70. doi: 10.1016/j.psychres.2011.10.022. Epub 2012 Mar 3. PMID: 22386220; PMCID: PMC3415314. [cited 2021 Sept 30]

2. Ehret M. Treatment of posttraumatic stress disorder: Focus on pharmacotherapy. Ment Health Clin. 2019;9(6):373-382. Published 2019 Nov 27. doi:10.9740/mhc.2019.11.373 [cited 2021 Sept 30]

3. van der Kolk B. Posttraumatic stress disorder and the nature of trauma. Dialogues Clin Neurosci. 2000;2(1):7-22. doi:10.31887/DCNS.2000.2.1/bvdkolk [cited 2021 Sept 30]

4. McFarlane AC. The long-term costs of traumatic stress: intertwined physical and psychological consequences. World Psychiatry. 2010;9(1):3-10. doi:10.1002/j.2051-5545.2010.tb00254.x [cited 2021 Sept 30]

5. Auxéméry Y. L’état de stress post-traumatique comme conséquence de l’interaction entre une susceptibilité génétique individuelle, un évènement traumatogène et un contexte social [Posttraumatic stress disorder (PTSD) as a consequence of the interaction between an individual genetic susceptibility, a traumatogenic event and a social context]. Encephale. 2012 Oct;38(5):373-80. French. doi: 10.1016/j.encep.2011.12.003. Epub 2012 Jan 24. PMID: 23062450.[cited 2021 Oct 1]

6. Frueh BC, Grubaugh AL, Yeager DE, Magruder KM. Delayed-onset post-traumatic stress disorder among war veterans in primary care clinics. Br J Psychiatry. 2009;194(6):515-520. doi:10.1192/bjp.bp.108.054700 [cited 2021 Oct 1]

7. Mann SK, Marwaha R. Posttraumatic Stress Disorder. [Updated 2021 Jul 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: [cited 2021 Oct 1]

8. Goenjian AK, Walling D, Steinberg AM, Karayan I, Najarian LM, Pynoos R. A prospective study of posttraumatic stress and depressive reactions among treated and untreated adolescents 5 years after a catastrophic disaster. Am J Psychiatry. 2005 Dec;162(12):2302-8. doi: 10.1176/appi.ajp.162.12.2302. PMID: 16330594. [cited 2021 Oct 1]

9. Figueroa RA, Cortés PF, Accatino L, Sorensen R. Trauma psicológico en la atención primaria: orientaciones de manejo [Management of psychological trauma in primary care]. Rev Med Chil. 2016 May;144(5):643-55. Spanish. doi: 10.4067/S0034-98872016000500013. PMID: 27552016. [cited 2021 Oct 1]

10. Screening for Posttraumatic Stress Disorder (PTSD) published by the ADAA 2021 [online] [cited 2021 Oct 1]

11. Treatments for PTSD Published by the APA [online] [cited 2021 Oct 1]

12. Mansell P, Read J. Posttraumatic stress disorder, drug companies, and the Internet. J Trauma Dissociation. 2009;10(1):9-23. doi: 10.1080/15299730802488494. PMID: 19197709. [cited 2021 Oct 1]

13. Seda G, Sanchez-Ortuno MM, Welsh CH, Halbower AC, Edinger JD. Comparative meta-analysis of prazosin and imagery rehearsal therapy for nightmare frequency, sleep quality, and posttraumatic stress. J Clin Sleep Med. 2015 Jan 15;11(1):11-22. doi: 10.5664/jcsm.4354. PMID: 25325592; PMCID: PMC4265653. [cited 2021 Oct 1]

Originally Published October 5, 2021 by Lyle Murphy

This content has been reviewed and approved by a licensed physician.

Dr. Michael Loes, M.D.


Dr. Michael Loes is board-certified in Internal Medicine, Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr. Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally, he is a well-published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response, and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.

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