Disaster and trauma studies often focus on identifying the incidence of PTSD as the sequel to traumatic events.

Early interventions with those affected after a disaster or traumatic event increasingly utilize psycho-education to clarify and normalize common post-traumatic stress reactions and coping strategies.

While mentioned as a possible response, the high incidence of depression after trauma is less delineated and often goes unrecognized by those suffering.

Depression Occurs after Trauma:

• A Rand corporation study reports that nearly 20 percent of military service members who have returned from Iraq and Afghanistan – 300,000 in all – report symptoms of Post-Traumatic Stress Disorder or major depression.
• In the first long-term study of the health impacts of the World Trade Center (WTC) collapse on September 11, 2001, findings indicate that seven percent of police officers were diagnosed with depression, nine percent with PTSD and eight percent with panic disorder. Twenty eight percent of other rescue and recovery workers had symptoms of depression.
• A survey of survivors from the Oklahoma City bombing showed that 23% had depression after the bombing.
• Depression affects approximately 15 percent to 25 percent of cancer patients.
• After a myocardial infarction, the incidence of major depression is from 15 percent to 20 percent, and an additional 27 percent of patients develop minor depression.

Both major depression and Post-Traumatic Stress Disorder (PTSD) occur frequently following traumatic exposure, both as separate disorders and concurrently.

Depression is the most common disorder suffered in conjunction with Post-Traumatic Stress Disorder.

Depression is nearly three to five times more likely in those with PTSD than those without PTSD.

Almost everyone has some experience with hope: We hope for the best. We hang on to hope. We despair when we lose hope.

It would seem that hope, which is broadly defined as an emotional state that promotes the belief in a positive outcome, is in inherent in human nature.

Reflections of the importance of hope are found in early mythology, religion, philosophy and literature.

Pandora, although forbidden, opened the box given to her by Zeus, and in a moment, all the curses were released into the world and all the blessing escaped and were lost- except one: hope.

“To have faith is to be sure of the things we hope for, to be certain of the things we cannot see.” ― The King James Version of the Bible

“Hope is a waking dream.” –Aristotle

“Where there is no hope, it is incumbent on us to invent it.” -Albert Camus

“Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops — at all.” -Emily Dickinson

Clearly we need hope, but even as we embrace it we often wonder – Does hope really make a difference? Is it myth, fiction, collective denial?

There is actually increasing scientific evidence that hope changes us psychologically and physiologically – that it makes a difference.

Recycling is a good idea, except when it comes to relationships.

Regardless of what people tell themselves about the time invested, the good times missed, the great sex, or the feeling that things will be different; in most cases the re-connection with an ex rarely brings a better outcome.

Research tells us that rekindling a relationship decreases happiness. Studies of college grads as well as larger national studies of older couples reveal that those people who cycle back to relationships, often over and over again, experience less satisfaction, more uncertainty and more disillusionment in their relationships than non-cycling partners.

Let’s face it – breaking up is hard to do. When it has happened there is usually a good reason on the part of one or both partners.

Why then do people look backwards? Why do they imagine it will be different?

Many people face a traumatic event in adult life. Be it a serious car accident, combat, rape, a natural disaster or the loss of a child, people are often confronted with a horrific event that threatens death or serious injury to themselves or someone else, or involves the traumatic loss of a friend or loved one.

While such trauma is in itself physically and emotionally assaultive, trauma theorist Robert Stolorow proposes that beyond the actual event, it is the emotions suffered after the event that become the unbearable emotional pain of trauma.

• Difficult to articulate and unrecognized by many, the emotional aftermath of adult trauma often goes unvalidated and unhealed.
• Drawing upon his own traumatic loss of a young wife, Stolorow reports that in the unreal time that stretches slowly after a trauma, there is an “excruciating sense” of being outside normal life, alone with feelings that no one else can understand.

Stolorow’s contribution to the field is his articulation of these feelings in a way that becomes an invaluable resource for validation.

In the preceding blog, we considered the importance of recognizing medical illness as psychological trauma.

In this blog we report on an interview with Michele Rosenthal, author of the trauma recovery memoir, BEFORE THE WORLD INTRUDED, survivor, and host of ‘Your Life After Trauma’.  

Diagnosed with a rare disease, Stevens Johnson Syndrome, at age thirteen, Michele journeyed through two decades of undiagnosed PTSD to eventual recognition, recovery and support of many as the founder of www.healmyptsd.com.

What she offers in lessons learned is of value for parents of children who have faced illness, as well as adults who wonder how they will ever reclaim their bodies, heal their sense of self and take a new self into the future.

Michele, your journey from illness started when you were only thirteen. Parents suffer so much when they see their children suffer. How did your parents respond?

My parents were phenomenal! They were there in a very active way. Their presence next to me, their translation of what was happening to me, their role in helping the staff understand me in a certain way were all crucial to my safety and comfort.

Despite the fact that more than 86% of Americans believe exercising for fitness improves a person’s odds of a long and healthy life by “a lot,” only 28% report they actually get as much physical exercise as they should. Some people can’t start; some start and stop; and some can’t stop.

Adding to the exercise benefits for improving physical health, the most recent publication of the Monitor of the American Psychological Association underscores the mounting evidence of exercise benefits on mental health. So clear is the impact of exercise on the body-mind connection that it raises the question of how psychologists might use it as part of their treatment arsenal or at the very least motivate their patients to exercise.

As closer look at some of the findings may provide the tipping point for starting, stopping and moderating exercise in a way that benefits physical and mental health.

Suicide ranks as the eleventh leading cause of death in the United States. We have lost loved ones across the generations.

• Older Americans are disproportionately likely to die by suicide. Although they comprise only 12 percent of the U.S. population, people age 65 and older accounted for 16 percent of suicide deaths in 2004.
• Suicide is the second leading cause of death in college students and the third leading cause of death in adolescents.  Every day 14 teens take their own lives.
•  According to the Centers for Disease Control and Prevention, for the second year in a row, middle -aged adults have the highest suicide rate in the country, surpassing even older Americans.

While there are many factors that contribute to suicide, an important new study identifies two factors that have been associated with increased risk for suicidal thought and behavior across the lifespan – hopelessness and lack of connectedness to others.

If you and your partner find yourselves battling over throwing out the garbage or doing the laundry, you are not alone and neither may actually be to blame. A closer look may offer some understanding and some alternatives.

• According to a 2007 Pew Research Center Survey of American adults, 62% ranked  “sharing household chores” as third in importance in a successful marriage  with 92% ranking “faithfulness” as number one and 70% ranking “happy sexual relationship” as number two. There were no differences of opinion between men and women; or between older adults and younger adults; or between married people and singles.
• Back in 1990 fewer than half (47%) of adults said sharing household chores was very important to a successful marriage. The fact that 60% of women work outside the home and  men are participating in the household and childcare at three times the rate they did in the 60’s, the ranking suggests that concrete help with the day to day chores is both needed and appreciated.

The Division of Labor

What may seem, however, like an easy division of labor, “you shop” and “I’ll cook” is actually not so easy. In fact the notion that a perfectly balanced list could or should exist is a myth. People just don’t function that way.

Numerous studies have identified exercise as a key factor in reducing depression symptoms. A recent study heightens the argument by finding that as compared to age, race, gender, body mass index cholesterol, blood pressure and diabetes, it was the sedentary lifestyle of a depressed person that alone accounted for about 25% of the risk of heart-related deaths. The message is that we need to move because our lives depend on it!

The problem is that when you are depressed often the last thing you want to do is exercise.

Given the despair, lethargy, self-doubt, exhaustion, disinterest in activities and shame experienced with depression, the suggestion to exercise feels like adding insult to injury. “I’m not exercising because I’m depressed.”

Knowing exercise could help, but feeling unable to do so often adds to the self-recriminations and low self-esteem of depression.  In one case, the more the young woman watched other family members exercise – the less possible it felt.

Depression’s Landscape.

Given the recent discussion of the pros and cons of medications and treatments for depression, it seems clear that people need to have information and treatment options. It also seems important to stack the deck toward feeling better with anything that might work for you. If you have wanted to exercise but find it impossible – here are some suggestions.