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Last edit of this page 02/06/05

Anxiety, depression and trauma

In 1998 National Mental Health Survey clinical levels of anxiety occurred in 9.7% of Australian population and depression in 5.8%. Only 38% of those who are depressed come to medical treatment, and less than half of those get effective medical treatment.

Given the failure of the mainstream health system in addressing psychic pain and spiritual numbing, you can expect to have similar or greater percentage of population than the Survey in any yoga class and seeking non-mainstream therapies - there over 500 psychotherapeutic modalities world wide.

Yoga practices may be an inoculation for traumatic injury and are transformative as therapy for trauma, anxiety & depression.

If you lower the threshold from the clinical level of  e.g. depression’s 5 out of 9 symptoms every day and all day, to the often disabling, then higher percentages than in the NMH Survey. If you’re an effective teacher and include the emotions in what you will work with in yoga, then the proportion of students with strong symptoms in your class will be greater still.

  • 70% of those surveyed did not use any health service.
  • Co-morbidity is an issue with these categories and thus with treatment options, for example:
  • 70% of those diagnosed with clinical depression also have clinically significant symptoms of anxiety
  • 50% of those with clinical anxiety also have clinically significant symptoms of depression
  • 22% children with anxiety also diagnosed ADHD
  • 85% with PTSD have other clinically significant conditions - substance abuse, depression, domestic violence
  • The medical model tends to remove responsibility from the patient because of a classified illness. It may disempower the ‘victim’ and their families. The illness becomes an inner perpetrator that patient/medical system fight against.
  • 15% of women will suffer a major depressive episode within 3-6 months of childbirth or adoption
  • 1 in 5 adults likely to have a major depressive episode once in their lives
  • 8.2 million prescriptions for anti-depressants written in 1998. A minimum 50% of patients do not comply

In 1998, 800,000 Australians were likely to be suffering symptoms of major depressive ‘illness’ with 5 out of the 9 disabling symptoms, listed below every day of the episode.

  • depressed mood
  • diminished interest or pleasure in almost all activities
  • significant weight loss or gain, insomnia or hypersomnia
  • physical agitation or retardation, fatigue
  • excessive guilt or worthlessness
  • diminished ability to think
  • recurrent thoughts of death
  • and not better accounted for by bereavement.

Causes

Hormonal changes; biological/environmental and cultural factors; genetic associations and/or learned helplessness from family training, analogous to a post hypnotic suggestion for living in the world. The rest of us know something is very wrong but the mainstream culture does not provide the practical or spiritual means to acknowledge the wrongs or to invite inclusion and healing. The effect on isolated and disengaged minorities of our denial of accountability is palpable in the field or the world channel even if we avoid them. We sense 'their' isolation, even if we end up calling it 'their' depression, anxiety or rage.

Trauma

The trauma model is a useful template for understanding many symptoms including anxiety and depression, as the trauma process is present in all of them. ‘The common denominator of psychological trauma is a feeling of intense fear, helplessness, loss of control and threat of annihilation’. The salient characteristic of the traumatic event is its power to inspire helplessness and terror. Traumatic reactions occur when action is of no avail and the person is overwhelmed. Traumatic symptoms then have a tendency to become disconnected from their source and to take on a life of their own.

‘Traumatized people act and feels as though their nervous systems have been disconnected from the present. Traumatic events have primary effects on the systems of attachment and meaning that link individual and community. The damage to the survivors faith and sense of community is particularly severe when the traumatic events themselves involve betrayal of important relationships’ from Trauma & Recovery by Judith Herman, Basic Books 1992.

The majority who experience or witness trauma do not develop PTSD. 50% with PTSD will recover. Example birth. A single traumatic event can occur almost anywhere. Bystanders are at risk e.g. children in domestic violence

  • 8% of peacekeepers develop PTSD
  • 10% female car accident victims experience lifetime prevalence of symptoms of PTSD, in one study
  • 5% male affected and this is the only significant gender difference found so far
  • 25% non-sexual assault, 50% rape survivors present lifetime PTSD symptoms, equal in both genders
  • In one study in Israel people who on admission to the emergency room had a pulse rate of 90+ had a 45% chance of developing PTSD
  • Those with a rate of 109+ had an 83% chance of developing PTSD. Highest heart rate of that group showed no remission of PTSD

Symptoms include intrusion & re-enactment of the event sometimes symbolically; avoidance of related real or symbolic triggers; increased or hyper arousal & vigilance; dissociation or ‘doublethink’ and constriction or the numbing response of action to no avail. Constrictive symptoms are not readily recognised. Their origins in a traumatic event are often lost. However, the threat of annihilation that defined the traumatic moment may pursue the survivor long after the danger has passed.

A balance between symptoms of constriction and those of intrusion is precisely what the traumatised person lacks. We are unable to sit with the unwanted cycle of upheaval and numbing in ourselves and the effect this has on others. Hence the attraction to the balance of yoga, restoring the capacity to feel safe in a relaxed body and mind and re-gain the ability to sit with pain and pleasure and gently master our minds.

‘To speak publicly about one’s knowledge of (wrongdoing) is to invite the stigma that attaches to the victim….an understanding of psychological trauma begins with rediscovering history... In the history of societies as well as of individuals (there are) moments of insight when repressed ideas, feelings and memories surface into consciousness’. In that instant the world turns. What was silenced is at last named, heard, seen and felt.

‘Survivors challenge us to reconnect fragments, to reconstruct history, to make meaning of their present symptoms in the light of past events.’

‘All the perpetrator asks is that the bystander do nothing. He appeals to the universal desire to see, hear, and speak no evil. The victim on the other hand asks the bystander to share the burden of pain. The victim demands action, engagement and remembering.’ ‘Trauma & Recovery’ Judith Herman, Basic Books 1992.’