The Traumatic Stress-Panic-Depression Triad

 Depression Lowers Our Threshold for Tolerance of Everyday Stressors

 Depression and stress are best friends. When one appears the other is usually not far behind. In fact, often people who convince themselves they are not depressed finally seek help due to stress. Why is this? Why does depression seem to be so stressful?

The shortest answer to these questions is that depression undercuts our stress tolerance. There are always going to be days when the driver in front of us cuts us off and someone at work does something to make our job more difficult. Most people have developed various coping mechanisms to deal with the normal stressors of daily living. We crack a joke, we distract ourselves or find some other way to manage our emotions and move on. When we have a high tolerance for stress, we take irritations in stride and quickly recover.

Coping mechanisms act like a bridge that supports the weight of stressful situations that roll across our lives every day. If the bridge is strong and can support heavy traffic, then we have a higher stress tolerance. If our bridge is shaky, then the activity on that bridge becomes even more burdensome. Depression works like termites in the supporting beams of the bridge. It’s unnerving to hear the bridge creak and groan while it sways under pressure.

Another way of thinking of the effect of depression on stress tolerance is to imagine a house with an air conditioner. As the outside temperature rises (stress) the heat may never meet the threshold for what that air conditioner can handle (stress tolerance). In other words, the air conditioner has a high tolerance for heat. But there comes a point at which the air in the room starts feeling very warm. At some point, the capacity of the air conditioner will be overwhelmed by rising heat. Everyone has a threshold for stress, but depression lowers it the way a clogged filter will hamper an air conditioner trying to cool hot air.

Depression lowers our stress tolerance: it makes us sweat over things that normally would not make us sweat. It can also make us panic about our combined difficulties as we peer through the lens of hopelessness. 

How heated up do things need to be before you can no longer keep it cool? How much irritation does it take to make you hot under the collar? 80? 90? 110 degrees? Whatever it is, that is your current stress tolerance. Depression often reduces the capacity of our air conditioner to handle the “heat” of everyday life. We have a lower threshold for tolerating stressful activities, events, and interactions.

It is no surprise, then, that people who are depressed are often irritable and get angry more easily. It also helps to explain why depression nudges us to withdraw from activities: we have to close off some rooms so that the smaller air conditioner has less volume to keep cool. Depression can degrade our sleep or our concentration making it harder to handle situations well throughout the day. If we handle a situation by making it worse, then we move through the day creating more problems and more strain. 

Conclusion and Summary

There is a Silver Lining

The upside to all this is that the symptoms of anxiety attacks, depression, and traumatic stress often conspire together to get our attention. Sometimes the emotional bridge by which we travel needs a major upgrade. Sometimes our lives experience global warming and we need a more energy-efficient, more powerful air conditioner. Depression and the heat of stress that follows can make us actually do something about the heat such as installing better insulation to hold on to whatever refreshing air comes our way. When the heat of stress spurs us to positive action we have discovered the silver-lining of depression. If we are too sad, frustrated, or angry to go on our merry way, then there is a golden opportunity for personal change. 

The same can be said about symptoms of anxiety attacks. Many people simply seek to get rid of their panic attacks, but discover that there is a fortutitous "catch" to treatment.  The catch is that the very skills and emotional intelligence that they must acquire to stop the panic attacks also opens up their whole lives in wonderfuls ways that they never imagined.  To be rid of the symptoms, they must deal with what causes panic attacks in their particular case.  Under the right direction or treatment, the removal of what causes panic attacks means the removal tall heaps of rubbish in their own emotional landscape that blocked their view of the real potential to live a more satisfying life.

Thus, many people find that when they face panic or depression squarely and constructively, they end up much happier than they were before the onset of their distress. This is the my-glass-is-half-full perspective on anxiety and depression. For some peculiar reason, we don’t often make significant life changes unless we are unhappy or frustrated. The symptoms of anxiety attacks often join with symptoms of depression like two friends cooperating to confront us with our need for positive change.

 What Causes Panic Attacks?

 To understand what causes panic attacks it is best to imagine a pie chart depicting multiple causes.  For each person the number of causes may vary.  More importantly, the proportions of each factor in the pie chart of causes will also vary from person to person.  Nevertheless, it is useful to have a list of what causes panic attacks in the majority of cases.

• Posttraumatic Stress:  Painful memories or reactions stemming from overwhelming experiences that are triggered by one of more features of one's present situation.  The similarity acts as a reminder of previous psychological trauma.  The avoidance of painful memories gives way to reexperiencing as aspect of the trauma and this grows naturally into the symptoms of anxiety attacks.
• Style of Denial:   A way of relating to one's own worries and fears by leaning too heavily on denial or stuffing emotions.   This deficit in emotional intelligence is a lack of self-awareness and inadequate stress management skills.
• Clnical Depression
• Various other causes including but not limited to such things as a genetic predisposition to anxiety, panic reactions modelled by parents, lack of opportunities to metabolize (i.e., verbalize) the normal anxiety of fearful situations, substance abuse that tampers with a person's adrenaline or relaxation responses, previous addictons stunting development of stress tolerance, lack of social support, etc.