Want to overcome persistent depression?

You don’t have to live with the fear of your anger any longer. Help is possible.

If you’re stuck in cycles of depression that keep going on and on, you probably know very well that self-critical voice in your head that finds fault with you.

You probably don’t know the self-critical voice is your anger turned against you. Freedom from persistent depression means help facing the roots of your anger.

Easier said than done? It is. Or, you wouldn’t keep trying to control it or hide it.  With the right kind of help, you can learn to accept your anger and use it well.

Maybe you’re thinking,  “I’m frustrated a lot. I have road rage. Sometimes I explode.” That doesn’t mean you aren’t afraid of your anger and its effects.

Let’s talk about depression, anger, why it’s a problem, and what to do to get help.

Persistent Depression

Persistent depression (often called dysthymia) has a list of common symptoms. You may have some of them and not others.  Below is the list.

Look at how many of those symptoms have to do with low self-esteem, hopelessness, guilt, anger, feelings of inadequacy, and, especially, self-criticism.

That’s important. I’ve highlighted them. It’s particularly these four that make your depression persistent. It’s terrible to live with bad feelings about yourself. 

• Loss of interest in daily activities
• Sadness, emptiness or feeling down
• Hopelessness
• Tiredness and lack of energy
• Low self-esteem, self-criticism or feeling incapable
• Trouble concentrating and making decisions
• Irritability or excessive anger
• Decreased activity, effectiveness, and productivity
• Avoidance of social activities
• Feelings of guilt and worries over the past
• Poor appetite or overeating
• Sleep problems

Your symptoms – especially those that have to do with guilt, anger, self-criticism, and low self-esteem – don’t come out of “nowhere.”

Frequently they are a result of childhood trauma. It could be physical or sexual abuse, neglect, bullying, or any experience that made you feel not good enough.

Is this you?

You might even live with a lot of shame. Maybe you aren’t sure you had any trauma or why you feel the way you do. 

But, if you’re persistently depressed, you likely blame yourself. For a lot of things. And, you’re looking for answers.

Childhood Trauma & Depression

Childhood trauma doesn’t have to be overt abuse or neglect. It can be a lot of things. For example, constant moving, parent’s divorce, early losses, illness.

Bullying, feeling different, a learning problem that made you think you weren’t smart. Any experience that made you feel insecure or bad about yourself is a traumatic one.

Childhood trauma leaves you with scars. Those scars turn into many different psychological symptoms. Depression is one of them.

If untreated, the symptoms very often persist into adulthood. Along with your feelings of depression come struggles with self-esteem, confidence – and anger.

Maybe you don’t feel much anger at all, or you try not to express it. You want people to like you. Maybe you feel a lot of anger. You probably don’t feel good about it though.

It might come out when you’re alone. Or in the car.  Possibly in frustrated outbursts at those you love. Then you feel guilty. Very guilty.

Yet, if you had trauma as a child, and if you’ve lived with depression for a long time and can’t get out of its vicious cycle – you have reason to be angry.

Anyone who’s had childhood trauma and is now repeatedly depressed is left with poor self-esteem. Maybe you were blamed for things as a little kid.

That led to blaming yourself because you had no other way to make sense of what was happening.

It’s common for traumatized kids to think it must be “your fault.” That can make you sad, insecure, frustrated, and angry.

Whether you aren’t aware of your anger or feel terribly guilty when you’ve let it out, you have a critical voice in your head. That’s always a part of depression.

That Critical Voice In Your Head

The critical voice in your head is a “guilt-ing” voice. It has endless lists of all the things you’ve done “wrong.” Guilt is one major thing that sets that voice off. 

And, that guilt-ing voice is a big part of persistent depression and what you need help with to overcome it.  

You feel guilty when you get angry – or maybe express any feeling you think is “too much.” It’s like you’ve done something really terrible. And, the voice condemns you.

Maybe you feel guilty about too many things? That’s common with persistent depression. You might never feel you can do anything right. Or well enough.

You look at other people and wonder – why do they seem to have it so much easier? Comparing yourself only adds fuel to the critic’s attacks.

Worst of all, you agree with it. That critical voice is very convincing. 

When you live with a critic in your head berating you all day long, you might even go into a shell. You can’t show your real self. It’s exhausting and lonely.

So, why is this happening to you? Who is this critic anyway? The critical voice in your head is your anger turned against you. 

Why Anger Is Such A Problem

When you feel guilty and anxious about being angry, that anger is turned on yourself. And, it becomes that critical voice, constantly angry and annoyed and irritated at you.

But, why is it so difficult to be angry? To know that anger is a normal, reasonable, or safe feeling to have, let alone express?

There are very individual reasons, usually arising from early experiences, that make your anger feel unsafe.  Generally, it takes psychotherapy to sort those out.

But, here are some possibilities that might apply to you:

• Fear your anger will hurt someone
• People got defensive and made you feel bad
• Your feelings were rejected or criticized
• An explosive or angry parent scared you
• No one listened when you tried to talk
• You were told “why” you “shouldn’t” be angry
• Fear that no one will like you
• Believing you have to be quiet and “good”

Many times, though, these feelings and beliefs aren’t conscious. And, what isn’t conscious contributes to your depression. 

But, conscious or unconscious, the result is:

You feel terrible when you get angry and try to keep it bottled up.  You need help, but may not be sure what to look for.

If you’ve had depression for a long time, you might wonder: is any hope at all?

What Kind Of Help Do You Need?

Psychotherapy is the best option to overcome persistent depression that won’t let up. And, your fear of your anger.  Any therapist you see must understand two things very well:

First, you have a critical voice in your head that finds fault with you all the time. Even if you do your best to hide it and present your most likable self.

Second, that voice was put in place long ago because you’re afraid of anger, don’t feel you’ll be heard, and that critical voice has greatly interfered with developing good feelings about yourself.

That’s only the beginning. You need a therapist who allows your anger and gets to the source of why you feel the way you do.

Choose a therapist that specializes in depression as well as understands the intricacies of childhood trauma and the various forms it can take.

Most often, a therapist with specialized training in psychoanalysis is a good place to start. Or someone that takes a psychodynamic approach.

Then, what should you look for in therapy?

Overcoming Persistent Depression 

Have you had therapy before? Or was the therapy you had not effective? In both cases, you’re probably wondering what to expect that can be helpful.

In your first consultations, it’s important to feel heard. And, that any potential therapist says things that touch and reach you in a way you haven’t felt before.

If that doesn’t happen, move on.

As therapy gets underway, here are things you must have from your therapist:

• Empathy and not criticism
• Help not taking the critical voice seriously
• Understanding your anger and its reasons
• Taking current effects of childhood trauma seriously
• A place to begin to express your anger
• Non-defensiveness if you feel angry or misunderstood
• Help working out unrealistic (yes, unrealistic) guilt
• A place to start feeling good about who you are

Therapy should be a safe place to express any feelings you have, at your own pace.  There’s no template just as your history is different from others.

What’s important in therapy for depression that persists is a therapist who can get to its roots, especially if you’re still living with the effects of trauma.

When you have this kind of help, you won’t be tormented by constant self-criticisms and fear of your anger. You can learn to use your anger to speak openly and assertively.

As you express your real feelings in therapy and with the people in your life, you’ll feel freer, happier, and more confident in the things you feel, think and do.

I’m Dr. Sandra Cohen, a Los Angeles based psychoanalyst. I specialize in the treatment of persistent depression and the effects of childhood trauma on your adult life. Hope and change are possible in good psychotherapy.