Depression can present in many forms. For some, it is a devastating crash that just pulls the rug out from under them and takes hold before they really know it has begun. For others, it is a long, slow process of weaving in and out of days that feel “meh” and days that feel overwhelming, rarely encountering a day that feels “good”.

When working with clients who have experienced trauma, one of the first questions I ask is whether they have been screened for PTSD. Most of the time, the answer will be a firm “no”, usually followed by a variation on, “I don’t have flashbacks”, or “I sleep just fine”. If clients decline assessment for PTSD, we move on and focus on the symptoms that brought them to therapy, which they often self-diagnose as anxiety or depression. Those symptoms include feelings of emotional d