Depression
The accumulation of all the other feelings internalized--shame, guilt, fear, betrayal, anger, and self-loathing--equals depression. It is really impossible for the self-esteem to suffer the impact of these negative feelings without the result being depression. One of the biggest problems with depression is that it is vague, and so she may not attribute it to her abuse. Granted, there are many causes of depression, and not all depressed women have been sexually abused, but it is very common for survivors to suffer from depression. Because she may have strugggled with so many negative feelings for so long, however, she may feel it is normal to feel "down" all the time, and she may settle for "getting through each day." She may not even recognize that joy can exist without a specific event, and so she feels this is all life has to offer--a struggle from day to day and then die. It is no wonder that a survivor may choose death as the better option for her.

Thoughts of suicide are common for a survivor to experience. She may not truly want to die as much as she is desperate to end the pain. She may view the uphill battle of recovery as adding fuel to the fire, and she may not feel she has any energy left to deal with it. ?But the thought of her life staying as it is may be just as horrifying. This dilemma may often push the survivor to try to escape through any means she can find: drugs, alcohol, or death.

Depression is a complex issue, and many women want a magic pill to cure it. Unless the survivor also has a chemical imbalance in her brain, the depression will not go away without dealing with the feelings that are causing it. This does take a commitment and a lot of mental work. The first step is to recognize that depression is a problem and that it stems, at least in part, from her sexual abuse. The recovery process in
From Survivor to Thriver Manual will guide her through the necessary steps to work through all the different feelings that make up her depression. Addressing her negative internal dialogue, which perpetuates the depression, is essential also. Her life does not have to consist of daily agony. It is hard to go through the recovery process, but it is not as hard as living a whole life in despair, which truly is never-ending.