Elisa A. Escalante / LCSW/ 6-11-2026
When PTSD is hard, it is inexplicably hard. But depression just might be the death of me. When these disorders combine, I go into a cave of isolation. It’s lonely in there, but it protects me and others. I’m protected from more triggers, and people are protected from me.
With a depression cave, I’m not allowing myself to be bothered by people that ask questions that aggravate my spirit. “What’s for breakfast? What’s for lunch? What’s for dinner?” Food. Who cares? The answer is not exciting and I am wasting energy by answering. “ When’s yoga? When’s BJJ?” meanwhile I’m in a crippling state of depression, I already decided I might skip my workout, and now I feel guilty because someone reminds me that I’m a failure, simply by asking a question. “Are you coming??” Someone may ask this about that social event I said “maybe” to, but now I cannot imagine going. It would be exhausting to pretend I’m happy, I would ruin the experience for everyone because I can’t smile. “How’s your diet?” I binged on fast food to regulate my emotions so that I don’t cry at work tomorrow. And now I’ll gain weight and it will be even harder to move my body. Wonderful.
People may say “you can tell me how you’re feeling”, but let’s be real. No one wants to hear these thoughts spoken out loud. The negativity would drive people mad. Which is also why the complex PTSD and depression combo leads to a deep sense of loneliness. My ex fiancé literally told me: “I’ll never date someone that has depression again”. (Good idea, and I’ll never date a narcissist with anger issues again. That made the depression worse)
I’ve lived with major depression for about 25 years. I’m very seasoned and extremely functional. I have done every single coping strategy and found ways to create those healthy atomic habits that manage it. I know enough to know that it will come in a crushing wave, but it will also go back to mild at some point too. I’m very effective with helping my clients with depression because I literally know how to manage it from personal experience. I give them more empathy, more grace, and more realistic strategies that won’t perpetuate the shame cycle.
Despite all the healthy coping, the cave will still be a necessary part of the depression process. We hide there. We rest and recover while our body is in a sad, numb, lethargic or dissociative state. We allow the tears to come, or coax them out if needed. I used to wonder what was wrong with me. If I’m so sad, why am I coming home, sitting in the dark, listening to the saddest song that was ever written, writing the saddest poem I have ever thought of while I smoke? Both my ex fiancé and ex BFF thought that this was an insane process. I’m only “making myself sadder”. Wrong. This was a ritual that my brain designed to get me through it. The cave is a way to preserve ourselves while we cleanse and let the wave pass.
Believe it or not, the depression intuition may guide us better than we realize. We are too busy shaming it to understand how effective some of the behaviors and compulsions are. Because when I allowed others to “yank me out” of the cave, they failed miserably. They aggravated me and made it worse. Forcing me up and out of my cave too early. Forcing me on a hike that my body wasn’t ready for. Forcing me to socialize when I can’t make eye contact, talk, or smile. Then they’re offended because their methods don’t work, the relationship is strained, the shame and depression go deeper. So, I’ll go into the cave when I need, and I’ll leave when I’m good and ready.
My Rules for Depression
1- Always have something to look forward to (literally have it booked in your calendar)
2- Move your body (in any which way you want and at whatever pace works for you)
3- Have a Social Hobby that’s low pressure & focuses on the activity, not mingling (martial arts, an art class, fitness class, karaoke or dance, a behaviorally activating hobby of some sort like woodwork, instruments, gardening, cooking etc. The key is to not be pressured to mingle while still getting the benefits of a social atmosphere )
4- Therapy (I almost insist), & Medication (optional but it could be necessary)
5- Find a Support group (this could even be online in free private social media platforms if necessary. Group therapy? Even better)
6- Change up your Routine (Depression breeds off of boredom and monotony. Stir shit up! Seek adventure and some occasional dopamine hits)
7- Force yourself to do a Self care Routine even if it feels pointless. (When it becomes a habit you will eventually see the benefits of it. The improvements could build motivation to continue. And the ritual may one day help you realize that you are actually quite deserving of self care)
8- Keep the Cave and create your personal ritual. It doesn’t have to look like mine, it needs to match your aura and feed your soul. That’s the best way I can explain it. I personally love Emo songs, Junk TV, coffee, writing, being around my cats, medicating, snacks, and my Pilates reformer. Where I can work my core in front of my TV/ music videos but I can move at a zombie pace.
Functionally Mental 