Depression is hard.

Depression is like sitting alone in a small, dark room with only one small window. When you look out that tiny window, you see other people moving through life in a way that’s vaguely familiar. They make plans, they laugh, they find pleasure in ordinary things. You remember being like that once, but now you can’t imagine what that feels like. The world is right there, just beyond the glass, yet somehow you cannot understand how to be a joyful part of it.  Disconnection and isolation abound.

Is It Depression, or Is It Moral Injury?

There are several different kinds of depression; Major, Persistent, Bipolar, Postpartum, Seasonal, and more. We don’t need to get lost in the weeds of psychoanalysis or diagnoses, but it might be worth our time to explore this question: Is what I am experiencing actually demoralization or moral injury, rather than clinical depression?

As a therapist with a decade of experience working with people to address and overcome this sense of disconnection, this is what I see most often. I have worked with many who struggle with what they (or the Western medical model) would label as depression, but is actually a deep and lasting moral injury. This injury is a loss of connection with self, with purpose, or with a sense of belonging and emotional safety. Moral injury is defined as “the profound psychological, behavioral and spiritual distress that results from perpetrating, witnessing, or failing to prevent acts that violate one’s deeply held moral beliefs and expectations.” In other words, this represents a deep wound, a rupture, to a person’s conscience or “moral compass.”

How Moral Injury Disconnects Us From Ourselves

Something, or many things, over the course of our lives happened that can cause one or many  of these ruptures. Emotional, spiritual, physical or sexual abuses, either happening to us or around us, that we couldn’t stop or escape. Necessarily, there was a disconnection that happened in order for us to survive these events. We disconnected from our very selves in order to survive the unsurvivable. This was an adaptive response of the Sympathetic Nervous System. Sure, it saved our lives. But it also left us lost, alone and wounded, with a nervous system permanently stuck in neutral. Forward would be moving toward connection, healing and social engagement. Reverse would move us toward collapse. And no one can survive this Western world in collapse. So it left us “survivors” but not resilient ones. We became doers who have no idea how to actually be with our own distress.

Distress tolerance is not the ability to survive horrible things, we already know you can do that. Rather, distress tolerance is your ability to stay connected to yourself in the experience of distress. And if you’ll remember, that whole connection thing is what we were talking about getting tripped up in the first place.

What Ayahuasca Can Open Up

Many are drawn to plant medicines like Ayahuasca for deep healing so they no longer feel this “depression” or disconnection. In the non-ordinary or expanded states of consciousness offered by traditional psychedelics, we are once again given access to belonging, to nonjudgment, self-compassion and forgiveness –  for ourselves and for others. With those medicines, for maybe the first time, we are shown that we are safe in our own bodies and that we are held in it all. We have no need for fear or control, resistance or score-keeping. With psychedelics, we are given teachings and healings and a sense of deep reconnection to the self before the wound, before the rupture. If we were stuck in a dark room before, we now have a light on and a very visible, open door. We feel connected again. We can see there is a way out and we think this is how we are “healed”. And we’d be right — mostly.

What Happens When the Ceremonies End

After the ceremonies end, we pack our bags, we say our goodbyes, and we go back home to the relationships, jobs and households we left. And because we now know we aren’t broken, we don’t need any more “fixing.” We just need to make a few tweaks, quit a few bad habits, or leave a toxic relationship or two to get back in “alignment” and we’re off and running with this ineffable glowiness and mystical connection. It felt like a magic wand was waved over us that changed everything.

But then something happens. Maybe not right away but within a few months, we can find ourselves right back where we were before the whole beautiful experience.

Why Integration Is Where Lasting Healing Happens

Integration is a buzz word in plant medicine circles, but for good reason. What is seemingly less understood within our culture is that the lasting healing potential after a psychedelic experience is actually what happens AFTER the medicine. The time to access and build that deep feeling of connection in ordinary states of consciousness. This is the time when we make use of the brain’s new neuroplasticity — the ability to reorganize, adapt, change structure, and make new meanings of painful life experiences by generating brand new cells; pruning and growing dendrites along existing neural networks. Psychedelics actually change and rewire the brain. This happens for different lengths of time depending on which medicine you have consumed. For example, the window of neuroplasticity for ketamine is 24-72 hours, for psilocybin 7-14 days and for ayahuasca up to 30 days. Many of the ruptures that were in the way of your sustained feelings of connection are still there and are now ready to be much more easily and thoroughly processed and reconsolidated in these windows. With this neuroplasticity, the trauma processing is now given fertile soil for planting new, much more adaptive beliefs about yourself and a smooth runway for landing back in your body with an increased distress tolerance and an overall sense of agency and self-leadership. Integration is how the patterns change for life.

Finding the Right Integration Support

Tackling these wounds, in a safe and protected container, with the support of a clinical trauma professional and/or psychedelic-assisted psychotherapist might be the greatest resilience-builder and integration support there is. These trauma-informed therapists are well-trained, and experienced in working with distressing internal states, disconnection, traumatic wounding and nonordinary states of consciousness.

It’s time to turn away from the small window in that room, and instead open the door and begin to walk toward building the life that is waiting for you.