During the last few years, most cases of major depression encountered by the author in his private practice proved to be issues of psychological trauma. Among the incriminated traumatic causes, very few were potentially life-threatening events, and some were various forms of sexual abuse; however, most were seemingly trivial experiences that had had deleterious effect on the subject’s narcissism or perceived social recognition. It appeared that in all cases where previous psychotherapy or psychiatric treatment had been performed, such trauma had been ignored or overlooked. Amazingly, careful and exhaustive trauma-targeted psychotherapy brought about exceptional relief and eventually recovery from the mood disorder.

More amazingly, five cases of apparent bipolar disorder proved to be traumatic disorders. One of these presented with a very typical first manic episode; the other four had been diagnosed with this condition in a psychiatric hospital, they had a documented bipolar history and had received mood-stabilisers or atypical neuroleptics with satisfying results. Here too, careful trauma-centered psychotherapy achieved complete recovery and allowed to stop chemical treatment. Four and a half year follow-up (the longest among these five cases) showed no relapse in any of the five patients, despite the lack of any chemical treatment.

Significant case reports will be discussed.