How PTSD And Depression Are Connected

Post-traumatic stress disorder (PTSD) and depression are separate mental illnesses according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, it’s not uncommon for them to co-occur simultaneously in the same individual. In other words, these two conditions have a comorbid relationship. 

Determining whether a diagnosis of one or both may be appropriate for a given individual can be difficult at times, since some symptoms may overlap. That’s one reason it’s typically important to seek the support of a qualified healthcare provider if you’re experiencing signs of PTSD, depression, or another mental illness. Read on for a brief overview of both of these conditions along with more information on their relationship.

What Is PTSD?

Post-traumatic stress disorder is categorized as a trauma- and stress-related disorder that can develop after a person experiences or witnesses a traumatic event. Examples of such events include war, a natural disaster, assault, the sudden or traumatic loss of a loved one, or a car accident. Note that ongoing instances of traumatization, such as abuse, may result in another type of this disorder known as complex PTSD, or c-PTSD. Symptoms of the two are generally the same, except that those associated with c-PTSD may be more intense, and these individuals may also experience low self-esteem, trouble regulating their emotions, and a pattern of unhealthy relationships in addition.

Symptoms of PTSD and c-PTSD in general can be very serious and are often debilitating. They typically fall into four categories:

1. Intrusion, such as intrusive thoughts, memories, flashbacks, or nightmares that can be so vivid that they’re like experiencing the event all over again

2. Avoidance of anything that reminds them of the event (people, places, things), typically along with avoidance of talking about it or how they feel about it

3. Mood/cognition changes, such as distorted, negative thoughts about themselves or others, guilt, hopelessness, detachment, and the inability to feel joy or satisfaction

4. Reactivity, such as feeling irritable, engaging in risky and/or self-destructive behaviors, having angry outbursts, trouble concentrating, and sleep disturbances

What Is Depression?

Depression, or major depressive disorder (MDD), is a mood disorder and one of the most common mental health disorders in general. The precise cause of depression isn’t fully understood, but it’s thought to be the result of some combination of genetics, brain chemistry, and environment or experiences—including traumatic experiences, if applicable. 

Depression symptoms can be very serious and are often debilitating as well. The most common ones include:

• A lack of interest in activities once enjoyed
• Feelings of hopelessness or worthlessness
• Significant changes in sleeping and/or eating patterns
• Trouble concentrating
• Fatigue or low energy
• Persistent feelings of sadness or emptiness
• Physical pain (headaches, stomachaches) that have no other clear cause

It’s also important to note that both PTSD and depression can manifest as self-harming behaviors or thoughts of suicide, which is one reason that it’s important to be able to recognize the symptoms of these disorders and seek treatment and support right away.

If you or someone you know is experiencing suicidal thoughts or behaviors, seek help immediately. The National Suicide Prevention Lifeline can be reached 24/7 by dialing 988.

The Link Between PTSD And Depression

According to research, almost 50% of people diagnosed with PTSD will also experience depression. The odds of someone with PTSD developing depression are three to five times higher than someone without PTSD. Diagnosis rates may even be low, since it can sometimes be difficult to isolate symptoms of depression in someone who is already showing signs of or has been diagnosed with PTSD.

PTSD develops as a result of having witnessed or experienced trauma, and depression can as well—though it can also be caused by other factors unrelated to trauma. This is one of the reasons that it’s not uncommon for someone who has gone through a traumatic event(s) to develop both PTSD and depression.

Treatment Options For PTSD And Depression

Treatment methods for these two illnesses can vary depending on the person and their specific circumstances. However, talk therapy—particularly cognitive behavioral therapy (CBT)—is typically the first recommended approach. It offers the individual a safe space to process and work through any trauma they may have experienced. A cognitive behavioral therapist will also help them learn to notice and then shift distorted thoughts about the experience, themselves, or others that may be contributing to their symptoms. Finally, therapy can teach the individual a set of healthy coping mechanisms that work for them so they can safely manage symptoms or other difficult emotions in the future. Note that medication may also be suggested in tandem with therapy in some cases. Lifestyle changes like eating nutritious foods and exercising regularly may also be recommended.

Some people may find the prospect of visiting a therapist in person to discuss a traumatic experience and/or difficult symptoms to be intimidating or nerve-wracking. In cases like these, online therapy can represent a more comfortable alternative. With an online therapy service like BetterHelp, you can get matched with a licensed therapist who you can speak with via video, phone, and/or in-app messaging from the comfort of home. A 2023 study suggests that online CBT for PTSD can be as effective as the in-person variety, and a wealth of studies in recent years have suggested the same for depression. That means you can typically feel comfortable in choosing whichever format feels best for you if you’re experiencing symptoms of either or both of these conditions.