Depression Or PTSD? How They Are Connected

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated July 16, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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Depression and post-traumatic stress disorder (PTSD) are separate, unique disorders 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.

Learn about treatment options for PTSD

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder is categorized by the DSM-5 as a trauma- and stress-related disorder that can develop after a person experiences or witnesses a traumatic or deeply disturbing event. Examples of such events include war, a natural disaster, assault, the sudden or traumatic loss of a loved one, or a car accident. A mental health professional can thoroughly evaluate an individual’s symptoms to decide whether to diagnose PTSD or not.

Note that ongoing instances of traumatization, such as abuse, may result in another type of this disorder known as complex posttraumatic stress disorder, or c-PTSD. The two often manifest as similar symptoms, except that those associated with c-PTSD from a series of traumatic events may be even more intense. Individuals with c-PTSD may experience more problems related to low self-esteem, trouble managing 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. Intrusions, such as intrusive thoughts, unwanted memories, flashbacks, or nightmares that can be so vivid that they’re like experiencing the event(s) all over again

  2. Avoidance of anything that reminds them of the event(s) (people, places, things) and brings up intrusive memories of it, 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, a tendency to feel detached, low energy levels, and the inability to feel joy or satisfaction

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

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What is depression, or major depressive disorder?

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 in most people and are often debilitating as well. Some of 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 the underlying dimensions of both PTSD and depression can manifest as self-harming behaviors like substance misuse (formerly known as “substance abuse”) or thoughts of suicide. This is just one reason that it’s important to be able to recognize the symptoms of these disorders and seek treatment and support right away.

Depression and PTSD: traumatic events and comorbidity

The key takeaway about the relationship between these two mental illnesses is that having PTSD increases your chances of developing depression. 

According to the National Center for PTSD, research suggests that a person with this illness is three to five times more likely to experience depression than someone without PTSD. Even these statistics may be lower than the actual numbers because it can sometimes be difficult to isolate symptoms of depression in someone who is already showing signs of or has been diagnosed with PTSD.

Posttraumatic stress disorder 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 alternative explanations for why it’s not uncommon for someone who has gone through a traumatic event(s) to develop both PTSD and depression.

Learn about treatment options for PTSD

Treatment options for depression or PTSD symptoms

Treatment methods for PTSD and depression can vary depending on the person and their specific circumstances. However, talk therapy—particularly cognitive behavioral therapy—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 therapist specializing in cognitive behavioral therapy (CBT) can also help them learn to notice PTSD symptoms 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 like a selective serotonin reuptake inhibitor (SSRI) may also be one of the treatment considerations suggested in tandem with therapy in some cases. Lifestyle changes like eating nutritious foods and exercising regularly may be recommended for PTSD and depressive and anxiety disorders as well.

Seeking online therapy for PTSD and/or depression

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 for learning to manage or reduce symptoms. 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 your home.

A 2023 study suggests that online CBT for PTSD can be as effective as the in-person type, and a wealth of studies and epidemiological surveys in recent years have suggested the same for depression and anxiety disorders. 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.

Takeaway

PTSD and depression are two distinct, separate mental health conditions. However, it’s not uncommon for an individual who is experiencing PTSD to develop depression as well. If you’re experiencing symptoms of either of these illnesses, it’s typically recommended that you seek professional support. Treatment for depression and PTSD is available and usually consists of some form of talk therapy, sometimes in combination with medication and/or recommended lifestyle changes.
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