Depression Or PTSD? How They Are Connected
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.
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 PTSD, 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.
If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.
Symptoms of PTSD and c-PTSD in general can be very serious and are often debilitating. They typically fall into four categories:
- 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
- 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
- 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
- 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
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.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.
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.
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 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
Can PTSD lead to depression?
It is common for people who have post-traumatic stress disorder (PTSD) to also experience depression, as surviving a traumatic or stressful event is a risk factor for both mental health conditions. Major depression can even be a progression secondary to post-traumatic stress disorder. For that reason, depression and post-traumatic stress disorder often co-occur, which can lead to feelings of persistent low mood and a loss of interest in activities.
It is important to address both conditions and seek mental health resources for a comprehensive approach to treatment, which may include cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs), and other evidence-based treatments. Consult a doctor before consuming prescription medication.
How do you deal with post-traumatic stress disorder triggers?
It is essential to understand the triggers — when they occur and why. Determining the foundation of these triggers may be easier with the help of trusted family members or a mental health professional. Coping strategies such as grounding techniques, controlled breathing, and relaxation exercises can also be helpful in managing anxiety related to post-traumatic stress disorder. Seeking additional resources like counseling can be vital in processing the impact of triggers over time.
How do you deal with post-traumatic stress disorder and anxiety?
Managing PTSD-related anxiety might involve therapeutic intervention, support groups, and self-help strategies. Cognitive behavioral therapy is one of the most effective treatments, but supplementing this treatment with mindfulness practices can contribute to improvement. Substance misuse, including alcohol or drugs, should be avoided as they can worsen anxiety symptoms.
While these conditions often occur comorbidly, not everyone with post-traumatic stress disorder will necessarily develop depression. According to research, most people with post-traumatic stress disorder do not experience depressive symptomology, but over 30% of people with post-traumatic stress disorder do.
Do people with post-traumatic stress disorder cry easily?
People with post-traumatic stress disorder may find themselves more prone to emotional reactions, including crying. Post-traumatic stress disorder can heighten emotional responsiveness and lead to intense emotional episodes when confronted with triggers or distressing memories. It's important to recognize that emotional responses vary among individuals, so seeking help from a mental health professional is advisable if these reactions become overwhelming.
Is it normal to cry with post-traumatic stress disorder?
Crying is a normal emotional response to traumatic experiences, and it can be part of the healing process for PTSD. However, the frequency or intensity of crying can vary from person to person. If crying becomes disruptive or persistent, it is advisable to seek help from a mental health provider, as this can be a sign of unresolved trauma.
How do I know if I suffer from PTSD?
Diagnosing post-traumatic stress disorder involves a comprehensive evaluation by a mental health professional or doctor. The process typically includes discussing your symptoms, experiences, and history of exposure to a traumatic or stressful event. If you exhibit symptoms such as re-experiencing the trauma, avoidance, hyperarousal, and emotional distress, you may be experiencing symptoms related to post-traumatic stress disorder. Seeking professional assessment is essential for an accurate diagnosis.
What happens when post-traumatic stress disorder is triggered?
When post-traumatic stress disorder is triggered, individuals may experience a range of distressing symptoms, such as flashbacks, nightmares, increased heart rate, intense anxiety, and a sense of impending danger. These symptoms can lead to emotional distress, making it important to develop coping strategies and seek treatment to manage the impact of triggers.
How do you know if you are traumatized?
Trauma can manifest in various ways, including symptoms of anxiety, emotional distress, trouble sleeping, and intrusive thoughts related to a stressful event. If you find that past experiences are significantly impacting your daily life, relationships, and well-being, it may be an indicator of existing trauma. Seeking support from mental health resources, such as counseling, family therapy, or support groups, can be beneficial in addressing the effects of trauma. More mental health resources can be found here.
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