Depression and Post-Traumatic Stress Disorder

Table of ContentsView AllTable of ContentsSymptomsDiagnosisPrevalenceWhat’s the Connection?Treatments

Table of ContentsView All

View All

Table of Contents

Symptoms

Diagnosis

Prevalence

What’s the Connection?

Treatments

Information presented in this article may be triggering for some people. If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

For more mental health resources, see ourNational Helpline Database.

Depression can also be a common response after a traumatic or stressful event, so it is perhaps not surprising that these two conditions can occur at the same time.

Research suggests that approximately 6.8% of all people will develop PTSD at some point in their lives.An estimated 8.3% of U.S. adults experience major depressive disorder in any given year.While estimates vary, one study found that 35.2% of people with PTSD also met the diagnostic criteria for major depressive disorder. Among veterans with PTSD, 68% also have depression.

If you’ve received a dual diagnosis, here’s why the conditions may be related.

At a GlanceDepression and post-traumatic stress disorder often go hand in hand. When a person has both conditions, they will experience symptoms of depression (like low mood, fatigue, and loss of interest) along with symptoms of PTSD (such as flashbacks, hypervigilance, and negative thoughts). There are many reasons why they co-occur, including the fact that depressed people are more likely to have experienced trauma and that having PTSD can lead to depression. If you have both condition, talk to your doctor about your treatment options. Medications and therapy can be particularly helpful.

At a Glance

Depression and post-traumatic stress disorder often go hand in hand. When a person has both conditions, they will experience symptoms of depression (like low mood, fatigue, and loss of interest) along with symptoms of PTSD (such as flashbacks, hypervigilance, and negative thoughts). There are many reasons why they co-occur, including the fact that depressed people are more likely to have experienced trauma and that having PTSD can lead to depression. If you have both condition, talk to your doctor about your treatment options. Medications and therapy can be particularly helpful.

Symptoms of Depression and PTSD

Everyone feels sad from time to time, but depression is different from just feeling unhappy or sad. Depression is more intense, lasts longer, and has a large negative impact on your life.

These symptoms of depression and PTSD are described in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR).

DepressionDepressed moodLoss of interest or pleasureWeight loss or weight gainSleep difficultiesFatigue or restlessnessFeeling worthless and/or guiltyDifficulties concentratingThoughts of dying or suicidePTSDUnwanted memoriesFlashbacksAvoidance of trauma remindersFeelings of isolationNegative thoughts and emotionsIrritabilityHypervigilanceExaggerated startle response

Depressed mood

Loss of interest or pleasure

Weight loss or weight gain

Sleep difficulties

Fatigue or restlessness

Feeling worthless and/or guilty

Difficulties concentrating

Thoughts of dying or suicide

PTSDUnwanted memoriesFlashbacksAvoidance of trauma remindersFeelings of isolationNegative thoughts and emotionsIrritabilityHypervigilanceExaggerated startle response

Unwanted memories

Flashbacks

Avoidance of trauma reminders

Feelings of isolation

Negative thoughts and emotions

Irritability

Hypervigilance

Exaggerated startle response

How Are Depression and PTSD Diagnosed?

According to the DSM-5-TR, to be diagnosed with amajor depressive episode, you must experience five or more of these symptoms within the same two-week period (or longer), and they must be a change from how you normally function. At least one of these symptoms must be either depressed mood or loss of interest or pleasure.

To be diagnosed with PTSD, DSM-5-TR diagnostic criteria specify that a person must have experienced a traumatic event and must experience symptoms that include:

These symptoms must be present for at least one month and must create significant distress or impairments in regular functioning.

A Verywell Report: Americans Find Strength in Online Therapy

How Often Depression and PTSD Coincide

Depression is one of the most commonly co-occurring diagnoses in people with post-traumatic stress disorder. In fact, researchers have found that among people who have (or have had) a diagnosis of PTSD, approximately half also experienced current or previous major depressive episode.

People who have had PTSD at some point in their lives are three to five times as likely as people without PTSD to also have depression.

Coping With PTSD

How Depression and PTSD Are Connected

PTSD and depression may be connected in a number of ways.

Increased Trauma

First, people with depression are more likely to have traumatic experiences than people without depression, which, in turn, may increase the likelihood that PTSD develops. A history of trauma and abuse is also a risk factor for depression, and those same traumatic experiences may also play a role in the onset of PTSD.

PTSD May Contribute to Depression

A second possibility is that the symptoms of PTSD can be so distressing and debilitating that they actually cause depression to develop.

Some people with PTSD may feeldetached or disconnectedfrom friends and family. They may also find little pleasure in activities they once enjoyed.

Finally, they may even have difficulty experiencing positive emotions like joy and happiness. It’s easy to see how experiencing these symptoms of PTSD may make someone feel very sad,lonely, and depressed.

Genetics May Play a Role

Another possibility is that there is some genetic factor involved in the development of both PTSD and depression. Family history is known to be a major risk factor for the development of depression. Research has also suggested that there may be a genetic predisposition for PTSD.So it makes sense that genetics may also play a role in the co-occurrence of the two conditions.

Getting Treatment for Depression and PTSD

If you have PTSD, it’s important to seek treatment as soon as possible. The sooner you address yourPTSD symptoms, the less likely it will be that they worsen and increase your risk for developing depression.

If you currently have PTSD and depression, it’s also important to get treatment as soon as possible. Each disorder may make the other worse.

Since PTSD and depression are commonly co-occurring mental disorders, mental health professionals trained in thetreatment of PTSDare also usually well-trained in the treatment of depression. In addition, some treatments, such asbehavioral activation, may be equally helpful in the treatment of PTSD and depression.

The presence of both conditions can complicate the treatment process. However, there are treatment options that can be a good choice for treating both conditions at the same time.

Cognitive-behavioral therapy(CBT), in particular, is an empirically supported treatment for both depression and PTSD.This approach involves identifying the negative cognitions that contribute to symptoms and then learning to replace these thoughts with more helpful responses.

Your doctor or psychiatrist will recommend treatment options that are best suited to your unique situation. This might involve the use of psychotherapy, such as CBT, as well as anti-anxiety or antidepressant medications. Self-help options such as lifestyle changes oronline therapycan also be used to complement professional treatments.

Takeaways

It isn’t uncommon for depression and post-traumatic disorder to occur together at the same time. Both can stem from trauma, but genetics can play a role in increasing the risk as well. Having PTSD can also contribute to the onset of depression. That’s why it’s so important to get an accurate diagnosis and treatment for both conditions. If you have symptoms of depression and PTSD, talk to your doctor about which treatments may be the most helpful for you.

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Flory JD, Yehuda R.Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations.Dialogues Clin Neurosci. 2015;17(2):141-150. doi:10.31887/DCNS.2015.17.2/jfloryNational Institute of Mental Health.Post-traumatic stress disorder.National Institute of Mental Health.Major depression.Knowles KA, Sripada RK, Defever M, Rauch SAM.Comorbid mood and anxiety disorders and severity of posttraumatic stress disorder symptoms in treatment-seeking veterans.Psychol Trauma. 2019;11(4):451-458. doi:10.1037/tra0000383American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.U.S. Department of Veterans Affairs.Depression, trauma, and PTSD.Wang SK, Feng M, Fang Y, et al.Psychological trauma, posttraumatic stress disorder and trauma-related depression: A mini-review.World J Psychiatry. 2023;13(6):331-339. doi:10.5498/wjp.v13.i6.331Howie H, Rijal CM, Ressler KJ.A review of epigenetic contributions to post-traumatic stress disorder.Dialogues Clin Neurosci. 2019;21(4):417-428. doi:10.31887/DCNS.2019.21.4/kresslerNakao M, Shirotsuki K, Sugaya N.Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies.Biopsychosoc Med. 2021;15(1):16. doi:10.1186/s13030-021-00219-wAdditional ReadingBiehn TL, Contractor A, Elhai JD, et al. Relations between the underlying dimensions of PTSD and major depression using an epidemiological survey of deployed Ohio National Guard soldiers.Journal of Affective Disorders.2013; 144: 106-111.Flory JD, Yehuda R.Comorbidity between post-traumatic stress disorder and major depressive disorder: Alternative explanations and treatment considerations.Dialogues in Clinical Neuroscience. 2015;17(2):141-150.Gros, DF, Price, M, Magruder, KM, and Frueh, BC.Symptom overlap in posttraumatic stress disorder and major depression.Psychiatry Res.2012; 196(2-3): 267-70. doi: 10.1016/j.psychres.2011.10.022.Rytwinksi, ND, Scur, MD, Feeny, NC, and Yountsrom, EA.The co-occurrence of major depressive disorder among individuals with posttraumatic stress disorder: A meta-analysis.J Trauma Stress.2013; 26(3):299-309. doi: 10.1002/jts.21814.

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Flory JD, Yehuda R.Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations.Dialogues Clin Neurosci. 2015;17(2):141-150. doi:10.31887/DCNS.2015.17.2/jfloryNational Institute of Mental Health.Post-traumatic stress disorder.National Institute of Mental Health.Major depression.Knowles KA, Sripada RK, Defever M, Rauch SAM.Comorbid mood and anxiety disorders and severity of posttraumatic stress disorder symptoms in treatment-seeking veterans.Psychol Trauma. 2019;11(4):451-458. doi:10.1037/tra0000383American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.U.S. Department of Veterans Affairs.Depression, trauma, and PTSD.Wang SK, Feng M, Fang Y, et al.Psychological trauma, posttraumatic stress disorder and trauma-related depression: A mini-review.World J Psychiatry. 2023;13(6):331-339. doi:10.5498/wjp.v13.i6.331Howie H, Rijal CM, Ressler KJ.A review of epigenetic contributions to post-traumatic stress disorder.Dialogues Clin Neurosci. 2019;21(4):417-428. doi:10.31887/DCNS.2019.21.4/kresslerNakao M, Shirotsuki K, Sugaya N.Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies.Biopsychosoc Med. 2021;15(1):16. doi:10.1186/s13030-021-00219-wAdditional ReadingBiehn TL, Contractor A, Elhai JD, et al. Relations between the underlying dimensions of PTSD and major depression using an epidemiological survey of deployed Ohio National Guard soldiers.Journal of Affective Disorders.2013; 144: 106-111.Flory JD, Yehuda R.Comorbidity between post-traumatic stress disorder and major depressive disorder: Alternative explanations and treatment considerations.Dialogues in Clinical Neuroscience. 2015;17(2):141-150.Gros, DF, Price, M, Magruder, KM, and Frueh, BC.Symptom overlap in posttraumatic stress disorder and major depression.Psychiatry Res.2012; 196(2-3): 267-70. doi: 10.1016/j.psychres.2011.10.022.Rytwinksi, ND, Scur, MD, Feeny, NC, and Yountsrom, EA.The co-occurrence of major depressive disorder among individuals with posttraumatic stress disorder: A meta-analysis.J Trauma Stress.2013; 26(3):299-309. doi: 10.1002/jts.21814.

Flory JD, Yehuda R.Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations.Dialogues Clin Neurosci. 2015;17(2):141-150. doi:10.31887/DCNS.2015.17.2/jfloryNational Institute of Mental Health.Post-traumatic stress disorder.National Institute of Mental Health.Major depression.Knowles KA, Sripada RK, Defever M, Rauch SAM.Comorbid mood and anxiety disorders and severity of posttraumatic stress disorder symptoms in treatment-seeking veterans.Psychol Trauma. 2019;11(4):451-458. doi:10.1037/tra0000383American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.U.S. Department of Veterans Affairs.Depression, trauma, and PTSD.Wang SK, Feng M, Fang Y, et al.Psychological trauma, posttraumatic stress disorder and trauma-related depression: A mini-review.World J Psychiatry. 2023;13(6):331-339. doi:10.5498/wjp.v13.i6.331Howie H, Rijal CM, Ressler KJ.A review of epigenetic contributions to post-traumatic stress disorder.Dialogues Clin Neurosci. 2019;21(4):417-428. doi:10.31887/DCNS.2019.21.4/kresslerNakao M, Shirotsuki K, Sugaya N.Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies.Biopsychosoc Med. 2021;15(1):16. doi:10.1186/s13030-021-00219-w

National Institute of Mental Health.Post-traumatic stress disorder.

National Institute of Mental Health.Major depression.

Knowles KA, Sripada RK, Defever M, Rauch SAM.Comorbid mood and anxiety disorders and severity of posttraumatic stress disorder symptoms in treatment-seeking veterans.Psychol Trauma. 2019;11(4):451-458. doi:10.1037/tra0000383

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

U.S. Department of Veterans Affairs.Depression, trauma, and PTSD.

Wang SK, Feng M, Fang Y, et al.Psychological trauma, posttraumatic stress disorder and trauma-related depression: A mini-review.World J Psychiatry. 2023;13(6):331-339. doi:10.5498/wjp.v13.i6.331

Howie H, Rijal CM, Ressler KJ.A review of epigenetic contributions to post-traumatic stress disorder.Dialogues Clin Neurosci. 2019;21(4):417-428. doi:10.31887/DCNS.2019.21.4/kressler

Nakao M, Shirotsuki K, Sugaya N.Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies.Biopsychosoc Med. 2021;15(1):16. doi:10.1186/s13030-021-00219-w

Biehn TL, Contractor A, Elhai JD, et al. Relations between the underlying dimensions of PTSD and major depression using an epidemiological survey of deployed Ohio National Guard soldiers.Journal of Affective Disorders.2013; 144: 106-111.Flory JD, Yehuda R.Comorbidity between post-traumatic stress disorder and major depressive disorder: Alternative explanations and treatment considerations.Dialogues in Clinical Neuroscience. 2015;17(2):141-150.Gros, DF, Price, M, Magruder, KM, and Frueh, BC.Symptom overlap in posttraumatic stress disorder and major depression.Psychiatry Res.2012; 196(2-3): 267-70. doi: 10.1016/j.psychres.2011.10.022.Rytwinksi, ND, Scur, MD, Feeny, NC, and Yountsrom, EA.The co-occurrence of major depressive disorder among individuals with posttraumatic stress disorder: A meta-analysis.J Trauma Stress.2013; 26(3):299-309. doi: 10.1002/jts.21814.

Flory JD, Yehuda R.Comorbidity between post-traumatic stress disorder and major depressive disorder: Alternative explanations and treatment considerations.Dialogues in Clinical Neuroscience. 2015;17(2):141-150.

Gros, DF, Price, M, Magruder, KM, and Frueh, BC.Symptom overlap in posttraumatic stress disorder and major depression.Psychiatry Res.2012; 196(2-3): 267-70. doi: 10.1016/j.psychres.2011.10.022.

Rytwinksi, ND, Scur, MD, Feeny, NC, and Yountsrom, EA.The co-occurrence of major depressive disorder among individuals with posttraumatic stress disorder: A meta-analysis.J Trauma Stress.2013; 26(3):299-309. doi: 10.1002/jts.21814.

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At a Glance#

Symptoms of Depression and PTSD#

How Are Depression and PTSD Diagnosed?#

How Often Depression and PTSD Coincide#

How Depression and PTSD Are Connected#

Increased Trauma#

PTSD May Contribute to Depression#

Genetics May Play a Role#

Getting Treatment for Depression and PTSD#

Takeaways#