PTSD Related Conditions The Relationship Between PTSD and Depression By Matthew Tull, PhD Matthew Tull, PhD Twitter Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our editorial process Updated on March 26, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Cultura RM / Frank and Helena/ Collection Mix: Subjects / Getty Images Information presented in this article may be triggering for some people. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for 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 our National Helpline Database. A diagnosis of post-traumatic stress disorder (PTSD) and depression commonly co-occur. PTSD is characterized by symptoms of anxiety, flashbacks, and reliving traumatic experiences. The condition develops after a person experiences some sort of traumatic event such as a natural disaster, car accident, attack, abuse, or combat. On the other hand, depression is characterized by low mood, loss of interest and pleasure, and changes in energy levels. 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 7.1% of U.S. adults experience major depressive disorder in any given year. Research has found that half of all people with PTSD also have a co-occurring major depressive disorder. If you've received a dual diagnosis, here's why the conditions may be related. Symptoms 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). Depression 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 PTSD Unwanted memories Flashbacks Avoidance of trauma reminders Feelings of isolation Negative thoughts and emotions Irritability Hypervigilance Exaggerated startle response Diagnosis According to the DSM-5, to be diagnosed with a major depressive episode, you must experience five of these symptoms within the same two-week period (or longer) and they must be a change from how you normally function. In order to be diagnosed with PTSD, DSM-5 diagnostic criteria specify that a person must have experienced a traumatic event, must experience symptoms that include intrusive thoughts, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity. 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 PTSD and Depression 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 48% to 55% also experienced current or previous depression. 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 They 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 feel detached or disconnected from 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 kind of 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 If you have PTSD, it's important to seek treatment as soon as possible. The sooner you address your PTSD 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 the treatment of PTSD are also usually well-trained in the treatment of depression. In addition, some treatments, such as behavioral 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 or online therapy can also be used to complement professional treatments. 4 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gros DF, Price M, Magruder KM, Frueh BC. Symptom overlap in posttraumatic stress disorder and major depression. Psychiatry Res. 2012;196(2-3):267-270. doi:10.1016/j.psychres.2011.10.022 Gros DF, Price M, Magruder KM, Frueh BC. Symptom overlap in posttraumatic stress disorder and major depression. Psychiatry Res. 2012;196(2-3):267-270. doi:10.1016/j.psychres.2011.10.022 American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013. Cornelis MC, Nugent NR, Amstadter AB, Koenen KC. Genetics of Post-Traumatic Stress Disorder: Review and Recommendations for Genome-Wide Association Studies. Curr Psychiatry Rep. 2010;12(4):313-326. doi:10.1007/s11920-010-0126-6 Additional Reading 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. By Matthew Tull, PhD Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for PTSD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.