How are depression and PTSD related?

We can all face moments in life when we feel deeply saddened, whether from losing a loved one, ending a relationship, or navigating through an especially difficult time. Yet when sadness persists for two weeks or longer, interferes with daily activities, and leaves you feeling emotionally drained, it may indicate a mental health condition.

Because the symptoms of depression and PTSD often overlap, accurately diagnosing these conditions can be challenging. Both mental health conditions share common symptoms, like low mood, irritability, and sleep problems. It’s also possible for you to have both PTSD and depression at the same time, making a diagnosis even more complex. 

How to tell the difference between PTSD and depression

PTSD is a mental health condition that affects people who’ve experienced or witnessed a traumatic event. For example, veterans of war, people who’ve experienced assault, first responders, and people who’ve survived a mass tragedy or natural disaster can develop PTSD. The trauma of these events can continue to affect their mental health for months or years after the incident.

To have PTSD, someone must experience the following for at least one month or more:

• Re-experiencing symptoms: Flashbacks, distressing thoughts, or signs of physical distress 
• Avoidance symptoms: Avoiding thoughts of the traumatic event or staying away from events or objects that serve as reminders of the trauma
• Arousal or reactivity symptoms: Being easily startled, having problems concentrating, feeling irritable or angry, or having trouble sleeping
• Cognition and mood symptoms: Losing interest in enjoyable activities, inability to feel happy, having exaggerated feelings of blame toward yourself or others, or having ongoing feelings of guilt, shame, fear, or anger

In contrast, depression is a mental health condition caused by factors including genetics, chemical imbalances in the brain, significant life events, or chronic illness. To be diagnosed with depression, you must have persistent sadness, low mood, and/or feelings of hopelessness nearly every day for at least two weeks.

Other symptoms of depression can include:

• Trouble focusing on tasks or making decisions
• Frequently crying 
• Feeling anger or irritable 
• Losing interest in activities you used to enjoy 
• Withdrawing socially
• Having trouble sleeping 
• Feeling anxious or agitated

Examining the underlying cause is one way doctors and mental health professionals differentiate between PTSD and depression. PTSD stems from experiencing or witnessing a traumatic event, while depression often develops as the result of a combination of factors and isn’t typically linked to a single incident.

Can PTSD and depression co-occur? 

It’s possible to have PTSD and depression at the same time. Research has shown that experiencing a traumatic event increases the risk of developing both PTSD and depression. One research review found that 52% of the participants diagnosed with PTSD also had major depressive disorder (MDD). 

Co-occurring PTSD and depression can worsen the symptoms of both conditions. Symptoms may overlap, including: 

• Sleep problems 
• Irritability 
• Loss of interest in activities you used to enjoy 
• Social withdrawal 
• Lack of focus 

Additionally, people with co-occurring PTSD and depression are at a higher risk for suicide.

If you’re experiencing the symptoms of PTSD, depression, or a combination of both, know that there’s help available. There are mental health providers who are trained in treating both conditions and can help you find happiness again. 

A note on safety: If you’re experiencing suicidal thoughts, know that you’re not alone and help is available. You can reach the Suicide and Crisis Lifeline by calling or texting 988 from any phone. There’s also an online chat option, and the counselors can provide confidential support to help keep you safe.

Seeking support for co-occurring PTSD and depression

Although experiencing traumatic events is linked to depression, not all physicians regularly screen for trauma. As a result, studies indicate that in primary care settings, people with PTSD are frequently undiagnosed or misdiagnosed with depression, anxiety, or a panic disorder.

Meeting with a mental health professional who’s trained in trauma-informed therapy can make all the difference for someone with PTSD. Trauma-informed therapy allows people to recognize the role of trauma in their life experiences while also feeling safe and empowered in their healing journey.

There are effective treatments for PTSD and depression, although approaches to treatment can vary. 

Depression is often treated with cognitive behavioral therapy (CBT), a form of talk therapy that focuses on your thoughts, feelings, and behaviors. It can help you challenge negative thoughts and patterns and create positive change. 

PTSD is often treated with:

• Cognitive processing therapy (CPT): This treatment approach helps you evaluate and change the upsetting thoughts you may be experiencing as a result of trauma. 
• Trauma-informed therapy: This is a form of talk therapy that recognizes and understands how traumatic experiences have impacted your mental, emotional, physical health and well-being. 
• Prolonged exposure (PE) therapy: This type of therapy gradually guides you toward trauma-related memories and feelings in a safe environment. Rather than avoiding your fears, you’ll learn how to reduce anxiety and face them with confidence. 

In some cases, medication may also be recommended as part of a comprehensive treatment plan for both depression and PTSD. You can work with your provider to determine if medication is the right option for you.

Find care with Rula

Navigating PTSD and depression can be challenging, especially when the symptoms overlap. You may have problems focusing or notice that you don’t enjoy spending time with friends and family or participating in activities that used to give you pleasure. Know that with the right treatment, finding peace is possible. 

With help from Rula, you can find a therapist who accepts your insurance and specializes in treating trauma and depression. When you’re ready, we can connect you with a mental health professional you can meet with in a convenient online setting as soon as tomorrow.

Find a therapist with Rula