Are PTSD and Depression Related?

Published 10/28/2020

More than eight million people in the United States have or had post-traumatic stress disorder (PTSD) at some point in their lives. And according to a study published in the Dialogues in Clinical Neuroscience, half of those with PTSD also have a major depressive disorder as well. Scientists are not sure whether PTSD causes depression (or vice versa) or whether it is just that a traumatic incident caused both of these mental illnesses.

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What is PTSD?

PTSD is a severe anxiety disorder one gets from experiencing a traumatic event or events. You do not even have to be a victim of the trauma because just witnessing it can be enough. That is why it is common for first responders such as paramedics and firefighters to develop the disorder. Other types of traumatic incidents that may cause PTSD may include:

  • Some type of abuse such as physical, sexual, or emotional
  • Being a victim of assault or terrorism
  • Witnessing or being involved in a serious accident
  • Experiencing a natural disaster like a flood, earthquake, or tornado
  • Being in combat or witnessing combat during your service

Who Gets PTSD?

While some people who go through one of these crises may develop PTSD, others who went through the same thing may not. Although researchers are not sure of the exact reason for this, there are some risk factors that seem to come into play that make you more susceptible such as:

  • Having a family member with a mental illness
  • Not having a good support system
  • Being in an unstable environment
  • Being exposed to a past trauma such as being in an abusive relationship or being a first responder
  • Dealing with more stress after the event
  • Not being allowed to grieve or heal properly
  • Having a drug or alcohol addiction

What Are the Symptoms of PTSD?

PTSD has four different categories of symptoms that include re-experiencing the trauma, avoiding the memories of the trauma, hypervigilance or hyperarousal symptoms, and mood and cognition symptoms. In order to be diagnosed with PTSD, you must have at least two symptoms from the mood and cognition category, two symptoms from the hypervigilance category, one symptom from the avoidance category, and one symptom from the re-experience category.

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The symptoms include:

Experience Symptoms

  • Having the same disturbing thoughts about the trauma over and over
  • Feeling stressed all the time
  • Suffering from nightmares and/or night terrors
  • Frequent flashbacks of the traumatic event

Avoidance

  • Going out of your way to avoid certain places that remind you of the trauma
  • Not accepting help from others
  • Staying away from people who remind you of the trauma
  • Ignoring memories or thoughts of the trauma
  • Pretending like the trauma never happened

Hypervigilance

  • Being overly jumpy or nervous
  • Not being able to concentrate
  • Practicing risky behaviors like drug or alcohol abuse
  • Insomnia or just not being able to stay asleep long
  • Constant anger or frustration
  • Taking your anger out on others
  • Feeling on edge or ready to explode

Mood and Cognition

  • Memory lapses or forgetting certain parts of the trauma
  • Thinking that your life is never going to get any better
  • Feeling like you may have caused the traumatic event
  • Constant feelings of fear, anger, and guilt
  • Not wanting to partake in activities you used to enjoy
  • Avoiding loved ones
  • Not being able to feel happy even when things are going well

If you are still not sure if you have PTSD, you can take a PTSD test online that can help you find out.

What is Depression?

Depression is another severe mental health disorder more common than PTSD. In fact, over 17 million people in the United States have had or has depression. Although it affects women more than men, it can happen to anyone of any gender, age, race, or culture.

Who Gets Depression?

It is common for those with depression to have another mental condition like an anxiety disorder, eating disorder, or PTSD. In fact, it is also common for those with physical ailments to develop depression. For instance, one in three people who have had a heart attack experience depression and one out of four with cancer have or had some type of depression. But it can also be a matter of:

  • Family history of mental illness
  • Alcohol or drug abuse
  • Those who are economically challenged
  • Victims of abuse or neglect
  • Those who have a history of mental illness

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What Are the Symptoms of Depression?

There are several types of depression and even though many of the symptoms are the same, there are a few distinct differences. However, the one that typically affects those with PTSD is chronic depressive disorder. Some of the most common symptoms of chronic depressive disorder include:

  • Feelings of sadness that lasts for over two weeks
  • Not being able to concentrate or having trouble making decisions
  • Memory lapses
  • Having feelings of hopelessness, shame, or low self-esteem
  • Chronic fatigue no matter how much you sleep
  • Sleeping more or less than usual
  • Eating more or less than usual
  • Gaining or losing weight
  • Moving or talking slower than usual
  • Not enjoying activities that you used to like
  • Avoiding friends and family
  • Thoughts of death or suicide

How Are PTSD and Depression Connected?

Experts believe that PTSD may be connected due to a chemical imbalance in the brain or genetics, but others claim that it is more likely a reaction to the traumatic event. For example, some people who live in an abusive household may get depression, others may have PTSD, while others could suffer from both. The two also share some of the same symptoms such as:

  • Sleep disturbances
  • Avoiding others
  • Lacking interest in favorite activities
  • Lack of concentration
  • Memory lapses

Getting Treatment

Because those with PTSD are three to five times more likely to end up with a depressive disorder, it is important for those with either of these illnesses to seek help right away. The therapist can determine whether you have just one or both by talking to you about your symptoms and background.

Treatment for both conditions can be addressed in the same manner by the same therapist in most cases. However, some of the treatments may be different. But the most common choice for both illnesses is talk therapy or psychotherapy. This includes different types of therapies including cognitive behavioral therapy, interpersonal therapy, and cognitive restructuring. You may also benefit from light therapy or exercise therapy.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy focuses on the link between your actions and your thoughts. Therapists guide you in understanding how your negative thoughts can lead to unhealthy behavior. With help from the therapist, you will acknowledge the negative thoughts that are causing your behaviors that can be unproductive or unhealthy. These may include:

  • Drinking alcohol
  • Using drugs
  • Smoking
  • Risky behavior

In addition, your therapist will help you respond to your negative thoughts with positive thoughts and behaviors. For example, if you make a mistake, you may learn to remind yourself that everyone makes mistakes. Positive thoughts can help shift your behaviors in the right direction.

Interpersonal Therapy

Because those who have both PTSD and depression tend to avoid friends and family as well as activities they once enjoyed, interpersonal therapy can help get you back out there. The therapist provides you with homework to help you feel comfortable around people again because we all need that support system to get better.

The therapy is usually less than 20 weeks, but it depends on the severity of your PTSD and depression. Some of the activities may include role-playing, journaling, positive thinking exercises, and group therapy. It is important for those who have been socially isolating themselves to reconnect with their loved ones for support and healing.

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Cognitive Restructuring

Similar to CBT, cognitive restructuring works on helping you alter your way of thinking. You will learn about some of the cognitive distortions you may be experiencing such as:

  • Personalizing
  • Negative predictions
  • Underestimating your coping mechanisms
  • Catastrophizing
  • Blaming others
  • Cognitive labeling
  • Delusions
  • Should haves and would haves
  • All or nothing thinking

The therapist may ask you to keep a journal of your daily thoughts and then go over them in a session once a week. This will help you realize how your negative thought patterns are affecting your life. Relaxation techniques and positive processing will likely be taught to help you manage your bad days. You may also be encouraged to practice mindfulness meditation or join a support group.

Light Therapy

Light therapy, also known as phototherapy, is a form of therapy that is typically used for seasonal affective disorder, but it can also help with the effects of PTSD. In this type of session, you would be exposed to an artificial light source by sitting near a lightbox that has between up to 10,000 lux. It is thought that the light increases the vitamin D in your body as well as the serotonin levels.

Exercise Therapy

One form of therapy that you can start today is exercise therapy. You do not need a therapist to do this, but it is best to work with one to practice other forms of therapy as well. Any kind of physical activity will work, but the therapist typically suggests taking walks outside in the sunlight to get the vitamin D and fresh air too.

If your PTSD has you cringing at the thought of being outside in any fashion, there are alternatives to any of these therapies. For example, all of the talk therapies can be done online with a licensed mental health professional. And exercise therapy can be doing some type of physical activity at home like dancing or doing chores. The first step is to talk to a professional so do that today.