Can You Have Both Post-Traumatic Stress Disorder (PTSD) And Depression?

Can you have post-traumatic stress disorder and be depressed at the same time? You bet! Research shows, in fact, that around half of all PTSD sufferers also have major depressive disorder — meaning this combo isn't just possible, but in fact extremely common. Some even suggest that combined depression and PTSD should be recognized as a subtype of post-traumatic stress disorder. 

PTSD vs depression: A symptom refresher

Some of the possible symptoms of post-traumatic stress disorder and major depressive disorder (or just "clinical depression" or "depression") definitely overlap. 

Someone who is diagnosed with PTSD will, according to the fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5):

• Have experienced or witnessed trauma or have greatly been impacted by others' traumatic experiences — this later category covers, for instance, people who suddenly lost a relative in a tragic and horrid car accident, or first responders who are constantly exposed to others' traumas, including witnessing gruesome scenes. 
• Suffer from at least one "intrusion" or "reexperiencing" symptom — these include flashbacks, intrusive memories, nightmares, and physical and mental reactions on being reminded of an aspect of the trauma. 
• Take persistent conscious or subconscious steps to avoid reminders of the trauma — avoiding people, places, events, circumstances, and anything else that could confront them with the past, or seek to suppress painful memories and feelings. 
• Experience negative changes in mood and thought — this can include anything from large memory gaps to feelings of worthlessness and guilt, negative feelings and thoughts about the world and the people in it, feelings of fear and anger, and a chronic inability to feel positive emotions. You'll see a large overlap with depression here. 
• Be plagued by hyperarousal symptoms like hypervigilance, a startle response that's "on steroids", dysfunctional sleep, trouble concentrating, and aggressive or angry outbursts. Trouble concentrating is often seen in depression, too, as is abnormal sleep patterns. 

While PTSD is a strictly trauma-related anxiety disorder, anyone, of any age and in any circumstances, can become clinically depressed. To be diagnosed, they'll have at least five of these symptoms over a minimum period of two weeks, and they'll greatly interfere with the person's life:

• A depressed mood — feeling sad, hopeless, empty, down, helpless, tearful, or in young people, also irritable. 
• Loss of interest in activities that previously seemed meaningful. 
• Significant spontaneous weight loss or gain, a result of an appetite decreased or increase. 
• Trouble sleeping or sleeping too much. 
• A physical slowing down or speeding up that can be observed by other people, clinically known as psychomotor retardation or agitation. 
• Fatigue or loss of energy. 
• Feelings of worthlessness and inappropriate guilt — also, of course, common in PTSD.
• Trouble concentrating and indecisiveness — again, also seen in PTSD.
• Repeated thoughts of death and suicide. While not a feature of PTSD, as such, it isn't uncommon for people who have suffered trauma to feel like their lives won't last long, something called a "foreshortened future". 

What should you do if you have PTSD and believe you are also depressed?

PTSD and depression may share some common symptoms — and in this case, also a common underlying cause. They're still two distinct diagnoses with different treatment approaches, however. If you have some of the tell-tale symptoms that suggest an additional diagnosis of major depressive disorder may be warranted — like a loss of interest in daily activities, weight loss or gain, low energy, and suicidal feelings — let your treating psychologist or psychiatrist know right away. 

People who have gone through trauma and "acquired" post-traumatic stress disorder as a result are more likely to suffer from depression too if they have an "internalizing" personality of brooding on their state of mind in their heads rather than externalizing their feelings. Depression is also more common among those PTSD sufferers who had adverse childhood experiences. Even if you don't tick those boxes, however, you can still be depressed as well as having PTSD.