What You Should Know About PTSD and Depression

It's not uncommon for patients to have dual diagnoses

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A diagnosis of PTSD and depression commonly co-occur. If you've received a dual diagnosis, learn why the conditions may be related. Does having one disorder make you susceptible to developing both?

What Is Depression?

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 a person's life.

The following symptoms of depression (also called a major depressive episode) are described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV):

  • Depressed mood for almost every day and for the majority of the day.
  • Loss of interest or pleasure in activities.
  • Considerable weight loss or weight gain.
  • Difficulties falling asleep or sleeping too much.
  • Feeling constantly on edge, restless or lethargic, and "slowed down."
  • Feeling worthless and/or guilty.
  • Difficulties concentrating and/or making decisions.
  • Thoughts of ending one's own life.

According to the DSM-IV, to be diagnosed with a major depressive episode, a person must experience five of these symptoms within the same two-week period (or longer).

How Often Do PTSD and Depression Coincide?

Depression is one of the most commonly 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 percent also experienced current or previous depression.

People who have had PTSD at some point in their lives are almost seven times as likely as people without PTSD to also have depression. Another study found that 44.5 percent of people with PTSD one month after experiencing a traumatic event had a depression diagnosis too.

How Are PTSD and Depression Connected?

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

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 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 is easy to see how experiencing these symptoms of PTSD may make someone feel very sad, lonely, and depressed.

A final possibility is that there is some kind of genetic factor involved in the development of both PTSD and depression.

Getting Treatment

If you have PTSD, it is important to seek treatment as soon as possible. The sooner you address your PTSD symptoms, the less likely they will become worse and increase your risk for depression.

If you currently have PTSD and depression, it is still important to get treatment as soon as possible. Each disorder may make the other worse. PTSD and depression are commonly co-occurring mental disorders.

Therefore, 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 good in treating PTSD and depression.

Sources

Breslau, N. (2002). Epidemiologic studies of trauma, posttraumatic stress disorder, and other psychiatric disorders. Canadian Journal of Psychiatry, 47, 923-929.

Breslau, N., Davis, G.C., Peterson, E.L., & Schultz, L. (1997). Psychiatric sequelae of posttraumatic stress disorder in women. Archives of General Psychiatry, 54, 81-87.

Jakupcak, M., Roberts, L.J., Martell, C., Mulick, P., Michael, S., Reed, R. et al. (2006). A pilot study of behavioral activation for veterans with posttraumatic stress disorder. Journal of Traumatic Stress, 19, 387-391.

Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C.B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048-1060.

Shalev, A.Y., Freedman, S., Peri, T., Brandes, D., Sahar, T., Orr, S.P., & Pitman, R.K. (1998). Prospective study of posttraumatic stress disorder and depression following trauma. American Journal of Psychiatry, 155, 630-637.

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