After something terrible happens, it makes sense to feel on edge. But what if, months or years later, you also feel flat, hopeless and cut off from everything you used to care about? Many people living with PTSD also struggle with depression, and the two can feed each other. This guide explains why they overlap, how they feel different and what PTSD and depression treatment can look like when you're dealing with both.
This post is general information, not a diagnosis or a treatment plan.
Can you have PTSD and depression at the same time?
Yes, and it's very common. A 2013 meta-analysis by Rytwinski and colleagues in the Journal of Traumatic Stress, which pooled 57 studies, found that about half of people with current PTSD also had major depression.
That means if you're living with both, you're far from alone. It also means good care should look at both, rather than treating one and hoping the other sorts itself out.
Why PTSD and depression happen together
There's no single reason, but several things help explain why PTSD and depression happen together so often:
Shared symptoms. Both can involve trouble sleeping, poor concentration, irritability, guilt and losing interest in things you used to enjoy.
Avoidance. With PTSD, people often avoid reminders of what happened. Over time, avoiding people, places and activities can shrink your life and leave you feeling lonely and low.
Shame and self-blame. Many people blame themselves for what happened or for how they've reacted since. Those beliefs can sink into a deeper sense of worthlessness.
Exhaustion. Living on high alert is draining. When your body is always braced for danger, there's little energy left for anything else.
Loss. Trauma can bring real losses, like a relationship, a job, your health or your sense of safety in the world. Grief and depression often follow.
Whatever the path, the result is the same: each condition can make the other harder to shake.
How they feel different
PTSD and depression overlap, but they have different centres of gravity. In general terms:
PTSD tends to centre on the past breaking into the present: flashbacks, nightmares, intrusive memories, feeling jumpy and avoiding reminders.
Depression tends to centre on a heavy, persistent low: sadness or numbness, hopelessness, low energy and a sense that nothing will get better.
When you have both, you might swing between feeling on edge and feeling shut down, or feel both at once. This isn't a checklist for diagnosing yourself. A psychologist can assess and diagnose these conditions if you need a formal diagnosis.
Signs it's time to reach out
You don't need to be sure what you're dealing with to ask for help. It may be time to talk to someone if:
memories, nightmares or feeling on guard are still affecting you weeks or months after an event
you feel low, numb or hopeless most days
you've stopped doing things you used to enjoy
you're pulling away from people or relying on alcohol or other substances to cope
sleep, work or relationships are suffering
If you're having thoughts of suicide, please go to the crisis information at the end of this post right away.
What a first session might look like
Your first session is mostly about getting to know you. Your therapist will ask how you've been feeling, what daily life looks like and what you'd like to change. You won't be asked to go into detail about what happened unless and until you're ready. Many people leave with a clearer sense of what's going on and one or two small things to try.
How therapy treats both
Treatment for PTSD and depression together usually happens in phases. The order and pace depend on you.
Stabilization first. Early sessions focus on building safety and steadiness, like grounding skills for flashbacks, routines that support sleep and small steps to reconnect with life. This can ease depression and make trauma work feel more manageable.
Working with the trauma. Once you feel steadier, you and your therapist may work directly with traumatic memories, so they lose some of their power.
Rebuilding. As symptoms ease, therapy can focus on reconnecting with people, goals and activities that matter to you.
Many people find that as trauma symptoms ease, their mood lifts too. Others need extra focus on depression along the way, such as working with harsh self-talk or gradually rebuilding daily activities. Good PTSD depression treatment pays attention to both. Our post on what treatments work for PTSD explains the evidence behind trauma approaches.
Approaches we use
According to the World Health Organization, the psychological treatments with the most evidence for PTSD are trauma-focused CBT and EMDR. Our therapists use a range of approaches, including:
EMDR. Helps your brain process memories that feel stuck, using bilateral stimulation like eye movements or taps. You don't have to describe every detail out loud.
CBT. Helps you notice and shift the thoughts and patterns that keep both trauma symptoms and low mood going.
Internal Family Systems (IFS). Works with the different "parts" of you, which can be especially helpful for childhood or long-standing trauma.
Somatic-informed work. Pays attention to how trauma and depression show up in the body.
If your trauma happened over a long period or started early in life, our post on complex PTSD treatment may be helpful too.
Everyday coping alongside therapy
Therapy does the heavy lifting, but small daily habits can support your progress:
Keep a simple routine. Regular times for waking, eating and sleeping can help both mood and nervous system.
Move your body gently. A short walk or stretching can ease tension and lift mood a little.
Use grounding when memories hit. Name five things you can see, press your feet into the floor or hold something cold.
Stay connected. Even brief contact with someone you trust can counter the pull to withdraw.
Be patient with yourself. Progress isn't a straight line, and hard days don't erase good ones.
For partners and family
When someone you love has PTSD and depression, it can be confusing and painful. They may seem distant, irritable or uninterested, and you may wonder whether it's something you did. Usually, it isn't.
Try to offer steady, low-pressure support. Ask how you can help, respect their need for space and encourage them to get support without pushing. Your own well-being matters too. Individual sessions can help you cope, and couples sessions can help when the relationship is under strain.
Finding a therapist for trauma and depression
If you've been searching for a therapist for PTSD and depression near me, or a therapist for trauma and depression near me, we offer sessions in person in Waterloo, Kitchener, Cambridge and Ottawa, and online anywhere in Ontario on a secure, encrypted video platform. When you book, let our admin team know you're looking for help with both trauma and depression, and they'll match you with a therapist who works with both.
Trauma depression treatment takes time, and you set the pace.
Cost and billing
Here's what to know about cost:
Sessions with our therapists range from $130 to $200, depending on the clinician. Couples sessions range from $170 to $200.
Depending on your plan, insurance may cover some or all of the cost. Coverage varies, so it's worth checking your plan.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers, including for sessions with a Registered Psychotherapist (Qualifying). Desjardins is the exception: through TELUS eClaims, we can direct bill Desjardins for sessions with an RSW, RP or psychologist, but not for an RP (Qualifying).
Your first step
Book a free 15-minute consultation with our admin team. You don't need to describe what happened. Just let them know you're looking for support with trauma and low mood, and whether you'd prefer in-person or online sessions.
If you're in crisis: call 911 if you or someone else is in immediate danger. If you're having thoughts of suicide, call or text 9-8-8 any time, day or night. You can find more options on our crisis lines page.
Living with both PTSD and depression is heavy. With the right support, it can get lighter.