Common Types of PTSD Comorbidities

Common psychiatric disorders comorbid with PTSD

Verywell / Jiaqi Zhou

Comorbidities in post-traumatic stress disorder (PTSD) are common and expected as they occur in approximately 78.5% of cases. If you’ve experienced a traumatic event or experience, such as a natural disaster, car accident, violence, serious illness, abuse, physical injury, or the death of a loved one, then you may be at risk of developing PTSD and other psychiatric disorders

PTSD is the most prevalent psychiatric disorder in trauma-related populations and is often diagnosed alongside other mental health disorders such as anxiety, depression, and substance use disorder. It can develop at any time but is often associated with at-risk populations such as children, veterans, and others who have experienced repeated violence or trauma. Early identification, diagnosis, and intervention are crucial to treating comorbid disorders properly.

If you’re suffering from a comorbid disorder, you’re not alone. Learn more about PTSD and what other disorders are most often connected.

Comorbidity and PTSD 

PTSD often occurs after a traumatic event. This traumatic event (or series of events) can cause physical and emotional harm to the individual, leading to a number of different symptoms. In addition to PTSD, you may experience chronic pain, a physical disability, an eating disorder, an alcohol addiction, or another condition. It can be challenging to diagnose comorbid disorders because symptoms often overlap.

Some common symptoms of PTSD include:

  • Flashbacks
  • Intrusive thoughts
  • Avoidance
  • Nightmares of the event
  • Difficulty concentrating
  • Changes in sleep patterns
  • Irritability, anger, or aggression
  • Risky or destructive behavior 
  • Negative thoughts
  • Feelings of social isolation
  • Loss of interest in activities you previously enjoyed

Many of these symptoms are present in anxiety disorder, major depression disorder, and other mental health disorders, which is why it’s so important to get a proper diagnosis. If you’ve experienced trauma, you’ll want to address your symptoms with a mental health professional who can help you understand what you’re feeling and how to treat it. You may be battling one or more mental health conditions that would require a more tailored treatment plan. 

Common Psychiatric Disorders Comorbid with PTSD 

Trauma can have a lasting impact on your mental health, even if it doesn’t cause PTSD. Simply reflecting on an event can make you stressed, anxious, or fearful. While this is normal, it shouldn’t affect your daily life. If, however, your symptoms worsen or cause a change in mood, behavior, or lifestyle, then you should visit a therapist or professional to uncover the underlying cause. 

If you’re experiencing PTSD and another condition, then you have a comorbidity, which needs to be diagnosed and treated. Here are some of the most common comorbid disorders in individuals with PTSD:

PTSD and Anxiety

PTSD, previously considered an anxiety disorder, often develops alongside a generalized anxiety disorder. It can lead to other disorders, such as panic disorder, social anxiety disorder, or obsessive-compulsive disorder. You may also develop phobias and overlapping anxiety symptoms as a result of the trauma. For example, if you were in a significant car accident, you may develop a fear of driving or accidents and thus avoid driving or traveling in cars.

While anxiety itself is normal, it should not affect your ability to function in daily life. If it does, you should visit a mental health professional.

PTSD and Depression

Among those diagnosed with PTSD, up to 48% develop major depression. Depression, like anxiety, is a common mental health condition that affects millions of Americans every year. If you have PTSD, you likely have symptoms that overlap with those of clinical depression. PTSD and depression are commonly linked, especially in trauma-impacted populations.

The problem is that together they cause greater impairment, lead to higher levels of distress, and put individuals at a greater risk for suicide.

PTSD and Alcohol Use Disorder (AUD)

If you’re experiencing nightmares, flashbacks, or other negative thoughts associated with your trauma, you may find yourself drinking alcohol to cope. While this can offer temporary relief, it is going to cause greater mental health issues and exacerbate existing symptoms.

Unfortunately, alcohol use is common among those who experience trauma and often leads to problematic drinking. Treating PTSD and AUD is challenging, and a health professional may advise you to stop drinking before beginning your PTSD treatment.

PTSD and Substance Use Disorder (SUD)

To treat the symptoms of PTSD, some people use drugs to self-medicate. This can quickly turn into an addiction. The severity of an addiction may be correlated to the severity of trauma. When battling a comorbid PTSD and drug use disorder, you face a significant risk of social and psychiatric impairment, but treating the underlying trauma and PTSD can be difficult, if not possible, if you don’t first address the substance use disorder. Medications for PTSD, for example, would not be advised for those battling a SUD.

PTSD and Disruptive Behaviors

An often overlooked connection is that between PTSD and disruptive behaviors. People that present with disruptive behaviors or have disruptive behavior disorders almost always have a history of trauma and often meet the criteria for PTSD. Disruptive behavior disorders include oppositional defiant disorder (ODD) and conduct disorder.

Treatment for PTSD

When treating PTSD, it’s important to address the underlying trauma, as well as the symptoms associated with your diagnosed conditions. Trauma can have significant long-term effects and lead to depression, panic disorder, suicidal thoughts, and other mental health issues. 

Your treatment should be tailored to your specific needs, as each condition requires a different plan and coping strategy. If you’ve been diagnosed with PTSD and another condition, a health professional may treat you with therapy, medication, or a combination. Some common treatments involve:

When treating PTSD and another condition, you want to make sure that medications and therapies don’t interact negatively or worsen symptoms. Certain combinations are being studied and researched to help advance the treatment of comorbid disorders, but each case should be evaluated and treated individually.

A Word From Verywell Mind

Far too many cases of PTSD go undiagnosed or untreated. There is no cure for PTSD, but symptoms can be treated and managed. Following a traumatic event, visit a therapist or another mental health professional to discuss your mental health needs. Even if you’re experiencing symptoms years later, you can still get help. Just remember, recovery takes time. 

If you or a loved one are struggling with PTSD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

11 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Qassem T, Aly-ElGabry D, Alzarouni A, Abdel-Aziz K, Arnone D. Psychiatric co-morbidities in post-traumatic stress disorder: detailed findings from the adult psychiatric morbidity survey in the english populationPsychiatr Q. 2021;92(1):321-330.

  2. Post-traumatic stress disorder. 2020. National Institute of Mental Health (NIMH).

  3. Division (DCD) DC. What are the five major types of anxiety disorders? February 2014. HHS.gov.

  4. Qassem T, Aly-ElGabry D, Alzarouni A, Abdel-Aziz K, Arnone D. Psychiatric co-morbidities in post-traumatic stress disorder: detailed findings from the adult psychiatric morbidity survey in the english populationPsychiatr Q. 2021;92(1):321-330. doi:10.1007/s11126-020-09797-4

  5. Flory JD, Yehuda R. Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerationsDialogues Clin Neurosci. 2015;17(2):141-150. doi:10.31887/DCNS.2015.17.2/jflory

  6. Tripp, J. C., Worley, M. J., Straus, E., Angkaw, A. C., Trim, R. S., & Norman, S. B. (2020). Bidirectional relationship of posttraumatic stress disorder (PTSD) symptom severity and alcohol use over the course of integrated treatmentPsychology of Addictive Behaviors, 34(4), 506–511. doi:10.1037/adb0000564

  7. Simpson TL, Rise P, Browne KC, Lehavot K, Kaysen D. Clinical presentations, social functioning, and treatment receipt among individuals with comorbid life‐time PTSD and alcohol use disorders versus drug use disorders: findings from NESARC‐III. Addiction. 2019;114(6):983-993. doi:10.1111/add.14565

  8. Mikolajewski AJ, Scheeringa MS. Links between oppositional defiant disorder dimensions, psychophysiology, and interpersonal versus non-interpersonal trauma. J Psychopathol Behav Assess. Published online September 15, 2021. doi:10.1007/s10862-021-09930-y

  9. Post-traumatic stress disorder. 2020. National Institute of Mental Health (NIMH).

  10. Ptsd facts & treatment. June 2021. anxiety and depression association of america, adaa.

  11. Pharmacological treatment of comorbid PTSD and substance use disorder: Recent progress. Addictive Behaviors. 2014;39(2):428-433.

By Sarah Sheppard
Sarah Sheppard is a writer, editor, ghostwriter, writing instructor, and advocate for mental health, women's issues, and more.