Is It PTSD or Something Else? 6 Conditions That May Occur With the Mental Health Condition
Updated on April 20, 2026
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Post-traumatic stress disorder (PTSD) can affect anyone who has experienced or witnessed a traumatic event or series of events, such as a natural disaster or long-term abuse.
PTSD often coexists with other mental health conditions. Up to 90 percent of people who have PTSD will experience at least one co-occurring psychiatric disorder, and two-thirds will have two or more.
These conditions can include substance use disorders and depression, among other illnesses. Sometimes these conditions are diagnosed before PTSD, sometimes after, with people unaware they have more than one condition, says Tara Emrani, MD, a clinical psychologist in New York City.
Here are six conditions that commonly co-occur with PTSD.
1. Substance Use Disorders (SUDs)
Addiction and PTSD are commonly linked. They’re bidirectional, meaning there are high rates of substance use disorder (SUD) with PTSD because PTSD is a risk factor for developing SUD, and SUD is a risk factor for developing PTSD after a trauma.
Overall, research suggests about 45 percent of people with PTSD meet the criteria for an SUD. SUDs stem from the recurrent use of alcohol or drugs despite negative consequences. These may be disruptions in relationships or at school or work, and may also include other health problems that result from using substances. Examples of common SUDs are alcohol use disorder, tobacco use disorder, and opioid use disorder. SUDs can range from mild to severe.
“When people with PTSD [turn] to alcohol use or [drug] use, they might be trying to numb themselves from their problems and their trauma,” Dr. Emrani says.
Feeling an urge to self-medicate with drugs or alcohol is a key sign of an SUD. Substance use often worsens PTSD symptoms in a number of ways:
- Interferes With Sleep People with PTSD may have sleep problems, so they may try to self-medicate with drugs or alcohol to help them sleep. However, self-medicating this way has the opposite effect: Drug and alcohol consumption can worsen sleep quality and exacerbate symptoms of PTSD.
- Alters Mood PTSD can make people feel emotionally cut off from others, depressed, hypervigilant, and irritable — all symptoms that can get worse with alcohol and drug use.
- Affects Concentration People with PTSD have difficulty concentrating, something that substance use can exacerbate.
- Perpetuates the Cycle of Avoidance Substance use can increase avoidance of your feelings, which is a symptom of PTSD.
Elspeth Cameron Ritchie, MD, MPH, a psychiatrist at MedStar Washington Hospital Center in Washington, DC, says that many of the military veterans with PTSD she has worked with over the years engage in marijuana and alcohol use with the hope that the substances will help them better deal with their trauma.
“A lot of them don’t know where to turn … [they] are just looking for an escape from these [traumatic] experiences,” says Dr. Ritchie, who retired from the U.S. Army in 2010 as a colonel and has been working with veterans and members of the military for the past three decades.
Contrary to popular belief, however, veterans experience PTSD at about the same rate overall as the general population — 7 percent and 6 percent of people in each group, respectively, will experience the condition in their lifetimes. But research also shows that veterans are 2 times more likely to have an alcohol use disorder than others with PTSD. They’re also 3 times more likely to have either a drug use disorder or tobacco use disorder.
Where can you find help if you’re dealing with both PTSD and an SUD? Ritchie says your primary care physician is a good person to start with. If they can’t assist you, they can at least point you in the direction of a specialist who can. You may also consider seeking guidance or advice from a therapist who treats SUDs or even a religious figure, like a chaplain, rabbi, or priest, whom you may regularly turn to for advice.
People generally have improved symptoms of both SUD and PTSD when the conditions are treated together. A good treatment plan may involve individual therapy or couples therapy with a partner, support groups like Alcoholics Anonymous, or medications that can help you manage both conditions.
Given how variable PTSD and SUD symptoms can be, be sure to consult your doctor about the best way to move forward with treatment.
2. Depression or Major Depressive Disorder
Depression and PTSD often occur simultaneously, with about 52 percent of people with PTSD also having major depressive disorder (MDD).
Depression is widespread. It’s more serious than just feeling down on one particular day — it’s persistent and interferes with daily functioning. Annually, this mental health condition affects an estimated 16 million American adults, and about 1 in 6 U.S. adults will experience depression at some point in their lifetime.
MDD, also known as clinical depression, can seriously impede your ability to function in everyday life. It’s a mood disorder that can show itself in the form of feelings of sadness and hopelessness, trouble sleeping, anxiety, or recurring thoughts of death and suicide, among other symptoms.
If you’re living with depression and PTSD, where do you turn? As with those dealing with SUDs, Ritchie says you need to be screened by your physician or another healthcare provider, like a psychiatrist or therapist, who can help identify the best treatment for you.
Treatment for PTSD and depression may be the same in some cases because symptoms overlap. Modalities include cognitive behavioral therapy (CBT), which helps people reorient previously negative styles of thought and action. It has been found effective treatment for both conditions. When it comes to medication, options to treat both include selective serotonin reuptake inhibitors (SSRIs).
3. Anxiety Disorders
PTSD used to be labeled an anxiety disorder, but the American Psychiatric Association reclassified the illness as a trauma- and stressor-related disorder in 2013.
Anxiety disorders involve excessive, intense, and persistent feelings of anxiousness that may worsen over time. As with other mental health disorders, once anxiety interferes with your daily life and ability to function, it’s time to seek medical attention.
Many types of anxiety disorders exist, including generalized anxiety disorder (GAD); panic disorder, which involves recurring and unexpected panic attacks with significant fear of them happening; and social anxiety disorder, which involves a distinct fear of certain social situations or fear of being rejected by or offending other people.
GAD is a common anxiety disorder, affecting about 5 percent of people in their lifetime. People who have this form of anxiety tend to feel excessive worry about everyday activities and events. If you have GAD, you may have difficulty controlling your anxieties, feel restless, experience headaches, or have difficulty sleeping. These concerns could be so consuming that they affect your ability to keep a job or manage your own health and well-being.
GAD is considered common among people with PTSD, according to research. Having the two conditions is associated with worse outcomes, a need for higher doses of psychiatric medication, more chronic symptoms with a lengthier recovery period, and a greater reduction in ability to function. GAD may also influence levels of avoidance, which can lead to both a lower likelihood of getting treatment in the first place and higher rates of discontinuing treatment.
“It’s important that these people [with PTSD and an anxiety disorder] discuss [it] with their medical team to seek out the treatment they need,” says Emrani.
Treatment for anxiety disorders can include:
- Psychotherapy, or “talk therapy,” which aims to help individuals reduce anxiety symptoms
- CBT, which is also helpful for depression
- Support groups
- Stress-management techniques, like exercise or meditation
Medications can’t cure anxiety disorders, but they can help alleviate symptoms. Some antidepressants, such as certain SSRIs, buspirone, and beta-blockers are some of those most commonly prescribed.
4. Neurocognitive Problems
Several neurocognitive problems, or issues with cognitive function, can co-occur with PTSD. This includes neurocognitive disorders, which can be caused by SUDs, traumatic brain injury, or other diseases.
Here’s a look at some of the ways PTSD and neurocognitive problems can go hand in hand.
Traumatic Brain Injury (TBI)
A traumatic brain injury (TBI) occurs from a blow or jolt, usually to the head, and is often linked to a psychologically traumatic event, like a car accident or a fall. A TBI’s level of impact can range from mild to severe. This type of injury may cause headaches, dizziness, issues with vision, memory lapses, difficulty staying focused, depression, and irritability and anxiety, among other symptoms.
“Traumatic brain injury and PTSD often exist in the same person, especially veterans,” Ritchie says. “TBI and PTSD are two of the signature wounds of war. Say someone is in a bomb blast. He or she could be dealing with a brain injury, as well as developing PTSD from the trauma of being in the explosion. Many of the symptoms of TBI are some of the same symptoms that you see from trauma itself. There is a big overlap.”
One study of 60 people found that PTSD symptoms in those with both TBI and PTSD are significantly more severe than they are in those with PTSD alone. More research is needed on larger populations to confirm these findings, however.
Neurocognitive Disorder (NCD)
This refers to a group of disorders that involve cognitive impairment. A TBI is not a neurocognitive disorder (NCD), but a TBI can cause one.
NCD can cause cognitive impairment that ranges from “mild to major.” Major cognitive impairment means involves significant cognitive decline and high impairment in your ability to function in your day-to-day life. Mild NCD involves cognitive problems that do not affect your ability to function if they’re accommodated.
While it used to be a separate diagnosis, the American Psychiatric Association folded dementia into NCD in 2013. The term “dementia” is still used in healthcare settings, however.
Research has found that PTSD is a risk factor for the later development of NCD. One research review found that people with PTSD had a dementia risk that was 1.6 times greater than people without the condition. But it’s still unclear how PTSD and NCD influence each other; more research is needed.
5. Borderline Personality Disorder (BPD)
Borderline personality disorder (BPD) is a mental health condition that affects emotional regulation abilities. If you have BPD, you may have moments when you experience intense and often uncontrollable feelings when an event triggers you. This can affect self-image and lead you to act impulsively, which can be disruptive to relationships.
BPD and PTSD can occur together. It’s believed that between 25 and 60 percent of people with BPD also have PTSD. The two conditions share some symptoms, including mood swings, emotional distress, and anxiety. BPD can be mistaken for PTSD, especially when childhood trauma is involved, and vice-versa. Self-harm is more common among people with BPD than PTSD. Triggers for BPD tend to be focused more on internal thoughts and emotions versus external triggers in PTSD.
Psychotherapy, particularly dialectical behavior therapy (DBT), can treat BPD. DBT focuses on developing skills including mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. DBT can also be effective for PTSD.
6. Other Physical Health Problems
People who experience childhood abuse, sexual assault, car accidents, combat trauma, and other forms of trauma that can lead to PTSD are more likely to self-report physical health problems than those without PTSD.
For instance, Ritchie says in war, the loss of a limb or another physical injury can lead to as many psychological effects as it does physical effects.
Often, injury leads to chronic pain. About 1 in 5 U.S. people experience chronic pain. But other times, chronic pain alongside PTSD isn’t clearly connected to the cause of PTSD.
Beyond chronic pain, PTSD can play a role in other physical conditions. An increased risk of cardiovascular disease has been connected to PTSD, including heart attacks, stroke, and coronary artery disease. Some research on cancer, autoimmune disease, and gastrointestinal disorders has also suggested people with PTSD may be more at risk, but evidence is conflicting or lacking. More research is needed on these conditions.
Resources We Trust
- Mayo Clinic: Post-Traumatic Stress Disorder (PTSD): Symptoms & Causes
- Cleveland Clinic: PTSD (Post-Traumatic Stress Disorder)
- American Psychiatric Association: What Is Posttraumatic Stress Disorder (PTSD)?
- Palo Alto University: Post-Traumatic Stress Disorder Comorbidity + Differential Diagnosis
- U.S. Department of Veterans Affairs: Trauma, PTSD, and Physical Health
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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