Spouses Want to Know: PTSD vs. Depression

Today’s spouse question is: “My husband went in to see the psychologist to see if he had PTSD and the answer was ‘nope, but you are in a major depression.’ He doesn’t seem depressed, but his character has DEFINITELY changed over the last few years. Can it be one and the same?”

This is a really important question. New research suggests that depression in men is not very well understood. This means that men who are depressed may not “seem depressed”.

We tend to think of “depressed” as basically meaning the same as “sad”, along with feelings such as guilt, shame, and worthlessness. But women may find it easier to acknowledge these feelings; new, gender-specific studies suggest that when guys feel depressed, they’re more likely to get mad about how they’re feeling. They can get irritable, angry and more aggressive; they can show risk-taking behaviour that’s out of character for them; and they can try to numb out their feelings by throwing themselves into their work, or developing other addictions, like drinking, drugs, gambling, or sex.

What makes it more tricky to diagnose is that PTSD and depression often happen together. As if that isn’t complicated enough, addictions can be pretty common with PTSD too. But, what makes PTSD unique is that it typically also involves symptoms of re-experiencing trauma (either through nightmares or unpleasant memories that can’t be controlled), as well as symptoms of avoidance (avoiding stuff that reminds them of the traumatic things that happened).

If that sounds about as clear as mud, then I have one more important word of caution: diagnosing a mental health condition is not like repainting your bathroom – you can’t just read up online, figure it looks easy enough, and decide to wing it by yourself. Seriously; I don’t like to throw this around, but geeks like me spend a few years in school learning to do this…

If you are working with a professional, please share whatever relevant information that you can with them, and then trust them to do the diagnosing for you.

I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.


*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.


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2 thoughts on “Spouses Want to Know: PTSD vs. Depression

  1. Hi Dee
    I know you want us to say we aren’t fine and tell you everything. We have enough problem telling people we know and love our true feelings so you or other psychologists have to be somewhat patient and give us the time we need to learn to trust you.

    1. Hi John!

      That is an excellent point; I really could have worded that better in the blog post, and I appreciate you giving me a chance to clarify.

      I certainly don’t expect that a new patient, just coming in, will tell me everything – they don’t know me yet, they have no reason to trust me yet, and some of the stuff is too painful for them to even think about, never mind to talk to a stranger about.

      A skilled clinician will know this, and will handle this with sensitivity. They should start with easy questions, and ask difficult questions slowly, gently, and stop when it’s clear that it’s getting really hard for you. What I need you to do, as the patient, is to tell me that you can’t talk about it yet if I ask a question that hits too close to home. Sometimes, it’s easier to lie through your teeth and say, “Nope, I don’t have that, I’m all good.”

      I can take better care of you if we work together to develop an accurate diagnosis slowly over time, than if we end up with the wrong diagnosis because it’s easier to pretend that everything is hunky-dory.

      I hope that makes sense to you.

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