PTSD And Depression Comorbidity Increase Risk Of Mortality In Women

PTSD And Depression Comorbidity Increase Risk Of Mortality In Women

POST-TRAUMATIC STRESS DISORDER and major depression comorbidity is linked to psychobiological changes in women that can lead to chronic disease and death. When these two conditions occur in tandem, a comprehensive approach to treatment must be taken to counteract their dangerous and complex emotional, psychological, and physical impact.

This article discusses:

Increased Mortality In Women With PTSD and Depression

A new study shows that post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) comorbidity can lead to physiological changes that cause serious illness and mortality in women.

An estimated 50% of women with PTSD also suffer from MDD. 1 out of every 2 women with this dual diagnosis have an increased risk of mortality.

A study of over 50,000 women were was conducted over 9 years period showed that women who suffer from symptoms of post-traumatic stress disorder (PTSD) and depression have more than twice as likely to die from complications compared to women who had not experienced trauma or depression.

Furthermore, research suggests that the biological impact of PTSD and MDD comorbidity may represent a subtype of PTSD.

Adverse Childhood Experiences Linked To Inflammation In The Body

Adverse childhood experiences (ACEs) are linked to an increased risk of developing PTSD in adulthood. The psychobiology of ACEs can make some adults predisposed to inflammation in the body, putting them at greater risk for certain health conditions.

PTSD Connected To Metabolic Dysfunction

PTSD is linked to physiological changes associated with metabolic dysfunction connected with the development of various diseases, specifically:

  • Changes in hypothalamic-pituitary-adrenal–axis
  • Immune system dysfunction
  • Oxidative stress
  • Sleep disturbances, and
  • Premature aging.

Researchers theorize that an increased discharge of cortisol by the hypothalamic-pituitary-adrenal axis in tandem with disruptions in the sympathetic nervous system can lead to irregularities in neurological and metabolic functioning.

Health Conditions Linked To PTSD

Numerous studies have shown that PTSD is linked to a range of adverse health outcomes, including:

  • Hypertension
  • Cardiovascular Disease
  • Metabolic Syndrome
  • Type 2 Diabetes
  • Obesity
  • Substance Use Disorders

PTSD and Depression Increase Risk of Suicide

Another health risk for women who experience PTSD and MDD is suicide. A 2009 study from Florida State University showed that women who experience both disorders are at greater risk for suicidal ideation and death by suicide.

Prevention Of Health Risks Associated With PTSD and Depression

It is imperative that women with PTSD and depression implement lifestyle changes to decrease the risk of mortality associated with their condition. Some effective actions include:

  • Regular exercise
  • Weight management
  • Smoking abstinence
  • Companionship


1 out of ever 2 women who suffer from cooccurring PTSD and MDD can experience psychobiological changes that cause 380% increase of death. Adverse childhood experiences can lead to inflammation in the body, which makes some people predisposed to illness and disease later in life. PTSD can cause metabolic dysfunction and systemic changes that lead to serious health conditions. Lifestyle changes are an important part of treatment.


  1. Roberts AL, Kubzansky LD, Chibnik LB, Rimm EB, Koenen KC. Association of Posttraumatic Stress and Depressive Symptoms With Mortality in WomenJAMA Netw Open. 2020;3(12):e2027935. doi:10.1001/jamanetworkopen.2020.27935
  2. Flory JD, Yehuda R. Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations. Dialogues Clin Neurosci. 2015 Jun;17(2):141-50. doi: 10.31887/DCNS.2015.17.2/jflory. PMID: 26246789; PMCID: PMC4518698
  3. Masodkar K, Johnson J, Peterson MJ. A Review of Posttraumatic Stress Disorder and Obesity: Exploring the Link. Prim Care Companion CNS Disord. 2016 Jan 7;18(1):10.4088/PCC.15r01848. doi: 10.4088/PCC.15r01848. PMID: 27247845; PMCID: PMC4874765.
  4. Farr OM, Sloan DM, Keane TM, Mantzoros CS. Stress- and PTSD-associated obesity and metabolic dysfunction: a growing problem requiring further research and novel treatments. Metabolism. 2014 Dec;63(12):1463-8. doi: 10.1016/j.metabol.2014.08.009. Epub 2014 Aug 28. PMID: 25267015; PMCID: PMC4459590.
  5. Brown, P. J., Stout, R. L., & Mueller, T. (1999). Substance use disorder and posttraumatic stress disorder comorbidity: Addiction and psychiatric treatment rates. Psychology of Addictive Behaviors, 13(2), 115–122.
  6. Cougle JR, Resnick H, Kilpatrick DG. PTSD, depression, and their comorbidity in relation to suicidality: cross-sectional and prospective analyses of a national probability sample of women. Depress Anxiety. 2009;26(12):1151-7. doi: 10.1002/da.20621. PMID: 19842171.

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      What Is Parental Alienation Syndrome?

      parental alienation syndrome

      The controversial theory of parental alienation syndrome (PAS) was conceptualized in the 1980s by clinical psychologist Richard A. Gardener, who defined it as follows:

      “The parental alienation syndrome is a childhood disorder that arises almost exclusively in the context of child-custody disputes. Its primary manifestation is the child’s campaign of denigration against a parent, a campaign that has no justification. It results from the combination of a programming or brainwashing parent’s indoctrination and the child’s own contributions to the vilification of the target parent.”

      The American Psychological Association rejects parental alienation syndrome as a legitimate diagnosis. It is not included in two important books that mental health professionals use to diagnose psychological issues. These books are the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) and the International Classification of Diseases, Eleventh Edition (ICD-11). Studies have shown that the theory behind this diagnosis is not true and it is not supported by science.

      Why is Parental Alienation A Rejected Theory?

      The American Bar Association published an article clearly stating, “there remains no test, no data, or any experiment to support claims made concerning PAS. Because of this lack of scientific credibility, many organizations—scientific, medical, and legal—continue to reject its use and acceptance.”

      It included reports from the Presidential Task Force of the American Psychological Association on Violence in the Family, The National Council of Juvenile and Family Court Judges (NCJFCJ), The American Prosecutors’ Research Institute and the National District Attorney’s Association.

      For several decades, parental alienation has repeated failed to stand the test of scientific scrutiny.

      Child Withdrawal Is A Relationship Issue Not A Pathology

      One of the reasons the theory of parental alienation syndrome is considered problematic is because it pathologizes children who have relational issues with a parent. Relationship breakdowns are not necessarily indicative of psychological disorders. In order words, withdrawing from a relationship with a parent may occur without any impairment of a child’s healthy psychological functioning. Moreover, mental health treatment is not always a prerequisite for resolving the issue of a child’s withdrawal from a parent.

      As painful as the situation is, it can be helpful to develop an understand of the child’s perspective. Parent-child attachment specialist Dr. Michael Kinsey, explains, “If a child is forced to choose, they might choose the person that they feel they are most like or they’ll also choose the person who they feel is safer or who they feel is the more desirable one to follow. In the case of the kind of scenario you’re discussing, it’s really a matter of survival.” Being in the ‘in-group’ of the narcissist is so essential to survival.”

      It can also help to read evidence-based research into the some of the reasons why some children withdraw from parents in high-conflict relationships.


      Many people searching for answers to an excruciatingly painful question relate to the theory of parental alienation syndrome. It can resonate deeply with parents who are grieving the absence of a beloved child. However, attributing the child’s withdrawal to a discredited mental health construct will not solve the problem. Children do not have to be afflicted with cognitive, affective, or behavioral problems in order to distance themselves from a parent. There are many reasons why a perfectly healthy child might take such a painful decision that merit further exploration.


      • Gardner, Richard A. “Recent trends in divorce and custody litigation.” In Academy forum, vol. 29, no. 2, pp. 3-7. 1985.
      • Thomas, R.M., Richardson, J.T. (2015, July 1) “Parental Alienation Syndrome: 30 Years On and Still Junk Science,” American Bar Association.
      • Vilalta, R., Winberg Nodal, M. “On The Myth of Parental Alienation Syndrome (PAS) and the DSM-5,” Psychologist Papers, 2017. Vol. 38(3), pp. 224-231.

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      7 Ways to Fight Mental Health Stigma

      man looking left side

      WHILE THE TOPIC of mental health is more widely discussed now than in the past, people experiencing loneliness, depression, anxiety, isolation, and hopelessness often feel judged by others. Unfortunately mental health challenges are as stigmatized now as ever and the consequence is that people who need support are reluctant to reach out for help. As the Chief Executive Officer of Orange County Rehab, part of my work is teaching people how to overcome misconceptions about mental health so that they can get the treatment they need and recover. If this resonates with your experience, here are 7 ways to fight mental health stigma.

      1. Seek medical help

      Most importantly, you should seek medical attention just as you would if you had a broken limb or were unwell, don’t allow the fear of being diagnosed with a mental health condition keep you or your loved ones from seeking treatment. Treatment is essential to alleviating symptoms that interfere with one’s professional and personal life, as well as delivering relief. Remember to be kind and compassionate to yourself and others while you or they seek therapy. Take courage and remember that you and your loved ones are worth it.

      2. Don’t buy into the stigma

      Your belief that you or the individual who is suffering from mental illness should be able to manage their condition on your own is a common misconception. As a result of these views, you may treat yourself or others with more harshness. It is important to seek care and support from those with mental illness to obtain a sense of self-worth, perspective and to overcome harmful judgement. As one realises, they aren’t the only one struggling in a certain area, they might begin to understand that they aren’t alone. Seeking assistance is a need.

      3. Educate yourself and others

      You can only be as powerful as the information you have. Learn as much as you can about your mental health condition, including its signs and symptoms, as well as its causes and remedies. The first step in obtaining the correct therapy for mental well-being is to be educated. Be willing to help people understand that mental health issues are medical conditions that can be treated in the same way that physical ailments are. To dispel some of the myths and misconceptions about mental health diagnoses, provide them with accurate facts.

      People are more inclined to change their attitudes about mental health conditions when they have a better understanding of what they are. Remember not to expect folks to immediately grasp what you’re saying. Stigma is a long-term process. As you go through this process, be kind to yourself and others. It is also possible that family therapy might be beneficial, since it provides a neutral setting in which to address hurdles and roadblocks.

      4. Choose your words carefully

      A mental health diagnosis remains a part of our identity as long as we meet the criteria. Words have the potential to do harm and it is important to be mindful about the language we use to described mental health matters. Practice compassion and keep in mind that each of us has a unique personality that consists of many distinct features.

      5. Join a support group

      Don’t isolate yourself. No one can assist if you are secretive about your mental health condition. You may find a wide range of activities and services from local and national support organizations. People with mental health issues, family members, friends, and the places they live in may all benefit from these organizations’ efforts to remove stigma and empower those who suffer. A good place to start is the National Alliance on Mental Illness (NAMI) or the Department of Veterans Affairs (if applicable). See what programs are available in your area or online.

      6. Empowerment over shame is the way to go

      If you’re going through a rough patch, don’t let anybody tell you otherwise. Honor and own
      your experience. While maintaining healthy boundaries, encourage individuals in need of assistance, hold space for their stories, and provide words of encouragement. Honesty is the best policy when it comes to dealing with those around you.

      Final thoughts

      Remember that there is more to who you are than a mental health diagnosis. As you share your story and interact with others, remember the full spectrum of who you are and recognize your abilities, talents, and goals. If a loved one is suffering from mental health issues, be sure to do the same for them. How you engage with others may have a significant impact on people’s perceptions of you and your mental health condition. Treat yourself and others around you with compassion. Acceptance is a process that requires time, effort, and patience.

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      Honoring Men’s Mental Health

      Men's Mental Health | Narcissistic Abuse Rehab

      Our theme for the month of November is Men’s Mental Health and Suicide Awareness. Narcissistic Abuse Rehab will be using our platform to raise awareness on these critical issues.

      Men often neglect their mental health

      Social pressure on men and boys to conform to traditional gender roles can place a heavy burden on men’s mental health. Physical strength, stoicism, dominance and controlling behaviors are rewarded. However, they can also have serious consequences for the wellbeing of men and boys. 

      Time and time again men and boys are often punished for showing emotion which can cause some to emotionally shut down. Because of this, it can be difficult for men and boys to recognize when they are in emotional distress. Ultimately, many men and boys don’t seek support until their problems have become a crisis. Many men and boys neglect their mental health.

      Recognizing male survivors of domestic abuse

      In cases of domestic abuse, men and boys are often unable to conceive of themselves as victims due to stereotypes of abusers being male and victims being female. The reality is that current research shows that 1 in 7 survivors of domestic abuse is male

      Men and boys are less likely to seek support when they are experiencing domestic abuse, including narcissistic abuse by a family member, peer or employer.

      4 of 5 suicides are men and boys

      A staggering 4 out of 5 suicides are men and boys who take their lives, mainly due to relationship problems. According to the Office for National Statistics suicide is the biggest killer of men and boys under 45 years old in the U.K. For men over 45, suicide is second only to drug overdoses as the top killer.

      Men and boys are facing a mental health crisis. This is why it’s critical to spread awareness about men’s mental health issues and options.

      Our goal this month is to highlight some of the issues that are causing mental distress in men and boys and where they can turn for support in order to restore their sense of wellbeing.

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