I was recently in a discussion regarding co-occurring conditions and it suddenly occurred to be that there is an un-stated or unwritten implication that many of the issues we refer to as comorbid or co-occurring are not really "co" occurring (as occurring with), but rather they are occurring over or around the underlying neurological issues.

This layering is like that of an onion with the co-occurring issues acting like a shell or filter through which the underlying personality or neurological issues are accessed or viewed.

Notice that we're separating PTSD and Anxiety/Depression from Fear, Anger, Sadness and Guilt.

The reason for this distinction is that in this context, Fear, Anger, Sadness and Guilt are 'direct experience emotions'. That is they are emotions that are the direct result of a current situation or past experience.

This correlation typically makes these emotions easier to address. If you address the causal event, you typically address the resulting emotion.

On the other hand, Anxiety and Depression are what we typically refer to as indirect or 'meta-emotions'. You might say these two emotions are in a class by themselves.

Generally speaking, Anxiety and Depression are not neurologically based. While there are persons suffering from Anxiety or Depression resulting from some form of chemical imbalance, for most persons, Anxiety and Depression are the result of long-term, chronic stress or sadness.

Unfortunately, this makes Anxiety and Depression more difficult to address as there is typically no specific causal event or issue that when addressed will release the subsequent emotions.

Also, because these emotional responses have 'generalized' and become part of the person's apparent personality, the feelings of Anxiety and Depression are no longer 'triggered' by any specific event(s), they are always present, sometimes in the background, sometimes "in your face", but always there.

PTSD is also an emotional response derived from a past event (or events) that is triggered in the present. PTSD responses can be triggered by specific events or they can be generalized to include Anxiety and Depression.