Understanding the Relationship Between Anxiety and Depression

Almost one in five adults has a mental illness in the U.S. Of these mental health conditions are depression and anxiety. They do share some similar symptoms. However, they are distinct in many ways. This article will explore the relationship between the two conditions and how to treat them. First, let’s look at the difference between anxiety and depression.

What is Anxiety?

Worry can be a normal reaction to stressful situations, but it may point to an anxiety disorder when it’s excessive or unfounded. An anxiety disorder is a mental health disorder involving overwhelming worry, fear, and unease. Having anxiety also involves anticipating future threats and worrying about what might happen.

People with anxiety disorder often have persistent thoughts about their well-being or those around them. They may feel excessively concerned about potential harm to themselves or others without adequate reason to warrant concern. In some cases, these worries may reach the point at which they interfere with day-to-day activities such as working or going to school.

Causes of Anxiety

There are many causes of anxiety, including:

• Genetics
• Past or childhood experiences
• Stress at work or school
• Brain chemistry
• Depression
• Sleep deprivation
• Unrealistic expectations or perfectionism
• Traumatic events, such as being in a car accident or experiencing a burglary

Types of Anxiety

There are several types of anxiety, including:

1. Generalized Anxiety Disorder:  The most common form of anxiety, which means you are greatly concerned about various situations. You may feel nervous or worried about many things, including work and school.
2. Panic Disorder: Involves having panic attacks, which are sudden feelings of terror that come on without warning and can last for several minutes or hours at a time.
3. Obsessive Compulsive Disorder (OCD): Characterized by repetitive thoughts and behaviors that interfere with daily life. People with OCD repeatedly perform certain rituals to reduce anxiety or fear.
4. Post-traumatic Stress Disorder PTSD: Causes a person to relive the traumatic event repeatedly, making them feel hypervigilant and afraid in typical situations.
5. Social Phobia/ Social Anxiety Disorder: Intense fear of negative judgment or scrutiny by others in social or performance situations. They tend to avoid such situations altogether because they feel too anxious to cope.

What is Depression?

Depression is a serious medical illness and mood disorder that negatively affects your feelings, thoughts, and behavior.

It’s not the same as being unhappy or in a blue mood. People with depression cannot merely “pull themselves together” and get better. It can interfere with their everyday lives, for example, their ability to work, study or carry out normal social activities. Without treatment, episodes of depression can last weeks, months, or years.

Causes of Depression

While there are many different types of depression and many different causes, these are some of the most common

• Chemical imbalance in the brain
• Lack of social support
• Persistent lack of sleep
• A traumatic experience
• Job loss or failure in school
• Serious illness or injury
• Loss of a loved one or a pet
• Genetics
• Chronic stress and anxiety
• Financial problems
• Substance abuse or dependence (e.g., alcohol or drug use)
• Some medical conditions may relate to depression, such as heart disease, Parkinson’s, and hormonal imbalances. 
• Some medications can also cause depression, as well as side effects that can mimic depressive symptoms. 

Types of Depression

There are different types of depression, and they can be categorized based on their severity, symptoms, duration, and causes. Here are some of the types of depression: 

1. Major Depressive Disorder (MDD): The most common and severe form of depression, major depression, can be disabling. It causes a persistent feeling of sadness and hopelessness
2. Persistent Depressive Disorder (Dysthymia): a low mood that is less severe than major depression but lasts for at least two years. 
3. Bipolar Disorder (Manic Depression): This involves extreme shifts in mood—from periods of mania to periods of depression—that can last for many days, even weeks, or months at a time.
4. Postpartum Depression (PPD): Typically occurs in the first year after childbirth. Hormonal changes often trigger it, but other factors such as stress, poor sleep habits, or family issues can also cause it. 
5. Premenstrual Dysphoric Disorder (PMDD): Some women experience severe emotional symptoms just before their periods each month, such as irritability, anxiety, anger, and physical symptoms like bloating or headaches.
6. Seasonal Affective Disorder (SAD): People with SAD feel depressed during the winter when there’s less sunlight.
7. Psychotic Depression: A major depressive disorder in which delusions or hallucinations are present during the illness. It’s a rare condition that typically requires hospitalization when first diagnosed.

Depression and Anxiety Symptoms

There can be an overlap of symptoms between anxiety and depression, so it may be difficult to determine which disorder a patient has. 

Overlapping Symptoms of Depression and Anxiety

Anxiety and depression share many symptoms in addition to their overlapping diagnoses. For example:

• Irritability
• Sleep issues
• Poor concentration and inability to make decisions
• Avoiding situations that require social interaction

Moreover, depression and anxiety disorders can make it difficult for people to experience positive emotions such as happiness, joy, or contentment. When combined with anxiety symptoms, depression symptoms can worsen and last longer than if they were experienced alone or vice versa.

The Link or Relationship Between Anxiety and Depression

Anxiety and depression disorders are both mental health conditions that affect how you feel and act. They are characterized by a combination of emotional, cognitive, and behavioral symptoms that can be life-limiting and cause tremendous distress. You may even ask yourself, “can someone  be diagnosed with depression and anxiety?“

Do anxiety and depression go together? 

It’s common for people with an anxiety disorder to have depression at some point in their lives — or vice versa. This is what we call comorbidity- two or more conditions exist at the same time. 

An American Psychiatric Association journal shows the following rates of depression and anxiety comorbidity.

• Study findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) suggest overlap at the symptom level, with 53% of patients suffering from major depression experiencing major anxiety.
• In terms of major depression, 45.7% of people with lifetime major depression also report having one or more anxiety disorders 
• A total of 41.6% of people with 12-month depression also had anxiety during that same period.
• Based on the perspectives of anxiety issues, the comorbidity between depression and anxiety shows the following trends: 

1. 50% of patients with panic disorders 
2. 44 % of patients with generalized anxiety disorder 
3. 48% of patients with post-traumatic stress disorder 
4. 20% – 70% among patients with social anxiety 

Many of the same factors influence anxiety disorders and depression

Anxiety and depression can go hand-in-hand because they share many risk factors.

1. Genetic vulnerability

Genetics plays a significant role in how anxiety disorders and depression develop. The risk of developing one of these conditions or both increases if you have a family member who has one of these conditions.

2. Childhood trauma

Children abused or neglected often develop post-traumatic stress disorder (PTSD). These experiences can lead to a higher risk of developing other mental health conditions such as depression, generalized anxiety disorder, and phobias later in life.

3. Acute stressors

Certain events can trigger episodes of anxiety and depression for those who are predisposed to it. These include experiences like 

• Assault or sexual abuse
• Car accidents
• loss of a loved one through death or divorce
• natural disasters like floods or earthquakes
• exposure to war zone conditions
• being held hostage by terrorists or kidnappers
• witnessing another person’s traumatic event
• acute or life-threatening injury or disease

Treatments for Anxiety and Depression

These two mental conditions are treatable with a combination of therapies, medications, self-help strategies, and lifestyle changes. There is no one-size-fits-all treatment for these conditions. Mental Health Professionals tailor treatments for anxiety and depression to each person’s unique circumstances. 

1. Medication

Medications for anxiety and depression are available in many different forms. Medicine aims to help you manage your symptoms and feel better. Types of drugs include:

Selective serotonin reuptake inhibitors (SSRIs)

Doctors commonly prescribe SSRIs to treat anxiety and depression disorders. The amount of serotonin in your brain increases when you take these drugs.

Some examples of SSRIs include 

• Citalopram
• Fluoxetine
• Paroxetine
• Sertraline)

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

These drugs affect serotonin and norepinephrine levels in the brain, which helps control mood swings associated with depression, panic attacks, or generalized anxiety disorder. Some examples of SNRIs include

• Duloxetine
• Venlafaxine

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants elevate your mood by increasing the availability of serotonin and norepinephrine in the brain. However, tricyclic antidepressants have a more significant potential for affecting more body systems like digestion than SSRIs.

• Imipramine
• Amitriptyline

Other Medications for Depression

• Atypical Agents
• Serotonin modulators

Other Medications for Anxiety

• Benzodiazepines
• Gabapentin
• Glutamate

2. Psychotherapy

Therapy provides a safe environment for exploring feelings and behaviors in an accepting atmosphere free from judgment or blame. Many different types of therapy are available for people with anxiety disorders or depression. Some may include 

• cognitive behavioral therapy (CBT)
• dialectical behavioral therapy (DBT)
• interpersonal therapy (IPT)
• problem-solving therapy

3. Self-help Strategies and Lifestyle Changes

Are there other ways how to deal with anxiety and depression? Many people find that changing their lifestyle can ease depression and anxiety disorders with medications and therapy. Here are some tips:

• Get regular exercise. 
• Practice relaxation techniques such as deep breathing, visualization, yoga, and meditation
• Get involved in a support group for people with anxiety or depression
• Music therapy to help you relax and reduce stress
• Make healthy changes to your diet

Seek Treatment for Anxiety and Depression

We hope this article provided an informative understanding of how anxiety and depression are interrelated. You must understand how each condition manifests itself to seek appropriate treatment for yourself or your loved one who suffers from either or both conditions.

Treatment for depression and anxiety is available, and you can find relief. Should you decide on an online psychiatrist or psychiatric nurse practitioner to help you, look no further! At Psychiatrists San Diego, Psychiatric Care NPS, we offer telemedicine to all California patients. We also accept various insurances and offer convenient online prescriptions for depression and online medications for anxiety.

Our goal is to make receiving treatment as easy for you as possible. If you are seeking online psychiatry services, you can speak with us via our Telepsychiatry service in the comfort of your home or office. Starting your journey to a healthier mind is just one click away! You can easily schedule an appointment online or connect with us at (619) 771-0083 today.