By Thomas Tjornehoj

While anxiety is generally considered a high-energy state and depression a low-energy state, anxiety and depression are more closely related than you might think. A person with depression often experiences a lot of anxiety, possibly even to the extent of having panic attacks.1

Anxiety disorders involve more than common nervousness and worry. They can cause terrifying fear about things other people wouldn’t think twice about. Many people with anxiety disorders fully comprehend that their thoughts are irrational. But they still can’t stop them. Feelings of losing inner control haunt them. This angst is one of the entry ways for depression.2

Why Are Anxiety and Depression Often Co-occurring?

“It’s a cycle,” says Sally R. Connolly, LCSW and therapist. “When you get anxious, you tend to have this pervasive thinking about some worry or some problem. You feel bad about it. Then you feel like you’ve failed. You move to depression.”

These two disorders – anxiety and depression – have a complicated relationship:

  • The chance of acquiring depression is much higher when an anxiety disorder already exists. Nearly half of those with major depression also suffer from severe and persistent anxiety.
  • People who are depressed often feel anxious and worried. One can easily trigger the other, with anxiety often preceding depression.
  • People with post-traumatic stress disorder (PTSD) are especially prone to developing depression.
  • A biological predisposition for both of these conditions if often at the root of an individual’s battle. This seems to be true with anxiety disorders even more than with depression. Connolly explains, “Some people are just worriers and pass it down.”

People with an anxiety disorder should speak with a psychiatrist, therapist or other healthcare professional about their symptoms. Treatment for an anxiety disorder should not be delayed. If not caught in time, depression may find the door wide open for moving in and setting up house in those individuals.2

What Causes Anxiety?

For reasons that are only partly understood today, the fight-or-flight center in these individuals’ brains becomes activated, even when no real threat exists. Being in a state of constant anxiety is like being stalked by an invisible predator. The feeling of being in danger never goes away. They are always on alert.1

Occasional anxiety is a normal part of life. It’s common for people to feel anxious if there’s conflict in a relationship, a problem at work, a big test looming or a major decision dead ahead. But anxiety disorders involve more than temporary worry or fear. For people with an anxiety disorder, the anxiety does not go away. It often gets worse over time to the point where feelings interfere with their daily functions.3

What Causes Depression?

Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. While it may occur at any age, it often begins in adulthood. As with many anxiety disorders, depression in children and adolescents may present itself as irritability more than low mood.4

By adulthood, depression shows up as hopelessness, despair and anger. With a low energy level, afflicted individuals often feel overwhelmed by the day-to-day tasks and personal relationships fundamental to life.1

As mentioned above, depression is often spawned from an anxiety disorder left untreated.

What Might Indicate that Both Anxiety and Depression Are Present?

Traits that may signal the presence of both anxiety disorder and depression include:

  • Irrational worries or fears that won’t go away
  • Physical symptoms, such as fatigue, headaches, rapid heartbeat, labored breathing or abdominal pain
  • Difficulty going to sleep or staying asleep
  • Changes in eating habits — either too much or too little
  • Trouble remembering, making decisions or concentrating
  • Constant feelings of sadness or worthlessness
  • Loss of usual interest in activities or hobbies
  • Feeling often tired and cranky
  • Inability to relax and live in the moment
  • Suffering from panic attacks, including the sense of losing inner control2

What Strategies Are Often Used in Treating this Dual Diagnosis?

Evidence-based research suggests that both anxiety and depression be treated at the same time.

Effective strategies often used in treating these co-occurring conditions include:

  • Cognitive Behavioral Therapy (CBT) – CBT is often used to treat people with both disorders. Fears, anxieties and tendencies toward depression are managed by seeking out their root causes. Once uncovered, patients learn how to take control of their emotions and life.
  • Antidepressant medications – Often combined with CBT, these may be prescribed in treating both disorders. Selective serotonin reuptake inhibitors (SSRIs) are new antidepressant drugs that produce fewer side effects than their predecessors.
  • Exercise – This can be very helpful for both disorders. Physical activity causes feel-good chemicals to be released in the body. This aids in relaxation and feeling of well-being.
  • Relaxation techniques – This typically involves meditation or mindfulness. These techniques can often help to remedy both disorders and improve quality of life.2

Finding the Right Resources to Answer Your Questions and Meet Your Complex Needs

Just as anxiety and depression tend to be worse when occurring together, treatment of these disorders is most effective when both conditions are addressed at the same time.1

Hartgrove Behavioral Health System provides integrated care that treats these and other mental health issues simultaneously. As part of our comprehensive care, medical specialists and therapists work together to help bring healing and balance in our patients’ lives — a feeling of being in charge of their inner self again.


Sources:

1Relationship Between Depression and Anxiety.” Healthy Place, June 15, 2016.

2How to Cope With Anxiety and Depression.” Everyday Health, August 27, 2015.

3Anxiety Disorders.” National Institute on Mental Health, March 2016.

4Depression.” National Institute on Mental Health, October 2016.