Best way to deal with depression and anxiety


How to Cope With Anxiety and Depression

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

The two conditions have a complicated relationship:

  • The incidence of developing depression in addition to an anxiety disorder is high — almost half of all people with major depression also suffer from severe and persistent anxiety, Connolly notes.
  • “People who are depressed often feel anxious and worried, so one can trigger the other,” she says. “Anxiety often comes before depression.”
  • There may be a biological predisposition to both depression and other anxiety disorders.
  • People who have post-traumatic stress disorder (PTSD), an anxiety disorder, are particularly likely to also develop depression, according to the National Institute of Mental Health (NIMH).

“Especially with anxiety, more so than depression, there often is some family history, and so therefore we think that there may be some genetic predisposition to this,” Connolly explains. “Some people are just worriers and pass it down.”

Symptoms of Anxiety and Depression

These are signs that a person may suffer from both anxiety disorder and depression:

  • Constant, irrational fear and worry
  • Physical symptoms like rapid heartbeat, fatigue, headaches, hot flashes, sweating, abdominal pain, and difficulty breathing
  • Insomnia
  • Changes in eating, either too much or too little
  • Difficulty with memory, decision making, and concentration
  • Constant feelings of sadness or worthlessness
  • Loss of interest in hobbies and activities
  • Feeling tired and cranky
  • Inability to relax
  • Panic attacks

The Road to Recovery

Both anxiety and depression should be treated together. Effective treatment strategies include:

  • Cognitive-behavioral therapy (CBT), which is often used to treat anxiety disorder with depression. CBT can teach people to manage their fears, anxieties, and depressive symptoms by figuring out what’s really causing them; people also learn how to take control of their emotions.
  • Antidepressant medications, which may be prescribed to help treat both conditions. These drugs are often used in conjunction with CBT. Selective serotonin reuptake inhibitors (SSRIs) are newer, commonly used antidepressants that offer fewer side effects than older antidepressants, according to the NIMH.
  • Exercise, which can also help both depression and anxiety disorders. Exercise releases chemicals in the body that make you feel good, and it can help you relax. Taking just a 10-minute walk may alleviate symptoms for several hours, the Anxiety and Depression Association of America states.
  • Relaxation techniques, which include practicing meditation and mindfulness. Both can ease symptoms of both anxiety and depression and improve your quality of life, according to a large research review published in the March 2014 issue of JAMA Internal Medicine.
  • Organizations offering mental health services, which can include a hospital or support group in your community. Check out the National Institute of Mental Health or the Anxiety and Depression Association of America for more resources.

Warning Signs You Shouldn’t Ignore

Loved ones of those struggling with anxiety and depression should be on the lookout for these warning signs of a mental health crisis:

  • Poor daily self-care, such as refusing to perform personal hygiene habits, get out of bed, or eat
  • Sudden and extreme changes in mood
  • Becoming violent, threatening, or aggressive
  • Abusing substances
  • Appearing confused or having hallucinations
  • Talking about suicide or about not having a reason to live

Treatment for anxiety disorders and depression needs to be administered and managed by a psychiatrist, Connolly says. “It’s really crucial for people with both to have a good assessment to rule out bipolar disorder,” she says. Bipolar disorder, a condition in which emotions can swing from very low to very high levels of mania and depression, is treated much differently than anxiety disorder with depression.

No one has to suffer from anxiety disorder or depression, and certainly not both. People with anxiety disorder should speak with a psychiatrist, therapist, or other healthcare professional about their symptoms, and start treatment before depression has a chance to set in.

How to Fight Depression and Anxiety

What’s the best way to deal with depressiona and anxiety? Quickly and definitively. Whatever kicks them off, depression and anxiety both are maintained by styles of thinking that magnify the initial insult and alter the workings of the brain in such a way that the longer an episode exists, the less it takes to set off future episodes.

Anxiety and depression are probably two faces of the same coin. Surveys have long shown that 60 to 70 percent of people with major depression also have an anxiety disorder, while half of those suffering anxiety also have symptoms of clinical depression.

The stress response system is overactive in both disorders. Excess activity of the stress response system sends emotional centers of the brain into overdrive so that negative events make a disproportionate impact and hijack rational response systems. You literally can’t think straight. You ruminate over and over about the difficulties and disappointments you encounter until that’s all you can focus on.

Researchers believe that some people react with anxiety to stressful life events, seeing danger lurking ahead everywhere—in applying for a job, asking for a favor, asking for a date. And some go beyond anxiety to become depressed, a kind of shutdown in response to anticipated danger.

People who have either condition typically overestimate the risk in a situation and underestimate their own resources for coping. Sufferers avoid what they fear instead of developing the skills to handle the kinds of situations that make them uncomfortable. Often enough, a lack of social skills is at the root. Some types of anxiety—obsessive-compulsive disorder, panic disorder, and social phobia—are particularly associated with depression.

The fact that anxiety usually precedes the development of depression presents a huge opportunity for the prevention of depression. Young people especially are not likely to outgrow anxiety on their own; they need to be taught specific mental skills.

Cognitive-behavioral therapy (CBT) gets at response patterns central to both conditions. And the drugs most commonly used against depression have also been proved effective against an array of anxiety disorders.

Although medication and CBT are equally effective in reducing anxiety/depression, CBT is better at preventing return of the disorder. Patients like it better, too, because it allows them to feel responsible for their own success. What’s more, the active coping that CBT encourages creates new brain circuits that circumvent the dysfunctional response pathways.

Cognitive-behavioral therapy teaches people to monitor the environment for the troubling emotional landmines that seem to set them off. That actually changes metabolic activity in the cortex, the thinking brain, to modulate mood states. It works from the top down. Drugs, by contrast, work from the bottom up, modulating neurotransmitters in the brainstem, which drive basic emotional behaviors.

Treatment with CBT averages 12 to 15 weeks, and patients can expect to see significant improvement by six weeks. Drug therapy is typically recommended for months, if not years.

Exercise is an important adjunct to any therapy. Exercise directly alters levels of neurohormones involved in circuits of emotion. It calms the hyperactivity of the nervous system and improves function of the brain’s emotion-sensing network. It also improves the ability of the body to tolerate stress. What’s more, it changes people’s perception of themselves, providing a sense of personal mastery and positive self-regard. It also reduces negative thinking.

However, just telling a distressed person to exercise is futile, as depression destroys initiative. The best thing a loved one can do is to simply announce: “Let’s go for a walk.” Then accompany the person out the door.

Anxiety – What you need to know

The notes here on the different kinds of anxiety and are not meant to give a diagnosis. But you might find them useful if, when you see a doctor, psychologist or counsellor they use these terms.

There are different kinds of anxiety disorders, but these are the most common:

Generalised Anxiety Disorder (GAD) is when people worry about a number of things, on most days for six or more months. It usually affects young adults, and women more than men. The anxiety is about a wide range of situations and issues, not just one specific event. It can be hard to control it and finds its way into all parts of daily life.

Phobias are extreme and irrational fears about a particular thing. The can be so great that the person goes to great lengths to avoid it, even if it’s harmless. For example social phobia is fear of being judged or embarrassed in public, even in everyday situations like when eating, speaking at work or making small talk. Another type is agoraphobia, often thought to be a fear of open spaces. It is also a fear of being closed in, or away from a safe place or person who makes you feel safe. It can be extremely disabling and frightening, and can leave people unable to leave their home.

Obsessive Compulsive Disorder (OCD) is when a person has unwanted, intrusive, persistent or repetitive thoughts (whakaaro), feelings, ideas, or sensations (obsessions) which cause anxiety. So they then carry out actions to reduce the anxiety or get rid of those thoughts. For example, the person may be afraid of germs and try to relieve the anxiety through repeated hand washing or avoiding touching things like door knobs. They may know these thoughts (whakaaro) are unreasonable but be unable to stop them. When OCD is severe and left untreated, it can be very distressing, and get in the way of work (mahi), school (kura) and normal life at home.

Post-traumatic Stress Disorder (PTSD) is a reaction to a highly stressful event outside the range of everyday experience when a person feels very unsafe or threatened. These are unsual experiences such as war, violent attack (verbal, physical or sexual) or a natural disaster. The symptoms usually include irritability, anxiety, flashbacks, repeated nightmares, and avoiding situations that might bring back memories of the event.

Panic Disorder is when a person has panic attacks. These are intense feelings of anxiety along with the kind of physical symptoms and overwhelming sensations you would have if you were in great danger, like a pounding heart, feeling faint, sweating, shaky limbs, nausea, chest pains, breathing discomfort and feelings of losing control. The symptoms rise and peak rapidly. The effects can be so severe that people experiencing panic attacks can believe they are dying. Despite being frightening and very uncomfortable they are not life threatening.

Visit the for more info on these and other kinds of Anxiety Disorders.

Depression and Anxiety: How to Identify and Treat Coexisting Symptoms

In addition to a formal treatment plan from your doctor, these strategies may help you find relief from symptoms. It’s important to know, though, that these tips may not work for everyone, and they may not work each time.

The goal of managing depression and anxiety is to create a series of treatment options that can all work together to help, to some degree, whenever you need to use them.

1. Allow yourself to feel what you’re feeling — and know that it’s not your fault

Depression and anxiety disorders are medical conditions. They aren’t the result of failure or weakness. What you feel is the result of underlying causes and triggers; it’s not the result of something you did or didn’t do.

2. Do something that you have control over, like making your bed or taking out the trash

In the moment, regaining a bit of control or power can help you cope with overwhelming symptoms. Accomplish a task you can manage, such as neatly restacking books or sorting your recycling. Do something to help give yourself a sense of accomplishment and power.

3. You could also create a morning, evening, or even daily routine

Routine is sometimes helpful for people with anxiety and depression. This provides structure and a sense of control. It also allows you to create space in your day for self-care techniques that can help you control symptoms.

4. Do your best to stick to a sleep schedule

Aim for seven to eight hours each night. More or less than that may complicate symptoms of both conditions. Inadequate or poor sleep can cause problems with your cardiovascular, endocrine, immune, and nervous symptoms.

5. Try to eat something nutritious, like an apple or some nuts, at least once a day

When you’re feeling depressed or anxious, you may reach for comforting foods like pasta and sweets to alleviate some of the tension. However, these foods provide little nutrition. Try to help nourish your body with fruits, vegetables, lean meats, and whole grains.

6. If you’re up for it, go for a walk around the block

Research suggests exercise can be an effective treatment for depression because it’s a natural mood booster and releases feel-good hormones. However, for some people, exercise or a gym can trigger anxiety and fear. If that’s the case for you, look for more natural ways to move, such as walking around your neighborhood or looking for an online exercise video you can do at home.

7. Do something that you know brings you comfort, such as watching a favorite movie or flipping through a magazine

Give yourself time to focus on you and the things you like. Down time is a great way to let your body rest, and it can distract your brain with things that bring you a boost.

8. If you haven’t left the house in a while, consider doing something you find soothing, like getting your nails done or getting a massage

Relaxation techniques can improve your quality of life and may reduce symptoms of depression and anxiety. Find an activity that feels right for you and you can practice regularly, such as:

  • yoga
  • meditation
  • breathing exercises
  • massage

9. Reach out to someone you’re comfortable talking to and talk about whatever you feel like, whether that’s how you’re feeling or something you saw on Twitter

Strong relationships are one of the best ways to help you feel better. Connecting with a friend or family member can provide a natural boost and let you find a reliable source of support and encouragement.

Depression and anxiety at work

You have difficulty concentrating on work, are exhausted because you can’t sleep, feel on the verge of tears all the time, are nervous and overwhelmed, or some combination of the above. But depression and anxiety are part of work and the daily grind, right? Better learn to suck it up and deal, right?

Not exactly. There’s a definite difference between regular ol’ stress at work—a big presentation, a client’s disapproval, a heavy workload—and serious depression and anxiety.

“When you experience really painful feelings that just won’t go away—no matter what you do—and those feelings interfere with all areas of your life, it’s important to get support, as you may be experiencing signs of depression and anxiety,” says Aimee Barr, a Brooklyn-based psychotherapist.

Depression and anxiety can be debilitating, so it’s not surprising that these two forces can impact your experiences at work. In a survey by the Anxiety and Depression Association of America (ADAA) that asked people which aspects of their job were affected by anxiety and depression, 56% said workplace performance, 51% said their relationship with coworkers and peers, 50% said their quality of work, and 43% said their relationships with superiors.

According to the 2019 study “Strong Minds At Work” conducted by insurance company Unum, mental illness is one of the top causes of worker disability in the U.S., with 62% of missed work days attributed to mental health conditions. Of workers diagnosed with a mental health disorder, 67% have an anxiety disorder and 66% have been diagnosed with depression.

The last thing you need is for your job stability or your boss’s perception of you to suffer when you are suffering. So if you’re feeling like anxiety or depression is hindering your work relationships and performance, try these expert-recommended strategies.

Start by talking to a professional

A therapist can help you develop a treatment plan, such as weekly talk therapy or medicine. But even looking for someone to see can be a tough first step when you’re already not feeling your best. So Dr. Ann Clark, CEO and founder of the San Diego-based Employee Assistance Program (EAP) provider ACI Specialty Benefits, recommends participating in your company’s EAP, if there is one.

“ is a confidential, employer-sponsored program to address absolutely any mental health concern including depression, anxiety, stress, emotional wellness, grief and loss, substance abuse and addiction, family and relationship issues, and any personal concern,” says Clark. She adds that employees typically have access to three to six free sessions—where the clinician offers assessment, short-term problem resolution, and referrals to additional resources.
If your company doesn’t have an EAP, you can find lots of resources online. For example, the ADAA has a “find help” section of their site, and the National Institute of Mental Health is another great source of information.

Talk to your boss or HR

Even though so many people say anxiety and depression interferes with work performance, only 40% of them disclose it to their employer. It’s likely that people don’t speak up and ask for help because there is still a stigma around mental health. People may be worried that they will be viewed as incapable of doing their job and could be let go as a result of asking for help.

But depending upon the severity of your symptoms, you may want to make certain people at work aware of your situation.

If you need to take a mental health day here or there, Clark recommends using a sick day or paid time off without providing a detailed explanation about your reason.

However, “if your depression and anxiety is starting to interfere with your work and your ability to do your job, I recommend speaking with your boss,” says Barr, noting that your boss has more of an impact on your work responsibilities than HR. (She recommends that you only turn to HR if your conversation with your boss does not yield any results.)

For example, if you’re working on a particularly difficult project that is causing you to feel anxious or depressed, you might want to let your manager know you need help so that he/she can delegate some of the responsibilities to your co-workers. You might say, “I want to deliver excellent results, but I’m feeling overwhelmed. It would be very helpful if I could work on this project with a few more people. Who on our team do you think could be a good fit?”

If you need to take a leave of absence or accommodations to your workspace, Clark says, “a simple statement like, ‘I have a medical condition that requires an extended leave,’ or, ‘I have a medical condition that requires I work in an area with natural sunlight,’ should suffice for HR or management.” Note that you may need to provide additional documentation from a doctor or clinician.

Create coping mechanisms

Taking care of yourself and developing coping mechanisms can help you throughout the workday. A professional can help you develop specific coping mechanisms for your symptoms.

In general, Barr recommends doing breathing exercises to reduce anxiety throughout the day. “We need to regulate our breathing, especially when things are really intense,” says Barr. “When our anxiety is at a high level, it’s hard to problem-solve and think critically.”

Take short breaks during the workday—go for a walk and cry if you feel the need, call a friend or family member, or simply take some time to yourself. It’s also important not to isolate yourself. Reach out to co-workers, join them for coffee breaks, and make a concerted effort to be engaged, rather than closing yourself off.

Nancy Halpern, an executive at the New York City-based executive coaching firm KNH Associates, emphasizes maintaining healthy habits such as eating well, getting enough sleep, exercising, and spending time with friends and family. She recommends making plans three to four nights a week so that you always have someone to talk to after a draining day.

Depression, anxiety, and other mental health conditions can make it especially challenging to get through even the normal routines of a work day, but a strong support system—at home and at work—can help you push through the tough times.

Find a more supportive work environment

The last thing you need when you’re pulling through depression is a job that adds to your unease. If your job is contributing to your depression, there is no sense in sticking it out. Could you use some help taking the first step but aren’t sure how? Join Monster for free today. As a member, you can upload up to five versions of your resume—each tailored to the types of jobs that interest you. Recruiters search Monster every day looking to fill top jobs with qualified candidates, just like you. Additionally, you can get job alerts sent directly to your inbox to cut down on time spent looking through ads. Those are two quick and easy ways Monster can help take some of the stress off your shoulders so you can concentrate on your own wellbeing. There are employers out there that pride themselves on fostering a collaborative, supportive workplace where employees can thrive.

This article is not intended as a substitute for professional legal or medical advice. Always seek the professional advice of an attorney and/or qualified health provider regarding any legal or medical questions you may have.

Most people experience feelings of anxiety or depression at times. Grief, loss of a job, divorce, illness, and other stressors can lead to feelings of sadness, worry, frustration, and loneliness. These are normal reactions to difficult life situations.

Some people experience these feelings daily, without a known stressor. This can interfere with the ability to carry out every day activities such as getting to work on time, proper self-care, or caring for children. In this case, people might be suffering from depression, anxiety, or a combination of the two.

Depression and anxiety can co-occur. Studies show that between 10% and 20% of adults in any given 12-month period will visit their primary care physician during a depressive or anxiety disorder episode, and that nearly 50% of them will suffer from a co-morbid, secondary depressive or anxiety disorder.

The presence of co-occurring depressive and anxiety disorders is associated with greater chronicity, slower recovery, increased rates of recurrence, and psychosocial disability.

It’s always helpful to know what symptoms to watch for and the most effective treatments.

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Symptoms of major depressive disorder

The essential feature of major depressive disorder is a period of two weeks during which there is either depressed mood most of the day nearly every day or loss of interest or pleasure in nearly all activities. Other potential symptoms include:

  • Significant weight loss when not dieting or weight gain and changes in appetite
  • Insomnia or hypersomnia nearly every day
  • Psychomotor agitation or retardation nearly every day
  • Fatigue or loss of energy nearly every day
  • Feelings of worthlessness or excessive guilt
  • Impaired ability to think or concentrate, and/or indecisiveness
  • Recurrent thoughts of death, recurrent suicidal ideation without a plan, or a suicide attempt or suicide plan

The symptoms of major depressive disorder cause significant distress or impairment in social, occupational, or other areas of functioning.

Symptoms of Generalized Anxiety Disorder

The essential feature of generalized anxiety disorder is excessive anxiety and worry about a number of events or activities. The intensity of the worry is out of proportion to the likelihood of the anticipated event. The excessive worry or anxiety occurs more days than not for a period of at least six months.

Anxiety and worry are associated with at least three (or more) of the following symptoms, with at least some symptoms present more often than not during the six-month period:

  • Restlessness or feeling keyed up or on edge
  • Easily fatigued
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Sleep disturbance

To meet the criteria for generalized anxiety disorder, the anxiety, worry, or physical symptoms cause significant distress in social, occupational, or other areas of functioning.

There are several features that separate generalized anxiety disorder from nonpathological anxiety.

  • Worries are excessive and typically interfere with psychosocial functioning
  • Worries are more pervasive, pronounced, and distressing
  • Worries have longer duration
  • Worries are more likely to be accompanied by physical symptoms (restlessness, keyed up)

People with generalized anxiety disorder are likely to experience somatic symptoms (sweating, nausea, diarrhea), muscle tension, and an exaggerated startle response.

Treatment of anxiety and depression

A treatment plan for co-occurring anxiety and depression should be designed to help the person manage and reduce symptoms of both disorders at the same time.

Several forms of psychotherapy are widely available and effective for both anxiety and depression.

  • Cognitive Behavioral Therapy (CBT): This short-term therapy works to replace negative and unproductive thought patterns with more realistic and useful ones. This treatment focuses on taking specific steps to manage and reduce symptoms.
  • Interpersonal “talk” therapy: This attachment-focused therapy centers on resolving interpersonal problems and symptomatic recovery.
  • Problem solving therapy: This treatment helps people learn tools to effectively manage the negative effects of stressful life events.

Both anxiety and depressive disorders respond to treatment with selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) medications.

Long-term, combined treatment (psychotherapy and medication management) is typically recommended for people with co-occurring anxiety and depression.

Article Sources Last Updated: Feb 13, 2018

The Link Between Migraine, Depression and Anxiety

Understanding the relationship between migraine and mental health

Migraine is linked to both depression and anxiety. In fact, people with migraine are about five times more likely to develop depression than someone without migraine, according to Dawn Buse, PhD, the director of behavioral medicine at the Montefiore Headache Center and an associate professor in the Department of Neurology at Albert Einstein College of Medicine in New York.

“It’s very logical when you’re living with a chronic disease like migraine, which is affecting your life in such a big way, that you’re going to feel sad, down and frustrated about how it’s affecting your life,” she says.

Buse says that about 20% of people with episodic migraine—headaches on 14 or fewer days per month—may also have depression, and that number goes up as the number of headache attack days per month increases. Similarly, about 20% of people with episodic migraine have anxiety, and between 30% and 50% of people with chronic migraine also have anxiety.

What’s the link?

Does migraine cause anxiety? Can depression cause migraines? Buse says that doctors aren’t entirely sure what the connection is. For many people, depression or anxiety begins months or years after their migraines start—partially because migraine can be so debilitating. Many others, however, develop migraine after living with depression or anxiety for some time. This indicates that depression and anxiety are not always a response to living with migraine. Like migraine, depression and anxiety can also run in families.

“We think there might be some underlying reason, maybe a genetic reason, or the fact that both depression and migraine act off similar biochemicals in the brain and in the body that predisposes someone to have one, and then the second,” Buse says.


Common symptoms of anxiety, like excessive worry, fear and irritability, can play off of migraine symptoms. Patients worry about when the next attack will come, feel helpless about the unpredictability of their symptoms, and feel frustration over the many ways that migraine is affecting their life.

When a person doesn’t know when the next attack is coming, it can cause a great deal of migraine anxiety, and, ultimately, depression. Symptoms of depression include fatigue, loss of interest or pleasure in things previously enjoyed, changes in sleep, changes in eating habits, and feelings of sadness and hopelessness, which also closely mirror common migraine symptoms like insomnia, loss of appetite and malaise.


Both depression and anxiety disorders increase the risk of suicide. Warning signs of suicide include:

  • Talking or writing about death
  • Giving away important possessions
  • Talking about feeling like a burden to other people
  • Increased use of alcohol or drugs
  • Reckless behavior
  • Extreme social withdrawal or isolation
  • Making calls or visits to others to say goodbye
  • Thoughts of hopelessness (that things will never get better in the future)

*If you or someone you know has serious thoughts about suicide, share your concerns openly with your healthcare professional or call the National Suicide Prevention Lifeline at 1(800) 273-8255. Depression is rarely permanent, and many effective treatment options are available.

Treatment options

The silver lining, Buse says, is that depression and anxiety are treatable in many ways, including through medications that target nerve transmitters. But there are also nonpharmacological therapies.

Treatments that include cognitive behavioral therapy (CBT) help us better manage stress and change the ways that we think and act, which could be contributing to our feelings of depression and anxiety, says Buse.

Relaxation therapies are similarly effective for some in treating anxiety and depression, as well as combating stress, which can exacerbate migraine symptoms. These strategies involve calming the nervous system with meditative exercises like deep breathing or guided visual imagery.

Buse also recommends biofeedback, where patients are connected to a machine that measures different physiological responses and compares them alongside biological information.

“In biofeedback, you can actually look at a computer screen and see when your nervous system is activated,” she says. This is helpful for anxiety, especially panic attacks or generalized anxiety, as well as insomnia and worry. There is very good evidence for these strategies helping with migraine management, Buse says.

Staying active and healthy is also important for patients who experience migraines and depression or anxiety, as is maintaining a consistent sleep schedule.

Keep making plans

One of Buse’s key pieces of advice is not to withdraw and let migraine keep you from being social.

“Keep in contact with friends and family,” Buse says. “You may have to cancel sometimes, you may have to leave early, or you may need to excuse yourself and go in a dark, quiet room. But don’t stop making plans, because when you start to isolate, you get lonely and depressed, and then you can really enter a downward spiral.”

More than anything, it’s important to remember that migraine and anxiety or depression are is not the fault of the patient, and that there are treatment options.

“We want to let patients know that improving and lifting their depression and anxiety conditions will also lead to better migraine outcomes, improving their entire quality of life and reducing disability,” she says.

Are you missing these signs of anxiety or depression?

It’s easy to overlook the clues that you may need help for one of these common conditions.

Published: August, 2018

Image: © davidf/Getty Images

The signs of mental illness aren’t always obvious. Subtle changes in mood or behavior are often attributed to aging, just like weaker muscles and fuzzy thinking. “There’s a tendency to dismiss it as, ‘Well, of course I’m worried, I have heart disease,’ or, ‘Of course I’m sad, I’m not as relevant as I once was,'” says Dr. Michael Craig Miller, an assistant professor of psychiatry at Harvard Medical School.

But depression (extreme sadness, worthlessness, or hopelessness) and anxiety (debilitating worry and agitation) do not need to be routine parts of aging. Getting help for these feelings can help you maintain your health and enjoy life to the fullest.

Sometimes recognizing depression and anxiety takes a little honest reflection about your behaviors, feelings, and habits. Here are some signposts:

  • Apathy. Have you lost interest in the activities that used to bring you joy? Has life lost so much meaning that you feel empty? Those are classic signs of depression.

  • Helplessness or hopelessness. Do you feel there is little you or anyone can do to improve your life? Helplessness and hopelessness also are classic signs of depression.

  • Changes in habits. Sleeping or eating too much or too little can be a sign of depression. So can drinking more alcohol than usual or engaging in risky behavior.

  • Persistent fatigue. It’s normal to be tired at the end of the day. But if you’re tired all the time, it could be due to depression or anxiety. Or it may be related to an underlying medical condition, such as an underactive thyroid or heart failure.

  • Difficulty focusing or making decisions. “People who are depressed and anxious have difficulty making decisions because they worry whatever they do will be wrong,” says Dr. Miller. Or you may have trouble concentrating or paying attention to others.

  • Mood swings. If you’re easily irritated (or extremely impatient or overly self-critical), or if you experience frequent mood swings, it could be a sign of depression or anxiety.

  • Unending worry. “Are you anticipating every possible problem and focusing on it rather than looking at the lake or sky or enjoying being with your grandchild?” Dr. Miller asks. He says that kind of worry could be due to an anxiety disorder.

  • Wanting to be alone. “If you enjoy solitude because you like the time to read or meditate, that’s fine. But that’s different from staying home because it takes too much energy to interact with others. That’s a sign of depression,” says Dr. Miller.

What you should do

Just because you’re experiencing one of those symptoms doesn’t mean you’ll be diagnosed with an anxiety disorder or depression. “But if you’re too caught up in one feeling or another, having less pleasure in life or having trouble doing what you need to do, then certainly get help,” says Dr. Miller.

Reaching out to family and friends may be a good way to start the process. “Talk to people who might be understanding, compassionate, and helpful,” Dr. Miller says. If you feel embarrassed to share your feelings or worries with those close to you, make an appointment with your doctor.


Help for depression and anxiety can come in a variety of forms, such as treating underlying conditions that may be causing depression, taking anti-depressant medications, or taking part in talk therapy.

There are also plenty of pill-free approaches that can help. Exercise is an important one. A daily walk can help you maintain your overall mood, energy, and positivity. “Increased blood flow to the brain seems to make nerves healthier. They plump up and make firmer connections,” Dr. Miller explains.

Another strategy is staying connected socially. Social connections are associated with reduced stress, improved immune system function, and longer life. People with more social connections also have lower levels of anxiety and depression, higher self-esteem, and a better overall sense of well-being.

The takeaway

You don’t have to suffer with depression or anxiety, no matter what your age. “It’s useful to find a way to manage it better so you can live your life fully and experience being alive,” says Dr. Miller. “You want to feel like every day that you wake up is a good day.”

For more information, check out the Harvard Special Health Report Understanding Depression (

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