Relationship between anxiety and depression

If you ask someone to name two common mental health problems, chances are they will think of anxiety and depression. Despite the fact that they are commonly referenced in conversation, people still struggle sometimes to determine the difference between these two conditions. This is because many people with anxiety also develop depression and vice versa. Roughly 50% of people diagnosed with depression with also be diagnosed with an anxiety disorder.1 However, it’s important to get an accurate diagnosis in order to treat the correct conditions.

Many people with depression may experience what is known as “anxious distress” in addition to their low mood.2 People with anxious distress often feel tense, restless, and have trouble concentrating because they worry so much. They are deeply afraid that something bad is going to happen or that they might lose control of themselves. People who experience anxious distress with depression may be at higher risk for suicide or need more intensive treatment, so it is important to identify these symptoms along with the depression.

Above all, it’s important to remember to let a doctor or mental health professional evaluate you to see if your symptoms meet the criteria for a depressive disorder or an anxiety disorder.3

Symptoms of Major Depression

  • depressed mood
  • lack of interest in enjoyable activities
  • increase or decrease in appetite
  • insomnia or hypersomnia
  • slowing of movement
  • lack of energy
  • feelings of guilt or worthlessness
  • trouble concentrating
  • suicidal thoughts or behaviors.

For a diagnosis of major depressive disorder, a person needs to have experienced five or more of these symptoms for at least two weeks. People experiencing some of these symptoms might also be diagnosed with persistent depressive disorder (dysthymia), premenstrual dysphoric disorder, or a depressive disorder due to another condition. They may also meet the criteria for bipolar disorder if they also experience symptoms of mania.

Symptoms of Generalized Anxiety Disorder

  • excessive worry
  • restlessness
  • being easily fatigued
  • trouble concentrating
  • irritability
  • sleep disturbance
  • muscle tension.

If you’ve experienced these symptoms most days for more than six months, and they cause distress in your daily life, then you may receive a diagnosis of generalized anxiety disorder. Other types of anxiety disorders include separation anxiety, panic disorder, or phobias, among others.

If you compare the two lists of symptoms, you can see that there is some overlap. Sleep problems, trouble concentrating, and fatigue are all symptoms of both anxiety and depression. Irritability may also manifest in forms of anxiety or depression (in place of low mood).

There are however, some distinguishing features. People with depression move slowly, and their reactions can seem flattened or dulled. People with anxiety tend to be more keyed up, as they struggle to manage their racing thoughts. Another distinguishing feature is the presence of fear about the future in people with anxiety. Depressed people who do not have anxiety are less likely to be fraught with worry about future events, as they are often resigned to believing that things will continue to be bad. In other words, they may predict the future based on how they feel in the moment.

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Talking to Your Doctor

If you have anxiety, depression, or both, chances are that your doctor will recommend medication, therapy, or a combination of the two. Keep track your symptoms and keep a log of how you feel each day, as this can help in the diagnostic process. It’s also important to speak up and ask your doctor whether they think you have depression, anxiety, or both. This clarity can help you understand the treatment focus and how to manage your symptoms. For example, a patient who is prescribed an antidepressant like a selective serotonin reuptake inhibitor (SSRI) may not realize that the medication has been prescribed for their anxiety, as SSRIs are used to treat both anxiety and depression.4 Never hesitate to ask about your diagnosis, as you have a right to your personal health information.

The most important quality that anxiety and depression share is that they are both very treatable conditions. Never hesitate to find people to help you stayed informed and on the right track towards a healthier mind and body. Who can you recruit to help you with your anxiety or depression today?

Article Sources Last Updated: Apr 16, 2019

The Complex Relationship Between Sleep, Depression & Anxiety

Excessive sleepiness not only affects your physical health, it has a big impact on your mental health as well. When you don’t get the 7-9 hours of quality sleep you need, it can heavily influence your outlook on life, energy level, motivation, and emotions.

If you’re feeling low, you may not realize that lack of sleep is the culprit. But even small levels of sleep deprivation over time can chip away at your happiness. You might see that you’re less enthusiastic, more irritable, or even have some of the symptoms of clinical depression, such as feeling persistently sad or empty. All these alterations to your mood can affect not only your individual mental health, but your relationships and family dynamics as well.

The link between sleep and mood has been seen over and over by researchers and doctors. For example, people with insomnia have greater levels of depression and anxiety than those who sleep normally. They are 10 times as likely to have clinical depression and 17 times as likely to have clinical anxiety. The more a person experiences insomnia and the more frequently they wake at night as a result, the higher the chances of developing depression.

Obstructive sleep apnea, a condition in which a person wakes frequently and very briefly throughout the night, is linked to depression as well. In one study of nearly 19,000 people, those with obstructive sleep apnea were five times as likely to suffer from clinical depression. Researchers believe this is because when sleep is disrupted over and over, it can alter brain activity and neurochemicals that affect a person’s mood and thinking.

The relationship between sleep and mood is complex, because disrupted sleep can lead to emotional changes, clinical depression or anxiety (as well as other psychiatric conditions), but these conditions can also compound or further disrupt sleep. In fact, altered sleep patterns are a hallmark of many mental health issues. If you find yourself sleeping too little or too much on a regular basis, it’s important to bring this up with your doctor so the two of you can look at your total physical and mental health picture and decide if further tests or a treatment plan is necessary.

The Link Between Depression and Anxiety

In addition to the characteristic depression symptoms of sadness, hopelessness, and fatigue, many people deal with an additional mental health condition: According to the Anxiety and Depression Association of America, nearly one-half of people with depression also experience anxiety — a nervous disorder characterized by a state of excessive uneasiness, often with panic attacks or compulsive behavior.

Part of the reason that depression and anxiety are so closely related may be biological, says Scott Bea, PsyD, a clinical psychologist at the Cleveland Clinic in Ohio. Pathways in the brain and neurochemicals can bring on negative emotional states.

Another reason may be that some forms of anxiety, such as chronic worry or obsessive-compulsive disorder, lead to repeating painful patterns that then can trigger depression.

Both depression and anxiety are characterized by excessive negative thoughts, whether they’re about negative events that have happened or about what might happen in the future. “This tendency to overthink can lead to feelings of fear, discouragement, and despair about the future,” Bea says. “It also keeps people from being more in contact with their real experience in the here and now.”

How to Manage Depression and Anxiety

If you have symptoms of both depression and anxiety, a therapist can help sort out where one condition begins and the other ends. When you address both conditions with a therapist, you’ll find that some treatments overlap. For instance, some antidepressant medications are used to treat anxiety disorders as well as depression.

Including talk therapy (psychotherapy) in your depression treatment can also help ease anxiety. Talk therapy addresses the way people think and how their thoughts affect behaviors, Bea says. Here are a few types of therapy for depression and anxiety:

  • Cognitive behavioral therapy (CBT), which explores the connection between thoughts and behaviors
  • Interpersonal therapy, which focuses on relationships
  • Acceptance and commitment therapy (ACT), which uses mindfulness

But there are some differences in treatments for depression and anxiety, particularly with what people do outside of therapy — what Bea calls “homework assignments.” People with depression often become inactive and are told to schedule activities to help lift their mood. “In contrast, some people with anxiety may be quite active already,” Bea says, but anxious thoughts get in the way of their activities. A therapist can provide suggestions about how you can address your specific symptoms.

Does Depression Lead to Anxiety?

The relationship between depression and anxiety is complex and often unique to each person. Sometimes dealing with anxiety can defuse depression symptoms, and for some people, treating depression will diminish anxiety, says Mark Smaller, PhD, president of the American Psychoanalytic Association. However, there’s also the possibility that when depression gets better, anxiety may be more apparent, he says.

Managing major depression is an important step, but being aware of anxiety symptoms can prompt you to seek treatment early and prevent the condition from getting worse.

How do you recognize signs of anxiety when you have depression? Anxiety tends to make people worry so much that it causes distress in their daily lives. Anxiety may trigger irrational fears and cause people to avoid places they think are dangerous or social situations where they think they’ll be judged. Other symptoms of anxiety include panic attacks, nightmares or flashbacks, and obsessive-compulsive behaviors. Your body may also react physically to anxiety by raising your heart rate and increasing your blood pressure.

Lifestyle Strategies to Help Ease Depression and Anxiety

As you seek treatment for both depression and anxiety, practice some basic strategies for easing both conditions. Some good ideas include exercising regularly, eating healthy foods, sleeping well, and replacing negative thoughts with positive ones. It’s also helpful to practice relaxation techniques, such as inhaling and exhaling slowly, counting to 10 or 20 slowly, listening to soothing music, meditating, doing yoga, getting a massage, finding ways to laugh, writing in a journal about why you’re feeling anxious, spending time with family and friends, and changing your outlook on factors that cause you stress.

It may take weeks or months of working with a therapist and taking medication before you see changes in how you feel, but know that if you stick with it and commit to the work, you can successfully manage depression and anxiety symptoms.

Anxiety and Depression in Children

The American Academy of Child and Adolescent Psychiatry (AACAP) recommends that healthcare providers routinely screen children for behavioral and mental health concerns. pdf iconexternal icon Some of the signs and symptoms of anxiety or depression in children could be caused by other conditions, such as trauma. Specific symptoms like having a hard time focusing could be a sign of attention-deficit/hyperactivity disorder (ADHD). It is important to get a careful evaluation to get the best diagnosis and treatment. Consultation with a health provider can help determine if medication should be part of the treatment. A mental health professional can develop a therapy plan that works best for the child and family. Behavior therapy includes child therapy, family therapy, or a combination of both. The school can also be included in the treatment plan. For very young children, involving parents in treatment is key. Cognitive-behavioral therapy is one form of therapy that is used to treat anxiety or depression, particularly in older children. It helps the child change negative thoughts into more positive, effective ways of thinking, leading to more effective behavior. Behavior therapy for anxiety may involve helping children cope with and manage anxiety symptoms while gradually exposing them to their fears so as to help them learn that bad things do not occur.

Treatments can also include a variety of ways to help the child feel less stressed and be healthier like nutritious food, physical activity, sufficient sleep, predictable routines, and social support.

Get help finding treatment

Here are tools to find a healthcare provider familiar with treatment options:

  • Psychologist Locatorexternal icon, a service of the American Psychological Association (APA) Practice Organization.
  • Child and Adolescent Psychiatrist Finderexternal icon, a research tool by the American Academy of Child and Adolescent Psychiatry (AACAP).
  • Find a Cognitive Behavioral Therapistexternal icon, a search tool by the Association for Behavioral and Cognitive Therapies.
  • If you need help finding treatment facilities, visit MentalHealth.govexternal icon.

Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with depression or anxiety. In addition to getting the right treatment, leading a healthy lifestyle can play a role in managing symptoms of depression or anxiety. Here are some healthy behaviors that may help:

  • Having a healthy eating plan centered on fruits, vegetables, whole grains, legumes (for example, beans, peas, and lentils), lean protein sources, and nuts and seeds
  • Participating in physical activity for at least 60 minutes each day
  • Getting the recommended amount of sleep each night based on age
  • Practicing mindfulness or relaxation techniques

Prevention of anxiety and depression

It is not known exactly why some children develop anxiety or depression. Many factors may play a role, including biology and temperament. But it is also known that some children are more likely to develop anxiety or depression when they experience trauma or stress, when they are maltreated, when they are bullied or rejected by other children, or when their own parents have anxiety or depression.

Although these factors appear to increase the risk for anxiety or depression, there are ways to decrease the chance that children experience them. Learn about public health approaches to prevent these risks:

  • Bullying prevention external icon
  • Child maltreatment prevention
  • Youth violence prevention
  • Depression after birth
  • Caring for children in a disaster

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