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Anxiety vs. Depression: Do I Have Both?

Anxiety vs. Depression: Do I Have Both?

"I'm not afraid of storms, for I'm learning how to sail my ship."

Louisa May Alcott

Sometimes it seems like our lives are wrapped in storm clouds that bring frightful thunder and drape our world in gray tones. The storms keep us tense as we anticipate the next lightning strike and hopeless because there is no joy in a colorless world. If you feel like you are constantly under these rain clouds? Exhausted but can't sleep, obsessively worried? Do you feel like the sun will never shine again? You are likely experiencing the symptoms of a mood disorder. But is it anxiety or depression? Are you wondering, “Do I have both?”

The short answer is yes. You likely have both anxiety and depression, and this is exceptionally common. Almost half of the people diagnosed with a depressive disorder are also diagnosed with an anxiety disorder. Conversely, feeling anxious all the time leads to deep depressive episodes.

The trick to managing these mental health disorders is to learn which one is the driving force in your everyday life and which is a symptom of the other. There are ways mental health professionals, like those at Goodman Psychologist Associates, can help by first assessing your symptoms, diagnosing specific disorders, and offering treatment options.

Anxiety vs. Depression: Are They the Same Thing?

Everyone experiences feelings of sadness, grief, fear, and depression. When these normal emotions persist and interfere with average day-to-day living, work, or relationships, they become mental health conditions usually called Depressive Disorder or Anxiety Disorder. Depression and anxiety can come from genetics, current circumstances, each other, or even medical conditions. While these disorders often go hand-in-hand, they are two distinct mental health issues. So, how do you know if you have anxiety, depression, or both? The key differences are in the diagnostic definition and criteria.

Anxiety Disorder

People with anxiety have intense and excessive fear and worry. Often thoughts start with the question, "What if?" Anxiety disorders are distinguished by symptoms involving anxious thoughts, unexplained physical sensations, and avoidant or self-protective behaviors experienced most of the time for at least six months.

Depressive Disorder

A person whose primary diagnosis is depression often doesn't show the same fear and uncertainty that people do with anxiety disorders. People with depression don't worry about their future because they already believe it will be full of the same bad stuff that is happening now. Instead, they have feelings of hopelessness and intense sadness. A depressive disorder is diagnosed when a person experiences symptoms for most of the day, every day, for at least two weeks.

Shared Symptoms of Anxiety and Depression

Depression and anxiety can be hard to tell apart because they have many overlapping effects on mental and physical health. You could have depression, anxiety, or both if you experience these common symptoms: 

  • Crankiness and irritability or feeling out of control
  • Trouble concentrating or thinking
  • Lowered motivation
  • Trouble making decisions
  • Poor memory or a foggy feeling
  • Weight changes or a reduction or increase in appetite
  • Sleeping too much or too little or insomnia
  • Digestive issues
  • Muscle tension, aches, pains, or headaches
  • Exhaustion and fatigue
  • Restlessness

What Causes Anxiety and Depression?

Both anxiety and depression can result from trauma, a physical injury, stress, inherent genetic predispositions, drugs or other substances, physical changes like menstruation, pregnancy, disability, or another mental health condition. Anxiety, depression or both can also stem from the same medical condition, such as:

  • Cancer.
  • Premenstrual dysphoric disorder (PMDD).
  • Heart disease.
  • Diabetes.
  • Thyroid problems.
  • Respiratory disorders like asthma and Chronic Obstructive Pulmonary Disorder (COPD).
  • Drug or alcohol withdrawal.
  • Chronic pain or irritable bowel syndrome.

How Are Anxiety and Depression Different?

When comparing anxiety vs. depression, they can clearly have the same symptoms and causes. A good way to distinguish anxiety from depression is to examine the prompting events that may have triggered one or both of the disorders and learn if there is a family history of mood disorders. Another way to tell these conditions apart is to look at symptoms that are unique to each.

Additional Mental Symptoms of Anxiety:

  • Feeling overwhelmed with worry, fear, and dread
  • Fear of the future, injury, sickness, and death
  • Rapid, intrusive, or frightening thoughts
  • Hypervigilance
  • Disassociation or detachment from reality, or depersonalization

Additional Physical Symptoms of Anxiety:

  • Elevated or fast heart rate and palpitations
  • Shortness of breath or rapid breathing
  • Tightness or pressure in the chest
  • Dizziness or lightheadedness
  • Sweating and shakiness
  • Dry mouth
  • A choking or strangling feeling
  • Hot flashes or chills
  • Tingling in the arms and legs
  • Avoidance of typical situations or events

Please Note: Many physical anxiety symptoms mimic the symptoms of a heart attack. If you are unsure what you are feeling, call a medical professional or 911.

Additional Mental Symptoms of Depression:

  • Intense and persistent sadness, sorrow, or grief; feeling tearful
  • Feeling empty, guilty, or hopeless
  • Persistent thoughts about worthlessness or guilt
  • Lack of interest and enjoyment in activities that used to be fun and interesting
  • Thoughts of self-harm, death, and suicide

Please note: If you have thoughts of self-harm or suicide, call the Suicide and Crisis Hotline by dialing 988. All calls are confidential, and the phone lines are available 24 hours a day.

Types of Anxiety Disorders

The differences between these mental health conditions are more apparent when looking at the types of disorders relating to either anxiety or depression.

There are multiple types of anxiety disorders. You can have one or more of these disorders, including:

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is common. An estimated 5.7% of Americans experience GAD at some time in their lives. GAD is characterized by chronic anxiety and worry that is often not triggered by external circumstances.

Panic Disorder

Panic disorder includes feelings of intense anxiety and is characterized by the repetition of unexpected and sudden moments of extreme fear and panic. These feelings are often accompanied by physical sensations such as palpitations, hyperventilation, chest pain, lightheadedness, and gastrointestinal problems like diarrhea or pain.

Post-Traumatic Stress Disorder (PTSD)

PTSD is an anxiety disorder that develops after a frightening ordeal or event in which physical harm was threatened or occurred. Military combat, physical or sexual assault, and disasters are examples of PTSD-inducing traumatic events.

Social Anxiety Disorder

Sometimes called social phobia, this anxiety disorder manifests with intense symptoms of anxiety accompanying social interactions.

Phobias

A phobia is an intense fear of something or someone that is unlikely to cause harm or that is unlikely to be encountered. For example, a fear of spiders (arachnophobia), small spaces (claustrophobia), or dolls (pedophobia) are common examples of phobias. Encountering a phobia, or even thinking about it, can cause severe anxiety and panic attacks.

Obsessive-Compulsive Disorder (OCD)

OCD is an anxiety disorder characterized by unwanted and uncontrolled thoughts or feelings and ritualistic-like behaviors used in an attempt to alleviate stress caused by thoughts.

Types of Depressive Disorders

Just like anxiety, depression also has multiple disorders, categorized as follows:

Major Depressive Disorder

Major depression is what most of us think of when we envision depression. It is the most common type and involves an overarching feeling of darkness and sadness. It can lead to thoughts or actions of self-harm and suicide.

Persistent Depressive Disorder

Persistent depressive disorder is less intense than major depressive disorder and allows many people to function daily despite their low mood. However, people with this disorder often have mild depression that has lasted for two or more years and have trouble experiencing joy or feelings of optimism and general happiness.

Seasonal Affective Disorder (SAD)

SAD occurs as the nights get longer as winter approaches. Changes in emotional status from feeling ok to being depressed can occur from disruption to our circadian rhythm, as well as our serotonin and melatonin production. Often this depressive disorder can be treated simply with light therapy but can also be managed with talk therapy and medication. SAD generally gets better as the nights get shorter and more natural sunlight is available.

Bipolar Disorder

Bipolar disorder, once called manic depression, differs from anxiety and depression. Bipolar disorder is characterized by intense highs (mania), moderate highs (hypomania), and severe lows (depression). These mood changes may come on suddenly and last for several days.

Treatment for Anxiety and Depression: The Same, But Different

Treatment for any mental health condition is tailored to the individual's diagnosis and needs. Anxiety and depression disorders each have their own treatment recommendations, although these plans often overlap in both medications used and the types of psychological assistance given.

Medications

Both anxiety and depression are regulated by serotonin. Serotonin is a neurotransmitter that acts like a hormone. According to Cleveland College, "Serotonin plays several roles in your body, including influencing learning, memory, happiness as well as regulating body temperature, sleep, sexual behavior, and hunger. Lack of enough serotonin plays a role in depression, anxiety, mania, and other health conditions."

When it comes to medication for anxiety and depression, there is little distinction. Both disorders have been shown to improve using selective serotonin reuptake inhibitors (SSRIs). You will likely receive a prescription for an antidepressant SSRI medication for an anxiety disorder, which can be confusing.

Examples of SSRI medication for the treatment of both anxiety and depression include:

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Vilazodone (Viibryd)

You could also be prescribed serotonin-norepinephrine reuptake inhibitors (SNRIs). Like SSRIs, these medications work to increase serotonin. Unlike SSRIs, they also increase the levels of norepinephrine. Examples of popular SNRIs include:

  • Desvenlafaxine (Pristiq)
  • Duloxetine (Cymbalta)
  • Levomilnacipran (Fetzima)
  • Venlafaxine (Effexor XR)

Therapies

Cognitive behavioral therapy (CBT) is the most effective treatment for depression and anxiety disorders. CBT is a form of talk therapy (also called psychotherapy) that aids in managing mental health issues by changing how you react, behave, and think.

CBT also teaches life skills so we can cope more effectively. Subsets of CBT include dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT). A typical CBT treatment plan involves limited and structured sessions with a mental health professional. CBT may be used by itself or in combination with other therapies or medications.

Additional Treatments

In addition to talk therapy and medications, both anxiety and depression can benefit from lifestyle changes and a willingness to get help. Some examples include:

  • Get treatment for the medical condition causing the mood disorder.
  • Exercise.
  • Eat a healthy diet rich in vitamins and nutrients.
  • Join a support group.
  • Utilize meditation practice and relaxation techniques.

Still Not Sure if You Have Anxiety, Depression, or Both?

Because anxiety and depression have similar symptoms, causes, and treatments, knowing which common mental health disorder is the primary condition can be difficult. Remember that anxiety tends to be about fear, and depression tends to be about hopelessness.

While depression and anxiety exist separately from each other, there is a high probability that a person with a depressive order has an anxiety disorder as a secondary symptom and vice versa.

To know for sure and to get the proper treatment, you need to see a mental health professional like the experts at Goodman Psychologist Associates. Our therapists are trained in anxiety and depressive disorders and have extensive experience treating both. Make an appointment today or call 630-377-3535. 

When those storm clouds surround us, it is hard to see our way out of them. It is even harder to ask for help. We encourage you to reach out to mental health specialists or to friends and family to talk. You don't have to tackle these issues alone.

Would You Like to Learn More?

Depression - 02/03/2023
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Dealing with Emotional Pain

How to Deal with Emotional Pain: 3 Ways to Feel Better Today

Emotional pain can stop us in our tracks. It can feel unbearable—almost physically painful at times—but unlike physical pain, taking a pain reliever and getting rest doesn’t make emotional pain go away. If you’re wondering how to deal with emotional pain, you aren’t alone.

Some emotional pain can stem from a major life change or disruption like a breakup, a divorce, the loss of a job, or the death of a loved one. When we can pinpoint the trigger of our emotional pain, it may help us to recognize that it’s part of the natural grieving process. Grief hurts.

Sometimes, though, the emotional pain can feel like it's too much to bear. It may last for months and may start to disrupt our day-to-day activities. When this happens, it's time to reach out for support. Whether the emotional pain comes from a life change or is more nebulous in nature, talking to a professional counselor can get you through. Reach out today to schedule an appointment with one of our therapists so that you can deal with emotional pain in a manageable way.

Why Emotional Pain Happens

Anyone who's experienced the deep emotional pain of a loss or trauma can attest that it hurts. Sometimes that hurt is so intense that it feels physical. In fact, it's not uncommon to experience physical manifestations of emotional pain.

When we're going through an emotional upset, we may have headaches, stomach pains, and digestive issues. Our sleep may be disrupted, and we may find that we're unable to focus on work or our usual activities. As a result, our performance can suffer in our jobs and personal lives.

We may also find that we don’t have much of an appetite, or some people may turn to comfort foods—feeling an almost insatiable desire to eat ice cream, cookies, chips, bread, and other carbs (they trigger "feel-good" serotonin in our brains and help us feel relaxed). Other people may turn to less healthy behaviors like smoking, drinking, or drugs in an attempt to numb and deal with emotional pain.

When we experience emotional pain, we can even experience real, physical symptoms. For example, as discussed in Scientific America's article, What Causes Chest Pains When Feelings Are Hurt?

“According to a 2009 study from the University of Arizona and the University of Maryland, activity in a brain region that regulates emotional reactions called the anterior cingulate cortex helps to explain how an emotional insult can trigger a biological cascade. During a particularly stressful experience, the anterior cingulate cortex may respond by increasing the activity of the vagus nerve—the nerve that starts in the brain stem and connects to the neck, chest, and abdomen. When the vagus nerve is overstimulated, it can cause pain and nausea.”

Those gut-wrenching, heart-achy feelings aren’t in our heads. They’re actual bodily reactions to the emotional discomfort. When we grieve or experience a loss, the physical sensations can be particularly strong and overwhelming.

At the same time, our brains are looking for patterns and reasons for the loss. We may find ourselves going through the stages of grief during a breakup or job loss, just like a death. We might experience "magical thinking” where we believe our thoughts, feelings, or actions might have inadvertently caused something to occur. We may try to rationalize and find a sense of control over the situation. Often, we may look for somewhere to put the blame or think, "If only I'd done something differently."

We may also experience guilt over what happened, or we may find ourselves feeling deeply sad, tired, and listless. It's not uncommon for those experiencing emotional pain to feel overcome with emotion suddenly. One minute we're standing in line at the grocery store listening to a song, and suddenly we're in tears.

During grief, sorrow, and emotional pain, we may also find that we feel anger. We might feel abandoned by our loved ones, unsupported in a situation at work, or enraged at our ex. All these complex emotions can come in waves—one moment we’re fine, and the next moment we’re ready to scream, cry, or both.

Emotional pain is challenging, but it doesn’t have to be permanent. It's essential that we feel grief and allow ourselves space to experience the emotions. However, when we don't know how to deal with emotional pain, or it becomes destructive and ever-present in our lives, it may be time to reach out. Whether our pain happens because of a loss or we're not sure what has caused our pain, a professional can provide the supportive space to talk through our problems.

Should we discover that our emotional pain is caused by depression, or if it’s a reaction to circumstances in our life, we can still find relief. While working with a therapist or counselor, it can also be helpful to try these three techniques to alleviate emotional pain.

3 Tips for Dealing with Emotional Pain

1. Practice Mindfulness

Mindfulness and meditation are helpful practices for addressing many different mental health concerns, including emotional pain and depression. When we're mindful, we bring our brains back "online" and help ourselves reorient to the moment. Instead of ruminating on the past source of our emotional pain (or worrying about the future), we look at the present. Even if these pockets of mindfulness are brief, they can help us find relief and deal with emotional pain.

Meditation and mindfulness are easy to learn. There are helpful apps out there like Headspace and Calm that can guide us through the process. There are also many resources online, including free videos on YouTube that can help you get the hang of mindfulness and meditation.

Practice mindfulness anywhere—at home, at the office, in the classroom. It doesn't require anything extra. To give it a shot, we can try to take several deep breaths, focusing on the air coming into our nose and out of our mouth. As we breathe, we can observe our thoughts and feelings. Rather than getting caught up in a thought, we allow the mind to acknowledge it and let it flow by.

Unlike depression and grief, which can trigger catastrophizing thoughts, mindfulness helps us feel calm and relaxed. We focus on the here and now rather than asking what if.

We can also try a mindful walk outside. During our walk, we can do a mental inventory. First, focus on what we see for one minute. Next, spend a minute focusing on the sounds we hear. For the next minute, focus on a physical sensation—like touching a tree, rubbing our fingers on a leaf, or taking off our shoes and walking through the grass. Then focus on the smells in the air, like the scent of flowers, trees, cars, even someone's cooking as we walk by. Repeat this sensory inventory for the duration of the walk.

2. Get Creative & Cerebral

Another way to deal with emotional pain is to focus on stimulating our brains in other ways. Therapy can often be part of the cerebral or cognitive approach (hence, Cognitive Behavioral Therapy). During CBT or talk therapy, we often identify negative thinking patterns and counter them with a more positive perspective.

But in addition to therapy, engaging our brains in other positive pursuits can help us deal with emotional pain in a positive, forward-focused way. When we're learning about a new subject, reading a book, or attempting something new, we use a different part of our brain. We do not forget the subject of our grief (which is often a fear during a loss—we don't want to "get over" someone we love). Instead, we're shifting our brains a little to allow ourselves a rest and to focus on other thoughts.

Journaling can be another technique to help us get our creative juices flowing and start to help us deal with emotional pain. Write out feelings, compose a letter to someone, or look for journal prompts that can help us explore some of the complicated emotions we’re experiencing.

Other outlets such as drawing and coloring, playing music, dancing, or photography can also be excellent ways to work through emotional pain and sadness. While something like dancing may feel challenging (or even impossible) at first, we can channel some of the frustrations and energy into our movement.

Exercise is a great coping tool and can have other benefits for our bodies as well. Again, the thought of going for a jog may seem absolutely out of our range at the moment. But slipping on comfortable shoes and taking a brisk walk around the block, or even doing some jumping jacks in our bedroom can help us start to see positive benefits and boost our mood.

3. Supplement Support

Grief, sorrow, depression, and emotional pain often feel very lonely. We may believe that no one will understand what we're going through; we may feel guilty like we can't offer emotional support back to our friends, or we may feel like we're worthless and people don't want to be around us.

When our brain is experiencing emotional pain, these irrational thoughts can feel very real and insurmountable. But it’s crucial that we find a support system. A therapist or counselor is an important part of the journey, but friends, family, and other people can help too.

We can look through the people in our lives and choose a few key people who might provide a sense of support and empathy. It's important to remind ourselves that we aren't a burden. Part of feeling better is asking for and accepting help to get us through this difficult time. Eventually, we can pay it forward when we're feeling more up to it.

If we can’t readily identify a friend who could support us, consider a family member, a teacher, a coworker, or someone from church or our religious practice. Emotional support can come from many different places, so explore social circles to find a connection.

Even talking to and hugging a pet can be therapeutic and helpful to get us through a difficult time. We can walk the dog or play with a cat and feel less alone. Animals can also remind us to be mindful—after all, they live in the moment, and it can be an excellent example of how we can shift our thinking too.

Most importantly, realize that if you aren’t sure how to deal with emotional pain, you don’t need to go it alone. There are ways to get the support you need to help you move forward to a brighter future. Reach out today to schedule with one of our practitioners. We're ready to listen and help you find ways to feel like yourself again.

Behavior / Blog / Depression - 08/19/2021
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Don't Worry, Be Happy

Don't Worry, Be Happy: How to Cope with Life

As we all know, some people worry too much.  Rather than solving a problem, too much worry becomes the problem.  Not only does excessive worry create much personal suffering, but it also affects the people around the worrier.  I wonder if a lot of our worrying in life is like this:  constant, spontaneous and effortless focus that gets dislodged by distracting external events or our own change of perspective.  Now, I think that anyone who does not worry is just living on a different planet; yet, as we know, just worrying about the weather does not make it rain.

9 Tips for Coping with Life, from a Psychologist

After 31 years of working in the field of psychology, I know a few things make a difference in coping with life.

  1. Pay Attention to the Important Things, More than the Urgent.  Sometimes the only way to get the important done is to stick it between the urgent things that drive our days. Worry is often related to disorganization.  Make a list of things to do each day and cross off tasks once they are completed.  Leave early enough to make appointments on time.  Put your keys in the same place every time you come home.  Keep your house straightened up.  When things are under control, there is less to worry about.
  2. Take Action on What You Want To Do And Figure Your Results As A “Prototype”. A handy friend of mine told me how he approaches building things.  He considers the first version as his working model.  Although I have two left hands with tools, I always thought I had to get it right the first time.  My combination of ridiculously high expectations and little tolerance for error was a deeply frustrating workshop ethic to follow.
  3. If You Do Not Know How To Do it, Ask For Help.  Most of us just need a little guidance or a resource with whom to check out our experience.  We all need support and positive feedback from time to time.  Other people may have solutions to problems that we haven’t thought about.  For reassurance, find people who know how to give it.  Many of us spend a lifetime looking in all the wrong places for approval.
  4. Try To Do The Right Thing.  Maintain your sense of integrity whenever you do something.  Tell the truth. Obey the law.  Keep to your promises.  Let your conscience be your guide.  Granted, we might tell an occasional lie or break a promise, and this is fairly common – but it can also set the stage for worry.  We may think sometimes that we can get ahead in the world the easy way – but the price we pay could be excessive worry, among other penalties.
  5. Minimize Catastrophic Thinking. Some people find it difficult to keep perspective when faced with even a minor stressor.  Not every mole means cancer and not every bill is going to lead to bankruptcy.  Test out the reality of these situations by talking them over with a trust friend.
  6. Limit Your Exposure to the News. Although there is value in keeping up with the latest news, understand that the media focus on bad news since this tends to sell best.  We seldom hear about the good news in the world on TV or newspapers.  Constant exposure to negative events increases our tendency to worry.  Instead, look for what is good in life.
  7. Sleep, Eat Properly, Exercise.  Lack of sleep and a bad diet can make us irritable, distracted, and anxious – all condition which set the stage for worry.  (Try to be mindful of the problem of overeating as a way of making our worries disappear.)  Exercise helps us dissipate the anxiety that often accompanies worry.
  8. Avoid Substance Abuse.  Drugs and alcohol may give the illusion of comfort for the time being, but using them has negative long-term consequences.  They increase depression, cloud judgment and may give you something to really worry about later.
  9. Learn How to Let Go of Worries. This is a skill that might require some practice and each of us will have our way of doing it.  Some people do this by allowing themselves perhaps half an hour a day of worry time – and at the end of the allotted time period, they will be free of worrying until the next day.  Some people give up their worries by writing them down on a piece of paper and then tearing them up.  Some people prefer to hand them over to a higher power.

The Serenity Prayer

God grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. Living one day at a time, enjoying one moment at a time, accepting hardships as the pathway to peace, taking, as He did, this sinful world as it is, not as I would have it, trusting that He will make all things right if I surrender to His Will, that I may be reasonably happy in this life and supremely happy with Him forever in the next.

As this year continues, on behalf of the psychologists in the practice, I want to thank you for recommending us to others.

Read more:

Behavior / Blog / Depression / Fear / Obsessive thoughts - 03/29/2012

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