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.
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.
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.
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.
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
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:
- Premenstrual dysphoric disorder (PMDD).
- Heart disease.
- Thyroid problems.
- Respiratory disorders like asthma and Chronic Obstructive Pulmonary Disorder (COPD).
- Drug or alcohol withdrawal.
- Chronic pain or irritable bowel syndrome.
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.
- Feeling overwhelmed with worry, fear, and dread
- Fear of the future, injury, sickness, and death
- Rapid, intrusive, or frightening thoughts
- Disassociation or detachment from reality, or depersonalization
- 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.
- 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.
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 (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 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.
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.
Sometimes called social phobia, this anxiety disorder manifests with intense symptoms of anxiety accompanying social interactions.
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.
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.
Just like anxiety, depression also has multiple disorders, categorized as follows:
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 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.
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, 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 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.
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)
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.
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.
- Eat a healthy diet rich in vitamins and nutrients.
- Join a support group.
- Utilize meditation practice and relaxation techniques.
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.