Depression and Anxiety

Mental health issues are notoriously complex. While psychologists have a successful manual to diagnose your mental health issues, those manuals are simply guidelines for treatment – they're not gospel in terms of how you experience your emotional and psychological wellness.

With that in mind, many people experience more than one type of mental health disorder, often in different degrees. When someone has more than one mental health problem, it's known as "comorbidity," and by far the two most comorbid diagnoses are anxiety and depression.

Types of Anxiety/Depression

For many, anxiety and depression have a type of chicken and egg issue. Some people suffer from depression and develop anxiety. Others suffer from anxiety and develop depression. Others experience both at the same time. Many people also have temporary comorbidity – for example, experiencing a temporary bout of depression after a severe panic attack, or experiencing anxiety when they suffer from events that cause further depression – while others suffer through both of these issues for a long period of time.

The link is so strong, that some anti-depressants are used to treat those that don't have depression, and are instead living with anxiety disorders, and anxiety coping tips are often recommended for those with depression – even when the person doesn't suffer from anxiety. Other research has also indicated that the same neurotransmitters may also play a role in causing both anxiety and depression.

While research has varied, the following table shows the comorbidity of depression with other disorders:

Co-occurence of different disorders
Depression + GAD up to 30%
Depression + PTSD up to 10%
Depression + specific phobia up to 20%
Depression + social phobia up to 30%
Depression + OCD up to 10%
Depression + panic disorder up to 65%

Many of these individuals developed their depression as a result of living with their anxiety. This appears to be especially true of those with panic disorder, likely because panic attacks have a tendency to cause feelings of severe fear, helplessness, and doom. Also, those living with anxiety may not be living the lifestyle they had imagined, thus reinforcing feelings that may eventually lead to depression.

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The two disorders are very different, and yet the reasons they contribute to each other's development become more obvious the more you learn about them.

Depression: Cause and Effects

Depression, like anxiety, may be caused by any number of factors, including:

  • Genetics
  • Upbringing
  • Trauma
  • Reinforcement
  • Social Learning

Depression is an emotional disorder, characterized either by periods of deep sadness, or by a "lack of happiness." Not everyone feels emotionally sad, but those that live with depression often have a hard time of imagining a world that's happy. Some may even have a "flat affect," which essentially implies no emotions at all.

Depression may be temporary, or a long term emotional disorder. After an intense breakup, for example, it's possible to have depression that may disappear as you learn to cope with the breakup. Anxiety makes it harder for that depression to disappear, because anxiety prevents healthy coping. Depression may also be a long term disorder – one that causes intense feelings of sadness, worthlessness, loss of interest in life, and other depressive symptoms.

Depression is the most common stand-alone psychological disorder, affecting as much as 10% of the population. However, anxiety disorders combined compromise a larger percentage of the population, with some estimates putting the number of people living with some form of anxiety as high as 18% or more.

Anxiety: Causes and Effects

Like depression, anxiety may be caused by a whole host of different factors. There are also numerous types of anxiety, including:

  • Generalized Anxiety Disorder
  • Panic Disorder
  • Post-Traumatic Stress Disorder
  • Social Phobia
  • Obsessive Compulsive Disorder

If you haven't yet, take my 7 minute anxiety test to get an idea of what type of anxiety you may be experiencing.

Because of the broad range of anxiety disorders, there is an even broader range of anxiety symptoms. But anxiety can best be described in terms of three issues:

  • Emotional – Anxiety, of course, is a mental health disorder, and that means it affects your emotions and your thoughts. You'll often have fears or worries, and develop a type of negative thinking (which is one of the reasons anxiety may cause depression).
  • Physical – Anxiety often comes with physical symptoms. Some of them are common, like an increased heart rate, sweating, and nausea. Others are less common, like leg pain, shoulder pain, and trouble holding your head up. It's also possible to experience physical symptoms of anxiety when no thoughts or emotional symptoms are present.
  • Behaviors – Anxiety also has a tendency to affect behaviors. In some cases, these may be obvious – like compulsions that you need to complete to reduce your anxiety. Others may be less obvious, like avoiding various situations because you're afraid of the potential for anxiety.

Anxiety is one of the most diverse disorders in the mental health world, causing a host of different problems and comprising of numerous physical, emotional, and behavioral symptoms. It's broad range of symptoms is one of the reasons that anxiety may cause depression.

What to Do if You Have Both Depression and Anxiety?

One of the most important things to realize is that it's genuinely possible to cure both anxiety and depression. But both disorders cause a feeling of there being no hope. It's crucial that you come to the realization that depression and anxiety are going to make you feel like you can't get relief, because that's what the disorders do.

That said, there is still a long road ahead. Both of these conditions require lifestyle changes, commitment to your recovery, and smart treatment decisions. Anxiety and depression often reinforce each other, so while you're recovering, both conditions may set you back and make it feel like the treatments aren't working. But thousands upon thousands of studies have confirmed that treating both conditions is possible for everyone.

Anywhere from 20 to 40 million people suffer from anxiety and depression in the United States alone, and millions more have recovered. While it may often feel like you're the only one that understands your pain and suffering, the truth is that these conditions are unfortunately very common. Yet millions have been able to recover by committing to effective, long term treatment choices.

Taking the Steps to Cure Anxiety Depression

Because both anxiety and depression reinforce each other, the sooner you start your treatments, the sooner you can recover. Talking to a therapist should be your first step, and in the interim, learning strategies to control your mental health is crucial.

I've helped thousands of people overcome their anxiety and depression. I tell them all that to start, you need to take my free 7 minute anxiety test. The test looks at your symptoms, runs them against others that have suffered the same symptoms, and uses it to generate recommended treatment options.

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References

Lowe B. et al. Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. (May 2008) General Hospital Psychiatry. Volume 30, Issue 3, Pages 191-199

Ravindran, Arun V.; Lam, Raymond W.; Filteau, Marie J.; Lespérance, François; Kennedy, Sidney H.; Parikh, Sagar V.; Patten, Scott B. Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults.: V. Complementary and alternative medicine treatments. Journal of Affective Disorders, Vol 117(Suppl 1), Oct 2009, S54-S64. doi: 10.1016/j.jad.2009.06.040

Westen, Drew; Morrison, Kate. A multidimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: An empirical examination of the status of empirically supported therapies. Journal of Consulting and Clinical Psychology, Vol 69(6), Dec 2001, 875-899. doi: 10.1037/0022-006X.69.6.875

Schoevers, R. A., et al. Comorbidity and risk-patterns of depression, generalised anxiety disorder and mixed anxiety-depression in later life: results from the AMSTEL study. International journal of geriatric psychiatry 18.11 (2003): 994-1001.

Kessler, Ronald C., et al. Lifetime panic-depression comorbidity in the National Comorbidity Survey. Archives of General Psychiatry 55.9 (1998): 801.

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