Persistent sadness, irritability and low self-esteem. These are just a few of the common signs of depression. They might be equally as debilitating as the symptoms of anxiety (nervousness, chest pain, and a sudden sense of doom), but they’re distinctly different.
Still, depression and anxiety often occur together. In fact, in one survey, 58.1% of respondents with generalized anxiety disorder (GAD) also met the criteria for major depression. When it comes to mental health, depression and anxiety are one of the most common comorbidities.
If you aren’t sure where one begins and the other ends, you’re not alone. Thankfully, there are ways to tell them apart, plus treatment options to help you manage the murky mix of symptoms.
The Relationship Between Depression and Anxiety
How They Begin
In some cases, anxiety and depression develop at the same time. For other people, anxiety comes first and later causes feelings of depression.
Others develop depression and then gradually show signs of anxiety during treatment for their depression. This can happen in a couple of ways. As you start to better manage your depression and engage in more social events, the pressure of socializing can initiate symptoms of anxiety. Another possibility is to develop anxiety as a side effect of certain antidepressants.
How They Differ
- Depression: With an episode of depression, your mood and self-esteem are at an all-time low. When you think about the future, you feel hopeless. You do not have a positive outlook. Therefore, you don’t believe anything good will happen to you or to others. Thoughts of death are often suicidal in nature. All types of depression stem from the same mental activity, although for someone with bipolar disorder, the intense periods of low mood contrast with a very elevated mood sometimes.
- Anxiety: If you have generalized anxiety disorder, your mental state is constant worry about the future. Your thoughts are uncontrollable. You often focus on the possibility of something negative happening, sometimes as severe as death. The worry is always greater than the actual risk.
This level of worry can make you avoid participating in certain activities. If you have social anxiety disorder, this means avoiding social settings where you might meet new people.
- Depression: Because depression is characterized by a low mood, the most telling physical symptom is moving slowly or talking low and slow. Your thoughts are also a bit slower, so it takes you longer to make decisions. It’s common to have changes in appetite, which can lead you to gain weight or lose it. You might also feel unexplained aches and pains.
- Anxiety: The physical symptoms of anxiety are what you would expect when you’re worried or feeling fearful. Symptoms most often include:
- Muscle tension
- Chest pain
- Increased heart rate
- Shortness of breath
What Anxiety and Depression Have in Common
The Anxiety and Depression Association of America (ADAA) outlines the overlapping symptoms between generalized anxiety disorder and depression. Symptoms they have in common include:
- Sleep problems
- Difficulty concentrating
Are They Different or the Same?
There’s still much debate over whether anxiety and depression are two distinct disorders or just two sides of the same coin. Mixed anxiety depressive disorder (MADD) does exist in the International Classification (ICD-10), but the American Psychiatric Association hasn’t classified the co-occurrence as a separate syndrome in the latest version of DSM-5. (The Diagnostic and Statistical Manual of Mental Disorders [DSM] is the handbook used by healthcare professionals as a guide on mental disorders.) European researchers argue that MADD should have its own classification because it “will help patients to gain appropriate treatment early.” They think early treatment might keep the condition from getting worse.
Other researchers suggest “…there are meaningful differences in the biology of GAD and depression that not only help confirm that they are indeed separate diseases but that they may in some cases be polar opposites.” Their findings showed that GAD patients tend to have a decrease in the volume of their hippocampus. This was also true for MDD patients with comorbid GAD. But it wasn’t found in patients without GAD. So the researchers concluded that a smaller hippocampus must be a characteristic of anxiety and not depression.
Coping with Depression and Anxiety
No matter how depression and anxiety are classified, there’s still a lot of overlap in how they’re treated. Here are some of the most effective ways to manage depression and anxiety:
1. Change Your Diet
When you’re feeling low, it’s natural to reach for convenient comfort foods or, worse, drugs and alcohol. But these choices only feed your depressed mood.
To avoid going down that slippery slope, fill your home and kitchen with healthy alternatives, and try to balance all your meals with a mix of proteins, fats, and carbohydrates. Following the MyPlate Method makes it easy: 50% of your plate should be filled with fruits and vegetables, and half of your grains should be whole grains. Also, limit alcohol and tobacco products to boost your overall health and well-being.
2. Start an Exercise Routine
Physical activity has a host of benefits, but the increase in endorphins is the most important when it comes to your mental health. Endorphins are the “feel-good” hormones released by your central nervous system. They reduce your perception of pain and bring you a sense of euphoria.
Studies have long since proven exercise is effective at helping depression and anxiety. “Depressed adults who took part in a fitness program displayed significantly greater improvements in depression, anxiety, and self-concept than those in a control group after 12 weeks of training,” according to Preventive Medicine. The researchers also found that the exercise participants maintained these improvements through the 12-month follow-up period.
3. Try Medication
A review of scientific research suggests the use of an anxiolytic (such as benzodiazepines or buspirone) with an antidepressant is effective in patients who have both anxiety and depression. When both types of medications are used, your doctor may taper the anxiolytic dosage to slowly ween you off it once your symptoms of acute anxiety have subsided.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are also popular prescriptions for treating anxiety and depression.
Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are used in patients with depression and anxiety as well. But these medications often come with undesirable side effects and the risk of overdosing.
Complementary and alternative medicine (CAM) is a growing form of treatment for anxiety and depression. CAM is usually done with prescription medication, but that’s a conversation you should have with your doctor.
There are several forms of CAM for anxiety and depression, but relaxation techniques “have been shown to be helpful for older adults with anxiety.” Relaxation looks different for everyone, but the most popular practices include yoga, meditation, and even acupuncture. The Anxiety and Depression Association of America notes that evidence supporting acupuncture is growing. This is the Chinese practice of inserting needles at certain points on your body to manipulate energy flow.
5. Try Cognitive Behavioral Therapy (CBT)
CBT has long been known as an effective treatment for depression and anxiety, both together and as separate disorders. With CBT, you spend time talking to a trained therapist. Their role is to teach you coping strategies to better manage your symptoms. You’re then empowered to practice the skills you learned during your therapy sessions and on your own. The ADAA says CBT helps you learn to control your thinking and maintain a sense of control and self-confidence. They also note that “benefits are usually seen in 12 to 16 weeks, depending on the individual.”
6. Look into Transcranial Magnetic Stimulation (TMS)
This therapy is FDA-approved for the treatment of depression, and it’s commonly used to treat anxiety as well. It’s a non-invasive, in-office procedure that delivers electromagnetic pulses to areas of your prefrontal cortex. That’s the region of the brain in charge of regulating your mood. If you haven’t had success with antidepressants or other prescription medications, TMS is a drug-free alternative with minimal to no side effects.
Untangle the Web with the Right Treatment
The ADAA suggests that if one disorder is causing more distress than the other, it makes sense to focus on treating that one first. Unfortunately, that may not be the case for everyone. That’s why it’s important to speak with your healthcare provider as soon as symptoms arise. The quickest method of treatment is almost always the best.
If you have specific questions about how TMS therapy can help treat your depression and anxiety, contact the experts at HPR Treatment Centers. We are happy to talk you through it and make sure you get the right form of treatment for you!