Anxiety and depression are two words that are often used outside of a clinical environment. People who have never experienced a documented mental illness sometimes make assumptions about another person’s state of mind, or their own, in any given situation. If you believe what you see on television, depression is most often associated with sadness and crying and anxiety is something that can be cured with a glass of wine.
Depression and anxiety are much more complex than they are portrayed on TV. Both conditions require a professional diagnosis to identify, and there are different symptoms and treatments for each. It is not uncommon, however, for anxiety and depression to occur together in the same person.
Jump to a section:
- What Is Depression?
- What Is Anxiety?
- Symptoms of Depression and Anxiety
- Do You Have Depression or Anxiety?
- Getting Help
What Is Depression?
Each year, depression affects approximately one out of every 15 adults. Approximately one out of every six adults will experience depression at least once in their lifetime. Depression interferes with a person’s ability to accomplish daily tasks at home and at work. It produces a general slowing down of functioning that can become fatal if allowed to escalate.
It is easy to confuse sadness with depression, but it is more than that. Grief, or sadness, is something most people experience due to a loss or disappointment. It can last for several weeks or even develop into depression, but it is brought about by a particular incident and usually a temporary condition. Depression, on the other hand, is not so much situational as it is elemental.
When a loved one dies, you are sad, but that sadness does not change who you are or how you see yourself. You feel the loss and wonder what your future will be like without that person in it, and you also remember the happy times the two of you shared. Your feelings of sadness and happy remembrance alternate and eventually balance out.
In depression, the sadness is often accompanied by a decreased sense of self-worth or even a self-hatred. You have negative projections about your future, but you tend to ascribe them to mistakes you’ve made or character flaws you perceive. You may spend time thinking about the failures in your life and use them as reasons to hate yourself or evidence that you are not as good as you wanted to be. Depression is an almost constant negative mood that is rarely interrupted with positive feelings.
Symptoms of depression can include:
- General tiredness and lack of energy
- Irritability and restlessness
- Constant sadness or dull mood
- Suicidal thoughts or attempts
- Decreased sense of pleasure in hobbies and activities
- Sudden weight loss or gain
- Negative mood or hopelessness
- Insomnia or excessive sleeping
- Physical symptoms with unexplained cause
- Guilt or helpless feelings
- Lack of concentration, memory or decision-making abilities
Depression can last for months or even years if left untreated. The negative feelings associated with depression tend to project into the future, giving life a gloomy outlook. A decreased sense of pleasure can become debilitating by eliminating any motivation for even the simplest activities. Over time, nothing seems to bring you pleasure, even things that made you happy in the past.
What is Anxiety?
Fear, apprehension, nervousness and worry are all part of an anxiety disorder. Regardless of whether these feelings are baseless or not, the emotions experienced in anxiety can cause physical symptoms. An anxiety disorder can become debilitating, keeping you from performing daily tasks and activities.
Anxiety is often a pre-emptive condition that happens before an event, like a test or an interview. It becomes a disorder when that anxiety is consistently disproportionate to the anticipated event. It is natural to sweat a little extra just before you give a big speech. If, however, you suffer from insomnia and nausea for three days before the speech, and this happens every time you give a speech, your anxiety probably rises to the level of a disorder.
As anxiety develops, it causes you to avoid the things, people or situations that scare you. This can mean avoiding daily activities like driving your car, going to the store or any type of social gathering. When the side effects of your anxiety — the sweating, shortness of breath, pounding headache, racing heart rate — become too much to bear, you may find it easier to avoid all frightening situations.
Anxiety is a general disorder that can be broken down into several more specific anxieties. These are some of the more common forms of anxiety disorders:
Social anxiety — A fear of people can keep someone suffering from social anxiety disorder from living a normal life. A social anxiety can include a wide range of fears relating to other people, either through intimate contact or in a crowd. Those fears can include the fear of public embarrassment or a fear of being judged by others.
Phobias — Phobias are irrational fears with a very specific cause. A person who suffers from a phobia is well aware of the fact that their fear is disproportional to the specific threat, but they experience the fear anyway. People can develop phobias to all kinds of things from spiders to heights. A phobia is more intense and long-lasting than fear. Phobias can cause physical and emotional symptoms and interfere with a person’s ability to function in daily life. There are more than 500 specific documented phobias.
Panic Disorder — The panic in this disorder can last for ten minutes or up to several hours and include shaking, nausea, dizziness, difficulty breathing and confusion. Panic attacks are usually triggered by a specific incident, but they can also come on spontaneously. Someone with a panic disorder will learn to anticipate panic attacks and may avoid many harmless situations just to keep from having a panic attack. In some cases, though, extreme stress can trigger an attack regardless of the situation.
Obsessive-Compulsive Disorder — In this disorder, compulsive behaviors are thought to alleviate anxiety. OCD is marked by repetitive behaviors that mirror obsessive thought. Someone suffering from OCD may have an irrational fear of oversleeping and therefore might constantly check and recheck the alarm clock every night. OCD behaviors can be debilitating because they interfere with daily activities. People with OCD may go out of their way to hide their disorder.
Separation anxiety — Like other anxiety disorders, separation anxiety is marked by an irrational reaction to a certain trigger. Being separated from people or places that make you feel safe or happy is often an unpleasant experience. People with separation anxiety, an issue often seen in children, are unable to cope with the separation and respond disproportionately to the event.
- Post-traumatic stress disorder — PTSD is anxiety disorder related to trauma. Some people who experience or witness a severe trauma, especially early in life, can develop an acute anxiety condition. Their need to avoid certain situations after the trauma can be irrational. Their thought patterns around the trauma are often compulsive like reoccurring nightmares or flashbacks. Their level of anxiety following the trauma might be appropriate, but it does not diminish and sometimes even escalates over time.
It is possible to experience anxiety in certain situations or under specific conditions but not in others. For example, someone who suffers from acrophobia, a fear of heights, may not be irrationally scared of spiders, snakes or confined spaces. Anxiety disorders can be very specific, although it is not uncommon for more than one phobia to occur together.
The symptoms of anxiety, which might occur in any type of anxiety disorder or could be signs of a general anxiety disorder, include:
- Gastrointestinal disturbances
- Sleep disturbances
- Increased heart rate
- Uncontrolled worry
- Avoidance impulse
- Unshakable focus on impending danger
The symptoms may seem to come out of nowhere and last for a short period of time, or they could be persistent. They can happen in any combination, and you do not have to experience all of the symptoms to identify your problem as anxiety. The best way to confirm a diagnosis for any type of anxiety disorder is to consult a mental health professional.
The exact causes of anxiety disorders are hard to pinpoint. They can be caused by trauma or other life experience, and they are believed to have a genetic component. In some cases, medical issues like heart disease or diabetes can trigger anxiety disorders, but there is still more to understand about anxiety.
People who have the same experience do not develop anxiety disorders at the same rate. Two people who were exposed to the same trauma may not both develop PTSD, for example. If one person has risk factors that make them prone to anxiety, however, they are more likely to develop PTSD.
Other factors that could make you prone to anxiety are:
- Thyroid conditions
- Rare tumors
- Drug abuse
- Chronic obstructive pulmonary disease (COPD)
- Irritable bowel syndrome
- Addiction withdrawal
Anxiety and Depression Symptoms
Anxiety and depression are two mental disorders with overlapping symptoms, which sometimes makes it difficult to figure out which one is the problem. Depression and anxiety often occur together, making it even harder to know what you are dealing with. Seeking professional help with your diagnosis is important, since each disorder has slightly different treatment modalities.
One of the major similarities between anxiety and depression is negative thoughts. Depression is often dominated by a gloomy mood and negative outlook for the future. People suffering from anxiety tend to fixate on their fears and assume the worst. Their constant worrying about what could happen next brings them down.
It can be very difficult to parse the difference between depression-type negative thoughts and those more likely associated with anxiety. Worrying about or expecting bad things to happen in the future is a sign of both disorders. On some level, the amount of emphasis placed on negative concerns is disproportional to reality, or what is likely to happen in the future. The resulting prolonged bad mood could be indicative of depression.
Anxiety can sometimes lead into depression as negative thoughts and feelings become more generalized and persistent. An acute anxiety attack often leaves a person feeling drained and tired. That low energy can develop into a prolonged sense of hopelessness that fits the diagnosis of depression. In time, the depression may resolve, leaving only anxiety, but a subsequent attack could bring the depression back.
Brain Activity in Anxiety and Depression
There are several factors that contribute to determining your mood, but one of the most important is your brain chemistry. Your brain uses specific chemicals, called neurotransmitters, to control your level of excitement, anxiety or depression. Serotonin, dopamine, and epinephrine are all neurotransmitters associated with both anxiety and depression.
There are some facts you should know about serotonin:
- It is believed to be the primary chemical responsible for mood regulation and balance
- It is found throughout the body, 80-90% of which is in the gastrointestinal tract
- It is found in lower levels in people who are depressed, although there is still some question as to whether the low levels of serotonin cause depression or the depression lowers serotonin levels
- It is converted from an amino acid in the body
- It can only be used in the brain if it is produced there
Dopamine is another important neurotransmitter associated with both depression and anxiety:
- It is made from an amino acid, but it is different from the one which produces serotonin
- It is an important neurotransmitter associated with pleasure
- It can be produced by the brain in anticipation of a pleasurable event, even if that event never occurs
- Levels that are excessively high can be even more damaging to the brain than low dopamine levels
- It is important in controlling body movements, and excessively low levels are associated with Parkinson’s disease
The third neurotransmitter associated with both anxiety and depression is epinephrine:
- It is produced by certain neurons
- It is important in your fight-or-flight reflex response
- It can be naturally increased in the body by exercise
- It is also called adrenalin
- It can be administered as a medicine for cardiac arrest or anaphylaxis
Resolving anxiety or depression is not as easy as rebalancing brain chemistry, however. Adjusting the levels of these three neurotransmitters can help, but there is more to it. Depression actually causes structural changes in the brain, and time and behavioral changes are needed to overcome the condition.
Do I Have Depression and Anxiety?
There are some suggestions in the clinical world that depression and anxiety are not truly two separate disorders. An article in Psychology Today refers to them as “two sides of the same coin,” indicating that depression and anxiety are more than just similar; they are linked.
The article describes anxiety as a sort of precursor to depression. In anxiety, there is a doubtful vision of the future, where in depression there is a complete shutdown. People with depression seem to have considered a gloomy future and given up hope entirely. Anxiety, in many ways, is the more functional version of the two.
Anxiety can morph into depression and then resolve, at least temporarily. Some people who suffer from anxiety move in and out of depression, while others progress into a consistent depression, and others do not go that far. Instead, they eventually resolve their anxiety in a positive direction.
A person experiencing anxiety and depression seems to function at a slower, more subdued pace, mentally and physically. However, the core of the disorder seems to be an overactive brain. In many instances, stress is thought to cause anxiety and depression. A natural response to certain stimuli, excessive or prolonged stress can bring on mental disease.
Stress activates the fight-or-flight response to quicken response time and heighten sensitivity to sensory input. When you remain in this heightened state of alert over a long period of time, your brain can get stuck in certain preparatory thought patterns. Once the stressor is removed, it can be very difficult for the brain to return to normal functioning.
The slowness you see in people suffering from anxiety and depression is in part due to the extraneous thoughts constantly racing through their brains. If they were truly in a physically dangerous situation, those thoughts would help them act quickly to survive danger. With their brains stuck in this hypersensitive mode, though, and no eminent danger to avoid, they struggle to process extraneous thoughts and emotions in addition to performing regular daily tasks.
Separating anxiety and depression can be tricky, but knowing more about each condition is helpful. There is a small genetic component to anxiety and depression. If you have a direct blood relative who experienced either condition, you are more susceptible yourself. That doesn’t mean you will inherit the disorders, but if you are exposed to another risk factor, like a trauma, you are more likely to experience some form of anxiety than another person who does not have a genetic history of the condition.
Depression is more likely to occur in someone who is over 40, and before depression develops, there is usually an episode of anxiety. A typical pattern for the two intertwined diseases is that anxiety is revealed in adolescence, and depression develops later in life. The anxiety is not necessarily a cause of the later depression. It is an indicator that there is a predilection to depression.
When properly treated, anxiety in adolescents can be resolved and the subsequent depression in later life avoided. Developing coping skills for the everyday risky situations in life can reduce and even eliminate anxiety moving forward.
Both anxiety and depression, in the absence of trauma or other acute triggers, tend to develop when the risk of everyday activities is overestimated. In conjunction with escalating the feeling of potential risk, people suffering from anxiety and depression also misjudge their own abilities to cope with that risk.
It is also important to understand the connection between mental and physical symptoms when dealing with both anxiety and depression. Sleep disturbance is the most common physical symptom associated with both of these conditions. If you have a consistent problem getting the sleep you need, over time you will begin to experience a worsening of your emotional symptoms, as well.
The other physical symptoms commonly related to anxiety and depression are irritable bowel syndrome and digestive disorders. The digestive system is very sensitive to most forms of anxiety. Continued physical symptoms of this sort can cause serious health problems and are likely to intensify your depression or anxiety.
Based on your age, the symptoms you are experiencing and your genetic history, you might be able to estimate whether you have anxiety or depression. For help with this evaluation, you can take our self-evaluation quiz online. At Brookhaven Retreat, we have the experience and resources to help you resolve whatever condition you are facing.
If you have both anxiety and depression, they can and should be treated simultaneously. Our experienced professionals at Brookhaven know how to help you unravel the mystery of emotional disorders and ultimately put you back in control of your life. Anxiety and depression are serious conditions that can have devastating consequences to your life, but they can be overcome with the right care and treatment.
Contact Brookhaven today to see if we have what is right for you.