Most people feel anxious or depressed at times. Losing a loved one, getting fired from a job, going through a divorce and other difficult situations can lead a person to feel sad, lonely, scared, nervous or anxious. These feelings are normal reactions to life's stressors. However, some people experience these feelings every day or almost every day for no apparent reason, making it difficult for them to carry on with normal, everyday functioning. These people may have an anxiety disorder, depression or both.

It is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. In fact, nearly one-half of those diagnosed with major depression are also diagnosed with an anxiety disorder. The good news is that these disorders are both treatable - separately and together. Read on to find out more about the co-occurrence of anxiety and depression and how they can be treated.

What is an anxiety disorder?

Anxiety disorders are a unique group of illnesses marked by persistent, irrational and uncontrollable anxiety. These disorders include generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder (SAD) and specific phobias. For more information about anxiety disorders, click here.

What is depression?

Click here to listen to ADAA Member Peter Roy-Byrne, M.D., discuss anxiety and depression on the “Patient Power” radio program.

Depression is a condition where a person feels discouraged, sad, hopeless, unmotivated and/or disinterested in life in general. When these feelings last for a short period of time, a person may have a simple case of the blues. However, when such feelings last for more than two weeks and when the feelings interfere with daily activities such as taking care of family, spending time with friends or going to work or school, this is called a Major Depressive Episode. Depression is a treatable illness that affects the way a person thinks, feels, behaves and functions. At any one point in time, 3 to 5 percent of people suffer from depression. The lifetime risk of depression is about 17 percent.

Symptoms of a Major Depressive Episode include:

Are there different types of depression?

There are three main types of depressive disorders: major depression, dysthymia and bipolar disorder. All three disorders can occur with any of the major anxiety disorders.

Major depression involves at least five of the symptoms above for a two-week period. An episode like this is disabling and will interfere with a person's ability to work, study, eat and sleep. Major depressive episodes may occur once or twice in a lifetime, or may re-occur frequently throughout one's life. They may occur spontaneously, during or after a life event such as the death of a loved one, the breakup of a romance, a medical illness, etc. Some people who have major depression will feel life is not worth living and some will attempt to end their lives.

Dysthymia is a less severe, more long-term and chronic form of depression. It involves the same symptoms as major depression, mainly low energy, poor appetite or overeating, and insomnia or oversleeping. It can manifest as stress, irritability and mild anhedonia (inability to derive pleasure from most activities). People with dysthymia might be thought of as always seeing the glass as half empty.

Bipolar disorder was once called manic-depression. It is characterized by a mood cycle that shifts from severe highs (mania) or mild highs (hypomania) to severe lows (depression). During the manic phase, a person may experience abnormal or excessive elation, irritability, a decreased need for sleep, grandiose notions, increased talking, racing thoughts, increased sexual desire, markedly increased energy, poor judgment and inappropriate social behavior. During the depressive phase, a person experiences the same symptoms as would a sufferer of major depression. Mood swings from manic to depressive are often gradual, although they can occasionally occur abruptly.

Is depression the same as an anxiety disorder?

No, depression and anxiety disorders are different. People with depressive disorders often experience some of the same symptoms of an anxiety disorder, such as nervousness, irritability, and problems sleeping and concentrating. However, each disorder has its own causes and its own emotional and behavioral symptoms.

Does depression cause anxiety or vice versa?

Many people who develop major depression have a history of an anxiety disorder earlier in life. There is no evidence one disorder causes the other, but there is clear evidence that many people suffer from both disorders.

Which should be treated first - anxiety or depression?

As with any illness, treatment should be tailored to your specific diagnosis. This means that a diagnosis of major depression and an anxiety disorder requires a treatment plan designed to help you cope with and reduce the symptoms of both disorders, often at the same time.

Some patients with both an anxiety disorder and depression will find one is diagnosed as the primary disorder and the other a secondary disorder, which may require one disorder to be treated first in order to effectively treat the other. For instance, if a person experiences social anxiety and is depressed because he or she can't go out with friends or attend family functions, the social anxiety may be triggering the depression and may need to be addressed first. On the other hand, for example, a person who is highly depressed may not be able to begin some of the treatments for certain anxiety disorders, which require high motivation and energy. In that instance, it may be necessary to treat the depression first.

Not everyone who suffers from both anxiety and depression will have one labeled their primary disorder and the other their secondary disorder. These people can often pursue treatment for both disorders simultaneously.

Can depression and anxiety disorders be treated the same way?

Often times, yes. In many cases, therapy can be tailored to an individual in such a way that it works to reduce the symptoms of both disorders. Certain therapies, including cognitive-behavioral therapy (which works to replace negative and unproductive thought patterns with positive ones), are used to effectively treat depression and anxiety disorders. Other therapies are targeted to specific anxiety disorders and may not apply to depression.

Certain medications also have been proven effective in treating both disorders, although this will depend on an individual's symptoms. Scientific research shows that both depression and anxiety disorders respond to treatment with medications including tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs). Although these medications are often called "antidepressants," they also have "anti-anxiety" effects, which is why a person can have an anxiety disorder and take an antidepressant. Originally they were only used to treat depression, which is why they are named as such, but later clinical trials proved they effectively treat anxiety as well.

For more information on treatment options, click here.

What other steps can I take to treat my anxiety and depression?

How do I find a therapist and what questions should I ask?

ADAA offers a searchable listing of mental health providers nationwide. To find a therapist in your area, click here.

To determine whether a particular provider may be right for you, consider asking the following questions during your initial consultation:

For more questions to ask and information on treatment options, click here.

How can I help a loved one?

Family support is an important part of the recovery process for both anxiety disorders and depression. Some things family members can do to help a loved one diagnosed with these disorders include:

It is also important for family members to keep in mind that the recovery process is stressful for them too. They should build a support network of relatives, friends and, when necessary, therapists for themselves. Remember that with proper treatment by a mental health professional, anxiety disorders and depression can be overcome.

More information on helping a family member can be found here.

Can children exhibit symptoms of anxiety and depression?

Yes, children can experience anxiety and depression just as adults do. It is important to recognize the symptoms of anxiety and depression in children as these disorders can affect a child's development and functioning. For more information on anxiety in children and adolescents, click here. For more on depression in children and adolescents, visit the National Mental Health Association by clicking here.

How can I help my child?

If you think your child is exhibiting symptoms of anxiety and/or depression, it is important to consult a mental health provider or physician. For information on when to seek help for your child and tips on finding the right professional, click here.

Additional Resources

American Psychiatric Association

American Psychological Association

Brainexplorer.org

Columbia University TeenScreen Program

Depression and Bipolar Support Alliance

National Institute of Mental Health

National Mental Health Association

Screening for Mental Health

 

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