Anxiety Vs. Depression: Mental Health Treatment

Anxiety and depression can be two distinct entities, with one characterized by a restless or agitated state and the other by lethargy and low motivation. However, in some cases, people with anxiety or depression experience symptoms of the other. 

While the two conditions may seem unrelated, anxiety and depression have several unique links. For example, people with depression often experience anxiety and worry that can increase the severity of depressive symptoms. Likewise, those with anxiety often experience pervasive feelings of concern or worry that may lead to a depressive episode. To understand the differences between anxiety and depression, it may be helpful to see the similarities, unique symptoms, and treatments for both.

Anxiety vs. depression

How do you know if you have depression and/or an anxiety disorder? The best way to find out for sure is by speaking with a mental health professional.

Depression and anxiety are both mental health conditions, but they have distinct characteristics despite some overlapping symptoms. Depression and anxiety often co-occur, making it challenging to distinguish between the two; while anxiety symptoms may include restlessness and fear, depression symptoms can include persistent sadness and loss of interest in activities one previously enjoyed. Both conditions can cause mental and physical symptoms such as fatigue and difficulty concentrating, impacting daily functioning and overall well-being.

However, anxiety and sadness are often normal parts of the human experience. For example, it can be normal to have anxiety before meeting for an interview or to feel depressed after losing a loved one. However, if you have feelings of anxiety or depression for weeks at a time that impact your ability to function, there is a possibility of an underlying mental health condition. If you believe that you or a family member is experiencing depression or anxiety, it may be beneficial to seek professional help to address these health conditions and provide appropriate support for depressive disorder and anxiety disorder management.

Talking to your healthcare provider or meeting with a professional therapist can help you identify the cause of the anxiety or depression while also helping you find treatment. You can also look at the symptoms of depressive and anxiety disorders below and let your doctor know if you are experiencing similar symptoms. 

Depressive disorders are conditions within the DSM-5 characterized by symptoms of depression, including but not limited to the following: 

• Hopelessness
• Extreme sadness
• A lack of motivation or initiative
• Appetite changes 
• Sleep changes
• Thoughts of suicide or death  
• A tendency to lose interest in previously enjoyed activities 
• Social withdrawal 
• Difficulty caring for your health and hygiene 

It can be natural to experience sadness or a lack of motivation occasionally. However, if these feelings persist for over two weeks and impact your functioning, talk to a healthcare provider for a depression screening. 

Causes of depression and major depressive disorders

Scientists in psychology have studied why people develop depression for several hundred years. Hippocrates, often referred to as the "father of medicine," mentioned melancholy in his text Aphorisms, describing it as follows: "If fear and sadness last a long time, such a state is melancholy." Hippocrates was the first to describe melancholy or depression in the 5th century BC in a clinical sense. However, he attributed the cause to the elements and fluids from the human body. 

It was not until the 18th century when Phillipe Pinel, a French physician specializing in mentally ill patients, encouraged clinical observation of psychiatric symptoms and introduced a form of patient-centered therapy to provide mental health support. Since then, depressive disorders have been extensively researched and can be identified by several subtypes, outlined in the current Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5TR). Below are the current estimated causes of these conditions. 

Researchers believe one of the primary causes of depression is an imbalance in brain chemicals, or neurotransmitters, that control mood, sleep, and appetite while inhibiting pain. These chemical mediators are primarily adrenaline, dopamine, serotonin, norepinephrine, and acetylcholine. The link between mood-mediating neurotransmitter imbalance and depression was first discovered in the 1960s and is the reason that the first antidepressant medication, known as an SSRI (selective serotonin reuptake inhibitor), was invented. 

A depressive episode might be incited for several reasons, including a family death, job loss, maltreatment, or other major life events. For some, the feelings pass quickly. For others, they do not. You're not weak or lacking in "grit" if you experience a long depressive episode. Each person is unique and responds differently to similar situations.

Depression can also result from changes in your body, such as chemical and hormonal changes as you age or a change in diet. In addition, there may be a genetic component to depression, as studies indicate its hereditary rate is around 40% to 50%. 

What are anxiety disorders? 

Anxiety disorders are characterized by feelings of anxiety that persist for more than two weeks. Anxiety is a spontaneous and unconscious mental reaction to a stimulus characterized by excessive worry and fear accompanied by physiological reactions, such as increased blood pressure. Like depression, anxiety symptoms can be natural and expected in stressful situations. However, if anxiety negatively impacts your functioning, it could be a sign of one of 10 anxiety disorders:

• Panic disorder
• Generalized anxiety disorder (GAD)
• Specific phobias
• Social anxiety disorder
• Separation anxiety disorder
• Selective mutism
• Agoraphobia
• Substance or medication-induced anxiety disorder
• Anxiety disorder due to another medical condition
• Other specified anxiety disorder

In the DSM-5, obsessive-compulsive disorder (OCD) is listed under obsessive-compulsive and related disorders, and post-traumatic stress disorder (PTSD) is listed under trauma and stressor-related disorders. Although previously considered anxiety disorders, they are no longer. 

Anxiety symptoms can include difficulty controlling worry and fearful thoughts, reduced functioning at work, school, or home, irritability, difficulty concentrating, difficulty sleeping, and muscle tension. 

People with anxiety disorders may also experience panic attacks characterized by symptoms like shortness of breath, a fast heartbeat, and sweaty palms. People with generalized anxiety disorder (GAD) may experience a persistent feeling of worry or anxiousness about several areas of life, including relationships, finances, school, and health.  

Anxiety disorders can be caused by prolonged stress and major life changes like a new job or moving to a new place. Like depression, anxiety can also be caused by chemical imbalances in the brain or a family history of anxiety.

Comorbidity of anxiety and depressive disorder

"Comorbidity" refers to the coexistence of two or more mental health diagnoses simultaneously. Anxiety and depression are distinct mental health conditions, but they can and often do co-occur. 

Why are anxiety and depression related? 

There are several theories about the critical relationship between anxiety and depression. One theory is that because similar events cause these conditions, they can occur concurrently. In addition, both may be caused by similar biological factors. 

Researchers have found a biological link between anxiety and depression, revealing how stress and anxiety can lead to depression. This link is caused by neurotransmitter receptors shared with distinct brain chemicals released when you experience stress or anxiety. The neural pathways stimulated when stressed or anxious are also shared by the same pathways that might lead to depressive episodes. 

Internal and external stressors

Behavioral and emotional responses to external or internal stressors can cause similar responses of anxiety and depression. For example, feeling depressed may cause one to fall behind at work, resulting in anxiety due to unfinished work. Similarly, anxiety may interfere with one's ability to focus on work, leading to feelings of depression from disappointment in oneself and low self-esteem. 

Also, one study published in the Journal of Anxiety Disorders found that the relationship between depression and anxiety was mediated by avoidance in individuals who first experienced anxiety. Avoidant behaviors may lead people to stay away from situations that cause anxiety, but this avoidance may also keep them from having positive experiences.   

Common mental health treatment options for anxiety and depression

Treatment options for anxiety and depression may be similar. In some cases, a healthcare provider can prescribe medications to ease the symptoms of these conditions or recommend therapy to help individuals better cope. Below are breakdowns of these options. 

Talk therapy as mental health support

Talk therapy often helps clients evaluate their emotional response to events or thoughts that may be causing worsening symptoms of anxiety or depression. In some cases, people who feel high anxiety or depression following certain events feel those feelings because of more significant underlying issues they may not be aware of. Talking with a therapist may help you uncover these underlying factors. 

Therapy and medication combined approach 

Many therapists use a combined approach of medication and therapy to treat anxiety and depression. Medications can help keep more difficult symptoms under control while giving therapy more time to be beneficial. Further, medications often encourage neuroplasticity, the ability of the brain's physical structure to be resilient to stress and change to reduce future chances of stress. 

Neuroplasticity can help make therapy more effective and reduce the period of treatment. Some people may be reluctant to take medication for anxiety or depression because they take medication for medical conditions or they worry they might depend on it or experience side effects. If you are concerned about the effects of medication, talk to your doctor. In addition, consult a doctor before starting, changing, or stopping medication.  

Medication for anxiety disorders and major depressive disorders

You may find that medication is only recommended for a short term until you work through the causes of anxiety and depression. Some people function better with long-term medications, but others may only take them for 12 months or less. The choice of how long you take a medication can be up to you and your provider. 

Support groups 

Some communities have support groups where people with similar conditions meet to discuss what they do to manage their symptoms. These groups may be hosted or moderated by a healthcare expert or a trained moderator with a similar diagnosis. While these groups might not involve one-on-one time with a therapist, they may be free and offer social connections. 

Online therapy for anxious depression

Therapy can be a beneficial, if not necessary, intervention to help you manage symptoms of anxiety and depression. However, when experiencing these symptoms, reaching out might be perceived as difficult, especially if you are struggling with completing daily tasks like keeping appointments or leaving home. 

Online therapy through a platform like BetterHelp may be helpful, as you can attend therapy sessions in the comfort of your home. In addition, several studies have shown online therapy to be as effective as in-person therapy, offering increased availability for those who live in remote areas or cannot travel easily, alongside more significant cost-effectiveness. 

You can choose between phone, video, or chat sessions with your therapist on an online platform. In addition, you can set your goals before you are matched with a provider, letting them know whether you'd like a therapist for anxiety, depression, or both. You can also express interest in a specific modality if you know of any you might find effective.