Are you anxious or are you depressed? In the world of mental health care, anxiety and depression are regarded as two distinct disorders. But in the world of real people, many suffer from both conditions. In fact, most mood disorders are a combination of anxiety and depression. Surveys show that 60-70% of those with depression also have anxiety. And half of those with chronic anxiety also have clinically significant symptoms of depression.
The coexistence of anxiety and depression carries some serious repercussions. It makes them more chronic, it impairs functioning at work and in relationships more, and it substantially raises suicide risk.
In truth, depression and anxiety are two sides of the same coin. Researchers suggest that what goes on in the brain and body are very similar. It just seems that some people with the vulnerability to mood problems react with anxiety and some people, in addition, go beyond that to become depressed.
People with depression tend to close down - it is a form of shutdown. Anxiety, on the other hand, is a kind of looking to the future, seeing dangerous things that might happen in the next hour, day, or weeks. Depression is all of that with the addition of 'I really don't think I'm going to be able to cope with this, maybe I'll just give up. It's shutdown with mental or physical slowing.
Research suggests that the stress response over-reacts to situations causing anxiety and depressiveness. Negative things then tend to cause a disproportionate impact and response.
You may identify with this inability to have a proportional response to situations. You may be awake at night worrying about the smallest of things, or you may feel very downcast because some small thing did not go your way. When something makes you anxious you may worry about it for a while but then begin to feel despondent that things are ever going to change.
Psychologists often have difficulty distinguishing anxiety from depression. The things that work best for depression also combat anxiety.
Who is at risk for combined anxiety and depression? There's definitely a family component. Looking at what disorders show up in your family history provides a clue to whether you will end up with both. If you have a lot of depression or anxiety in your family tree chances are your susceptible yourself.
The nature of the anxiety also has an influence on how depressed you feel. Obsessive-compulsiveness, panic attacks, and social anxiety are particularly associated with depression as there is often no relief from the worry.
Age plays a role, too. A person who develops anxiety for the first time after age 40 is likely also to have depression. Someone who develops panic attacks for the first time at age 50 often has a history of depression or is experiencing depression at the same time.
Usually, anxiety precedes depression, typically by several years. Currently, the average age of onset of anxiety is late childhood/early adolescence. This actually presents an opportunity for the prevention of depression, as the average age of first onset of depression is now mid-20s. A young person is not likely to outgrow anxiety unless he/she learns some mental skills. But dealing with anxiety when it first appears can prevent the subsequent development of depression.
The cornerstone of anxiety and depression is overestimating the risk in a situation and underestimating personal resources for coping. Those vulnerable see lots of risk in everyday things-applying for a job, asking for a favour, asking for a date. They also doubt that they have the abilities to deal with these situations and can withdraw.
Further, anxiety and depression share an avoidant coping style. Sufferers avoid what they fear instead of developing the skills to handle the kinds of situations that make them uncomfortable.
Often enough a lack of social skills is at the root. In fact the link between social phobia and depression is dramatic. It often affects young people who can't go out, can't date, don't have friends. They're very isolated, all alone, and feel cut off.
A simple question to ask yourself if you are suffering from anxiety/depression is “ What am I avoiding?” “What do I need to do with my life, my marriage, or my work that I have really been avoiding doing? What decision may I be avoiding that leaves me desperately worried or gloomy?”
Whatever the situation, the twin problems of anxiety and depression can become very debilitating as you feel increasingly helpless to do something about the problems you worry about. So you go around in circles and find it very difficult to create positive momentum with your life. The best thing you can do for now is to tell someone, to admit to your problem and to your helplessness. To give it a name. To get help. To help yourself.
Dr. Colm O'Connor is a Cork Psychologist. He has written hundreds of articles on family psychology - some posted here.