Anxiety vs Depression

Anxiety and depression are common mental health conditions that can impact the way a person thinks, feels, and behaves. These two conditions have many similarities and differences in terms of their causes, symptoms, and treatments.

What is anxiety?

Many people experience feelings of anxiety from time to time, particularly when faced with a stressful situation or event. However, for some people, anxiety can become persistent and overwhelming, impacting their ability to function in certain areas of life.

There are several types of anxiety disorders, including generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (also known as social phobia), and phobias. Anxiety disorders share many similarities but may also have slightly different triggers or symptoms ^[1].

What is depression?

Depression is a mental health condition that typically causes a person to feel ongoing or intense feelings of sadness or low mood for long periods of time. Someone with depression might experience severe impairments in their quality of life and have difficulties maintaining normal daily functioning.

People can experience differing symptoms but still have the same diagnosis of depression. For example, some people may find that they struggle to eat while feeling very low, while others may find that they eat a lot more than usual ^[2].

Anxiety vs depression: Symptoms

Both anxiety and depression can cause impairments in personal, professional, and social functioning. The two conditions may share some similarities in symptoms, such as changes in sleep, energy levels, and confidence, but typically present differently ^[3].

Symptoms of anxiety disorders can include ^[1][3]:

• Feeling unable to stop worrying about things
• Struggling to go to sleep or stay asleep
• Feeling restless
• Being irritable
• Having stomach pain or headaches
• Feeling very tired
• Struggling to concentrate
• Experiencing panic attacks
• Racing heart
• Sweating or feeling hot
• Shaking
• Thinking that something terrible is going to happen
• Chest pain
• Feeling very afraid of certain people, places, or things
• Avoiding social situations
• Low self-esteem

Symptoms of depression include ^[2][3]:

• Feeling very low in mood
• Feeling very tired all the time
• Sleeping a lot more or a lot less than usual
• Waking up often in the night or early in the morning
• Eating a lot more or a lot less than usual
• Feeling no enjoyment in things that were previously enjoyable
• Lacking in motivation or energy
• Trouble concentrating or thinking
• Feeling helpless, hopeless, or worthless
• Social withdrawal and isolation
• Having thoughts of self-harm or suicide

Anxiety vs depression: Causes

There is no clear cause for either anxiety or depression, but both conditions share several potentially contributing risk factors and triggers.

Genetics

The risk of developing anxiety or depression is greatly increased in those with a direct family member with anxiety, depression, or another mental health condition. It is believed that there is a strong genetic heritability for both conditions ^[4][5].

Past experiences

Past experiences can contribute to the development of anxiety or depression, including childhood trauma such as abuse or neglect, bullying, or the death of a loved one. Similarly, past experiences could trigger specific anxieties or phobias, such as witnessing a plane crash leading to a fear of flying ^[6][7].

Life changes or stressors

Current or recent circumstances can also contribute to the development of anxiety or depression, including difficulties with relationships, finances, housing, or employment, experiencing abuse or racism, the death of a loved one, or social isolation ^[6][7].

Brain chemistry and functioning

Research suggests that there are several neurotransmitters that can be involved in the development of depression and anxiety. Studies indicate that abnormalities in the levels of serotonin, glutamate, and GABA can lead to or worsen these conditions. Many people respond well to treatment with medications that act on these neurotransmitters, further confirming this link ^[4][8].

Research also suggests that abnormal activity or size of certain areas of the brain may also play a part in the development of mood and anxiety disorders. Some people with these conditions have been found to have abnormalities in the amygdala and hippocampus, the parts of the brain responsible for emotion and memory, respectively, indicating that these changes may be caused by, or lead to, mental health issues ^[5][9].

Furthermore, it is believed that there are several cases of depression that may have been caused by damage to the brain from a severe head injury, further indicating that changes in certain parts of the brain can alter mood ^[7].

Physical health problems

Depression and anxiety can both be triggered or exacerbated by long-term or serious physical health conditions. This may be due to persistent worrying or fear about ongoing treatment or possible outcomes ^[2][7].

Similarly, there may be physical health conditions that cause similar symptoms to anxiety or depression, thus worsening symptoms of these conditions. For example, heart conditions could cause an irregular heartbeat and chest pain, which can also be symptoms of anxiety, thereby potentially worsening or causing other anxiety symptoms ^[1].

Other mental health conditions

Many mental health conditions occur alongside at least one other mental health condition. This may be due to several reasons, such as a genetic predisposition for mental illness, life circumstances, or childhood trauma, all of which can be contributing factors to the development of several different conditions. As such, it is very common for depression and anxiety to co-occur, as they share several risk factors ^[4][5].

Medication or substance use

Various substances can contribute to the development of symptoms of anxiety and depression, including mental and physical health medications, alcohol, illicit drugs, and caffeine. Chemicals in these substances can alter the way the brain functions, thereby changing mood, thoughts, and behavior, as well as potentially causing physical symptoms such as a racing heart ^[1][2][7].

Hormones

Hormonal changes that occur during adolescence, during a person’s menstrual cycle, during and after pregnancy, and during menopause can also contribute to significant changes in mood and potentially cause depression ^[10].

Anxiety vs depression: Treatment

Treatment for anxiety and depression is typically very similar, with a combination of therapeutic interventions and medications. Treatment will vary depending on the individual, the severity of their symptoms, and their response to certain treatments ^[3].

Therapy

Psychotherapy is a commonly prescribed treatment for both anxiety and depression, in which individuals can explore and discuss their emotional distress, any possible underlying causes of their condition, and how to manage their symptoms ^[1][2].

One type of psychotherapy that has been found to be effective for both anxiety and depression is cognitive behavioral therapy (CBT). CBT can help individuals to better understand their condition, learn to spot and manage triggers, alter negative thoughts and behaviors, and learn positive coping strategies ^[4][11].

Specific types of anxiety disorders, particularly phobias, can be treated with a type of therapy called exposure and response prevention therapy (ERP). Initially designed to treat obsessive compulsive disorder (OCD), ERP can help alter negative responses to specific triggers with systematic exposure, eventually leading to desensitization and an alleviation of symptoms ^[12].

Medication

There are various types of medications that may be prescribed to help manage anxiety and depression, some of which can be effective at treating both conditions.

• Antidepressants: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline, and citalopram, and serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine and duloxetine, are typically effective medications in the treatment of both anxiety and depression. Older antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) may also be prescribed but have a higher risk of side effects so are not a first-line treatment ^[1][4].
• Benzodiazepines: Benzodiazepines, such as diazepam, are effective in the short-term treatment of symptoms of various anxiety disorders but are not effective in the treatment of depression. Due to their risk of abuse and dependency, benzodiazepines are not commonly prescribed as a first-line treatment for anxiety and should be used with caution ^[1].
• Beta-blockers: Beta-blockers, such as propranolol, can help in the short-term treatment of physical symptoms of anxiety, but are not effective at treating depression ^[1].
• Antipsychotics: Atypical antipsychotics, such as quetiapine, may be prescribed in the treatment of depression if the condition has not been successfully managed with antidepressant medication ^[13].

Self-care

There are also various self-care tips and techniques that can help with managing symptoms of anxiety and depression, such as ^[11][14]:

• Diet: Research suggests that a diet consisting of processed food, high sugar and fat content, and low vitamin content can contribute to worsening mental health, so eating healthy foods and consuming a diet rich in necessary vitamins and minerals can improve symptoms of depression and anxiety.
• Exercise: Engaging in regular exercise can help to improve mental and physical wellbeing, thereby helping to reduce symptoms of anxiety and depression.
• Sleep: Trying to form and maintain a regular sleep schedule, by going to sleep and waking up at the same time each day, can help to improve symptoms of anxiety and depression.
• Mindfulness: Mindfulness techniques, including meditation and yoga, can help to reduce negative emotions and stress. Mindfulness helps to calm both the mind and body while focusing on the present, thereby helping to manage symptoms of anxiety and depression.
• Support: Talking to others, whether a professional, loved one, or in a support group, can help to reduce negative emotions, stress, and feelings of loneliness.

Can you have anxiety and depression at the same time?

Many mental health conditions commonly occur alongside another, often referred to as co-morbid conditions. It is very common for people to experience anxiety and depression at the same time.

Over half of people with one condition also have the other, and it is likely that the figure is even higher when accounting for those who have symptoms of both conditions but have not received a diagnosis for one or both ^[3][15].

For example, it is common to have a diagnosis of depression and have symptoms of anxiety that do not quite meet the criteria for diagnosis, or vice versa.

Symptoms of either condition may also contribute to the development of additional symptoms. For example, if someone with depression struggles to attend work or school regularly, they may fall behind on their work, thus causing them to become increasingly anxious.

People with more than one mental health condition, such as those with both anxiety and depression, may need more specialized treatment to help in managing symptoms of both conditions.

Although there are types of treatment that can alleviate symptoms of both anxiety and depression, some people may find that while one condition is being effectively treated, the other is not, thereby requiring additional intervention ^[4][15].