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The words "anxiety" and "depression" are often uttered in the same breath, as if they were the same thing. They're not, but an alarming amount of people does have both. How can you tell the difference, and what treatment is available if you have both?

The terms "depression" and "anxiety" — incidentally two of the most common mental health problems — are often both uttered in the same breath, as if they were the same thing. They're not, but similar imbalances in brain chemistry may be behind both, and anxiety and depression also often coexist in the same person; one study found that of the people who seek medical attention during an episode of either anxiety or depression, more than half also have the other. It gets even more interesting when you learn that those people often didn't visit their doctor because of a mental health complaint at all, but rather for physical issues such as back pain or headaches. 

When you know something "isn't right", but you're not sure whether you're suffering from anxiety, depression, or both, "Doctor Google" is likely to be your first point of call in this day and age — and your internet browsing is what led you here, to SteadyHealth. We'd encourage you to talk to your primary care provider, a psychologist, or a psyschiatrist, but in the meantime, we'll take a look at the features of depression, anxiety, and both. 

Exploring the symptoms of depression

Everyone feels down, apathetic, lonely, or unmotivated at times, often in response to stresses life throws our way — things like bereavement, job loss, a breakup, or any number of other objectively life-changing events. Depression can be diagnosed when a "dark cloud" overshadows everything else, and it just won't lift. While diagnostic criteria specify that you need to feel this way for at least two weeks, many depressed people struggle for much longer before they seek help. 

The symptoms that characterize depression are:

  • Feeling depressed — which can manifest as pervasive sadness, a very low feeling, pessimism, or hopelessness, but also as irritability and low self esteem
  • Having lost interest in activities you used to enjoy or find meaning in, such as hobbies, work, and social interactions
  • Fatigue or low energy
  • Not being able to sleep, or sleeping too much
  • Changes in appetite and weight — some people don't feel like eating, while others overeat
  • Trouble concentrating, being indecisive, and forgetting things
  • Thoughts about death, suicidal feelings, plans to commit suicide, or attempting suicide

People diagnosed with depression will either experience a depressed mood or a loss of interest in previously meaningful activities, and have a total of at least five of these symptoms for a prolonged period of time. Depression also often features physical symptoms like headaches or stomach aches, which have no determinable physical cause. A few different conditions for under the general umbrella of "depression" — major depressive disorder, but also postpartum depression, seasonal affective disorder (SAD), or "adjustment disorder with depressed mood", a kind of depression triggered by a specific event. 

Recognizing anxiety

Many different conditions, from panic disorder to post-traumatic stress disorder and specific phobias, fall under anxiety disorders. Each has their own specific diagnostic criteria. We'll take a look at the symptoms of generalized anxiety disorder (GAD), one of the most common anxiety disorders around — and the disorder most likely to apply when someone is "generally anxious":

  • Extreme and disproportionate worry — this relates to future events, such as work or school performance or social inclusion
  • Persistently feeling restless
  • Disordered sleep
  • Muscle tension
  • Irritability
  • The symptoms are severe enough that they have a major impact on your quality of life and ability to participate in daily activities, and cannot be explained by another medical condition

Anxiety and depression: What they share, and what they don't

Both depression and anxiety can lead a person to be irritable or agitated, to have trouble concentrating, and to suffer from fatigue and disordered sleep. The two conditions also have significant differences, however. 

Whereas anxiety tends to be future-oriented in that people ruminate about bad outcomes that will happen at some later point, those suffering from depression have usually already "assigned themselves" a bad outcome, and are resigned to it. People with anxiety might be hypervigilant — also manifested through phenomena like an exelerated heartbeat or excessive sweating — while those with depression have dulled senses. Anxiety and depression can both feature recurrent thoughts about death, but whereas depressed people are most likely to think about suicide, those with anxiety tend to worry that they or a loved one will die. 

Treatment for depression vs anxiety — and what you can expect if you have both

Some of the very same treatments have been shown to be beneficial for both depression and anxiety disorders. These include antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) Fluoxetine (Prozac) and venlafaxine (Effexor) are both FDA-approved to treat both generalized anxiety disorder and depression, for instance, while sertraline (Zoloft) can be prescribed for social anxiet y disorder as well as depression. Despite the fact that many medications are approved to treat both depression and certain anxiety disorders, it is not yet clear whether they are also effective at treating comorbid anxiety and depression — so if you are prescribed an antidepressant, it is important to check back in to talk about how well it is working. 

Talk therapy is another treatment that has been shown to play an important role in treating both anxiety and depression. Cognitive behavioral therapy (CBT), a short-term therapy that seeks to identify ways in which your thinking has "gone wrong" and then works on changing your thought patterns, is often the therapy of choice. Interpersonal therapy centers on your relationships with other people, and can also be effective, while problem-solving therapy is another kind of cognitive behavioral therapy that focuses on dealing with stressful events.

What now?

If you recognize the symptoms of depression, anxiety, or both, it is time to speak to your primary care provider, a psychologist, or a psychiatrist. This admittedly difficult step will set a diagnostic process to determine what you are facing, which will in turn allow you to receive the treatment you need. 

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