Did you know that around half of depressed people are also suffering from an anxiety disorder at the same time? Whether it's generalized anxiety disorder, PTSD, agoraphobia, social phobia, or panic disorder, this means that it is as common to have an anxiety disorder in addition to depression as it is to, well, not have an anxiety disorder while you're depressed.
What is depression? What are anxiety disorders?
We know you already know, but it's important to look at how the symptoms of both conditions can overlap.
Depression is a serious mental illness that robs sufferers of their quality of life and ability to function well by causing widely varying symptoms, such as:
- A "depressed mood", feelings of guilt and worthlessness, trouble concentrating, and a negative self-image.
- Taking away your motivation to get involved in activities that would make your life better if you did them, from big-picture things like going to work and trying to excel there, to, for instance, getting up and brushing your teeth.
- Physical symptoms like weight loss or gain due to decreased or increased appetite, sleep problems, being fatigued, and even physical pain.
- Invasive thoughts about death or committing suicide.
Anxiety disorders are, meanwhile, a broad spectrum. Different anxiety disorders come with different symptoms, but some common ones include:
- Invasive worries and fears that just won't go away, and that may be related to specific experiences or things but can also be more general. Constantly or often feeling "on edge" (being hypervigilant), and often being irritable. Many anxious people find it hard to concentrate, too, and may constantly feel something is about to go very wrong.
- Physical symptoms like fatigue, insomnia, tense muscles, heart palpitations, sweating, and shortness of breath.
As you can see, some symptoms — like fatigue and dysfunctional sleep — are common to both depression and anxiety. Others are, however, specific to one of them.
What can combined anxiety and depression look like?
Research has identified four major ways in which depression and anxiety can mix:
- Someone may have been diagnosed with an anxiety disorder after meeting the full diagnostic criteria for this disorder. They also have some of the symptoms of major depressive disorder, but not enough to be diagnosed with it.
- Someone may have been diagnosed with major depressive disorder (or, potentially, one of the other disorders that fall on the depressive spectrum) but also have some symptoms of an anxiety disorder. These symptoms may impact the person's life, but they do not meet the diagnostic criteria for an anxiety disorder.
- The third option is that a person meets diagnostic criteria for both depression and an anxiety disorder.
- Then, it's also possible to have some symptoms of depression combined with some symptoms of anxiety disorders, but not enough to be diagnosed with either disorder. This is called mixed anxiety-depression. In around 20 percent of these cases, the person will develop major depression at some point in the near future.
When anxiety and depression mix: The consequences
For people who were already diagnosed with either depression or an anxiety disorder, and who are currently receiving treatment, it is important to talk to their healthcare providers about the full spectrum of symptoms they experience. If you are anxious but only have a depression diagnosis, let your doctor or psychologist know. Ditto if you have been diagnosed with an anxiety disorder but are also feeling pretty depressed.
The right diagnosis can lead to the right treatment. Don't assume your doctor or psychologist will catch your additional illness on their own, as data indicates that comorbid anxiety and depression are heavily underdiagnosed.
How are comorbid anxiety and depression treated?
Talk therapy can help people with anxiety disorders and depression alike, and we'd definitely recommend including psychotherapy in your treatment plan, in consulation with your doctor. When it comes to pharmacological treatment options, however, there are differences.
Medications most suitable for the treatment of comorbid depression and anxiety include:
- Paroxetine (Seroxat, Paxil) for people who are both depressed and suffering from panic disorder, social anxiety disorder, post-traumatic stress disorder, and generalized anxiety disorder.
- Fluoxetine (Prozac) for depression in combination with premenstrual dysphoric disorder or obsessive compulsive disorder.
- Sertraline (Zoloft) for depression with premenstrual dysphoric disorder or panic disorder.
- Venlafaxine (Effexor) for depressed together with generalized anxiety disorder.
It may, thus, be possible to catch "two birds with one stone".