Why depression and anxiety are such good friends.

 

L’art de la fugue.

Depression and anxiety go well together. They will not always occur together, meaning it doesn’t have to be like that, that when you have depression, you’ll experience anxiety as well. Although they can feel very different, with anxiety you can feel all tense and ramped up while with depression you can experience low mood and loss of pleasure. This is of course a very very broad description to make the point that they are quite different.

Yet in the clinical field we see that they tend to go together[1]. Also lot of medication can be used to treat both. When I was put on antidepressants, an anti-anxiety medication was added after a few months which really propelled me into recovery.

Anxiety and depression may feel very different, as I mentioned before but they have a lot of symptoms in common[2]. Restlessness, fatigue, irritability, problems with concentration, sleeping difficulties, ….

The most noticeable symptom of anxiety is arousal or ‘being on high alert’ A symptom that usually doesn’t show up in depression. What you’ll find in depression but not in General Anxiety Disorder (GAD) is anhedonia or an inability to experience pleasure[3].


If you are interested in the criteria for Depressive Disorders like they are described in the DSM V, you can download them here.

If you want to read how General Anxiety Disorder is described in the DSM V, you can download them here.


Do both disorders have a similar origin in the brain?

A lot of research was done to find a possible answer to that question. The answer that was most agreed upon is centered around the ‘fight or flight response to stress’. Psychologists often characterize anxiety as a sense of helplessness at its core and depression as a sense of hopelessness. Both could be interpret as a flight response to a stressor. Both are closely associated with an oversensitive stress response system.

Researchers think that the occurrence of both disabilities are more common in people who’d experienced childhood abuse or trauma. This could cause the stress response system to become more vulnerable. The main hormones involved in depression and anxiety aren’t always the same but the changes can occur in the same symptoms like trouble sleeping.

As I lived through burnout as well, I’ve experienced the same symptoms with that diagnosis although burnout isn’t a psychiatric diagnosis. What I’ve heard researchers say is that the same HPA-axis could be involved as in depression. Some theorists place burnout in the category of depression.

If symptoms and thought processes of both anxiety and depression have a lot in common, could the same brain chemistry be responsible for them?

A lower level of the neurotransmitter serotonin is both found in depression as in anxiety. The way the brain handles another neurotransmitter norepinephrine can be similar in anxiety and depression. To return to my observation that inspired this post, me being prescribed anti-anxiety medication, I found out that some antidepressants work on the serotonin levels and also can affect norepinephrine levels in the brain. That could explain why they’re useful for both depression and anxiety.

As depression and anxiety can occur together and intensify each other, so must treatment propose an adequate answer to both problems[4].


Notes, credits and further reads.

Childhood trauma, the ACE-study.

Depression and the brain, how stress affects the body.

Are you at risk for burnout?


[1] Online article. Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder.

[2] Online article in Psychology Today. Depression and anxiety first cousins at least. Part 2-5.

[3] Online article. Avoidance mediates the relationship between anxiety and depression over a decade later.

[4] The Comorbidity of Anxiety and Depression.

Picture credits click here.

21 thoughts on “Why depression and anxiety are such good friends.

  1. I always wonder about people who simply say off the cuff “I have anxiety” much like they say “I get depressed” without thinking about it much. I wonder if they’re confusing it with much sexier terms for run-of-the-mill worry and sadness. As somebody who has had debilitating anxiety and depression, I can certainly recognize the difference between the two and you’re right, it’s like they’re cousins. I don’t want to belittle or demean anyone’s worry or sadness, but I think those are human emotions. True anxiety and depression are mental health issues.

    Liked by 2 people

    1. I think people should engage a professional when they feel something is wrong.
      Stating that you are ‘depressed’ or ‘having anxiety’ because you feel like that is a more fancy term is not ok.
      I’ve heard people saying the weirdest things, claiming they had ‘cured’ their anxiety with this and that. Well, I am rather skeptical when I hear such statements and wonder what they are exactly talking about: the mental health issues or maybe a more intense ‘normal’ emotion.

      Liked by 1 person

      1. I had worry before going to jail. To me, that’s pretty normal sounding, even if it was extreme worry. In early 2019, I had 10-12 weeks of anxiety that rendered me unable to work, and some days, unable to cope. Weird things started to happen in my mind, like I became afraid of taking left turns in my car and any vehicle that went by my house I thought was trouble. My wife actually took a week off work just to basically sit with me. That wasn’t worry. I had nothing to be worried about. I was scared to death about nothing, and while I logically knew it, that made it even scarier.

        Liked by 1 person

      2. Anxiety takes everything and the longer you stay in fear the less you can do about it. That is what it feels to me.
        I’ve recently discovered in therapy that anxiety plays a big role in my mental health but it is with me for such a long time that I don’t even notice it. Only in extreme panic I know that it’s not ok. I start to see things that aren’t really there.
        To be able to distinguish between normal worry or tension and a pathological form is necessary. When it interferes so much with daily life that you can’t live your life like you ‘normally’ would do, is a sign for me that something is wrong.

        Like

  2. Interesting. Anxiety and depression seem so different, yet I can see how they would have a common origin. Certainly they can feed one another. Struggling against anxiety until it seems like nothing will work easily leads to a depressive outlook, while the stress of battling depression could create anxiety about how long it will go on.

    Liked by 1 person

    1. Exactly, both feelings of hopelessness and helplessness are very encouraging to one another. I may case at least. I was quite surprised to learn that they are so closely related because of the different emotions they generate. But learning this it makes sense to me. I’m glad that there is medication around that helps both things 🙂

      Liked by 1 person

  3. Amazing post! Thank you for sharing. Lately, I have been thinking a lot about the link between anxiety and depression and you’ve just given me all the info that I needed in one single post – and answered many of my questions.
    Especially the ones about the different hormones – I always want to read about this subject and there’s a crazy amount of articles on the internet about it but your’s been just the amazing summary I needed 🙂

    Cheers,

    Mark

    Liked by 1 person

      1. Yes – as you know, recently I haven’t really been able to decide whether I am suffering from depression or not and seeing all the information in one place is pretty helpful. Like….. I am not trying to self-diagnose as it’s never a good idea but reading things backed up by reliable sources does help me a lot (until I finally get the time to seek professional help).

        Liked by 1 person

      2. Okay…just hit sent before finishing my comment 🙂 a final thought that I wanted to add is that i have kind of arrived to the conclusion that I may be suffering from burnout and not depression but I still need to learn more about them…and yeah, see a professional who’ll probably be better at deciding it 🙂 – I am the kind of person who’s never sure about anything so.. 😀

        Liked by 1 person

      3. A good professional can help to make that distinction.
        Some psychologists classify burnout in the category of depression because almost the same brain regions are active in both.
        But as always there is a lot of talk about that and sometimes that isn’t the real issue.

        Liked by 1 person

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