Most people feel anxious or depressed at times. Losing a loved one, getting fired from a job, going through a divorce, and other difficult situations can lead a person to feel sad, lonely, scared, nervous, or anxious. These feelings are normal reactions to life's stressors. But some people experience these feelings daily or nearly daily for no apparent reason, making it difficult to carry on with normal, everyday functioning. These people may have an anxiety disorder, depression, or both.

It is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with major depression are also diagnosed with an anxiety disorder. The good news is that these disorders are both treatable, separately and together. Read on to find out more about the co-occurrence of anxiety and depression and how they can be treated.

Anxiety disorders

Anxiety disorders are a unique group of illnesses marked by persistent, irrational and uncontrollable anxiety. These disorders include generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder, and specific phobias. Read a brief overview of anxiety disorders.

Depression

Listen to ADAA Member Peter Roy-Byrne, M.D., discuss anxiety and depression; or download a transcript.

Depression is a condition in which a person feels discouraged, sad, hopeless, unmotivated, or disinterested in life in general. When these feelings last for a short period of time, it may be a case of "the blues." But when such feelings last for more than two weeks and when the feelings interfere with daily activities such as taking care of family, spending time with friends or going to work or school, it's likely a major depressive episode. Depression is a treatable illness that affects the way a person thinks, feels, behaves, and functions. At any point in time, 3 to 5 percent of people suffer from depression; the lifetime risk of depression is about 17 percent.

Symptoms of a major depressive episode:

Types of depression

Three main types of depressive disorders—major depression, dysthymia, and bipolar disorder—can occur with any of the anxiety disorders.

Major depression involves at least five of the symptoms above for a two-week period. Such an episode is disabling and will interfere with the ability to work, study, eat, and sleep. Major depressive episodes may occur once or twice in a lifetime, or they may re-occur frequently. They may also take place spontaneously, during or after the death of a loved one, a romantic breakup, a medical illness, or other life event. Some people with major depression may feel that life is not worth living and some will attempt to end their lives.

Dysthymia is a less severe, long-term, and chronic form of depression. It involves the same symptoms as major depression, mainly low energy, poor appetite or overeating, and insomnia or oversleeping. It can manifest as stress, irritability, and mild anhedonia, which is the inability to derive pleasure from most activities. People with dysthymia might be thought of as always seeing the glass as half empty.

Bipolar disorder, once called manic-depression, is characterized by a mood cycle that shifts from severe highs (mania) or mild highs (hypomania) to severe lows (depression). During the manic phase, a person may experience abnormal or excessive elation, irritability, a decreased need for sleep, grandiose notions, increased talking, racing thoughts, increased sexual desire, markedly increased energy, poor judgment, and inappropriate social behavior. During the depressive phase, a person experiences the same symptoms as would a sufferer of major depression. Mood swings from manic to depressive are often gradual, although occasionally they can occur abruptly.

Depression and anxiety disorders: not the same

Depression and anxiety disorders are different, but people with depression often experience symptoms similar to those of an anxiety disorder, such as nervousness, irritability, and problems sleeping and concentrating. But each disorder has its own causes and its own emotional and behavioral symptoms. Many people who develop major depression have a history of an anxiety disorder earlier in life. There is no evidence one disorder causes the other, but there is clear evidence that many people suffer from both disorders.

Diagnosis and initial treatment

As with any illness, treatment should be tailored to a specific diagnosis. A treatment plan for a diagnosis of major depression and an anxiety disorder should be designed to help a person manage and reduce the symptoms of both disorders, often at the same time.

Some patients with an anxiety disorder and depression may have one diagnosed as a primary disorder and the other secondary; this may require that one disorder is treated first to effectively treat the other. If a person experiences social anxiety disorder and is depressed about not being able to go out with friends or attend family functions, the social anxiety may be triggering the depression, so it should be addressed first. Or if a person who is highly depressed is unable to begin treatment for an anxiety disorder, which requires high motivation and energy, it may be necessary to treat the depression first.

Treating depression and anxiety disorders

Often depression and an anxiety disorder can be treated the same way. In many cases, therapy can be tailored to an individual so that it works to reduce the symptoms of both disorders. Cognitive-behavioral therapy (which works to replace negative and unproductive thought patterns with positive ones), is often effectively used to treat depression and anxiety disorders. Other therapies are targeted to specific anxiety disorders that may not apply to depression.

Some medications have proved effective in treating both disorders. Scientific research shows that both depression and anxiety disorders respond to treatment the medications known as tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs). Although these medications are often called antidepressants, they also have anti-anxiety effects. Originally used only to treat depression, later clinical trials proved their effectiveness in treating anxiety disorders, too.

For more information on treatment options.

Taking other steps

Find a therapist and ask questions

Members of the Anxiety Disorders Association of America who specialize in anxiety disorders have provided descriptions of their practices in find a therapist.

A therapist should be willing to answer any questions you may have about methods, training, and fees. Here are some questions you may want to ask a therapist during a consultation:

Helping a loved one

Support is an important part of the recovery process for someone with an anxiety disorder and depression. Family members can help a loved one diagnosed with one or more disorders:

It is important for family members to keep in mind that the recovery process is stressful for them, too. It's helpful for them to build a support network of relatives, friends, and therapists for themselves, if necessary. With proper treatment from a mental health professional, anxiety disorders and depression can be overcome.

Get more information about helping a family member.

Children with anxiety and depression

Children can experience anxiety disorders and depression, too. It is important to recognize the symptoms because these disorders can affect a child's development and functioning. Read more about anxiety in children and adolescents.

Helping your child

If you think your child is exhibiting symptoms of an anxiety disorder or depression, consult a mental health provider or physician. Find out more about seeking help for your child.

Additional Resources

American Psychological Association

Brainexplorer.org

Columbia University TeenScreen Program

Depression and Bipolar Support Alliance

National Institute of Mental Health

National Mental Health Association

Screening for Mental Health