Medically Reviewed by Pat F. Bass III, MD, MPH
After a while, that can take a huge emotional toll, and depression often sets in. There’s no conclusive explanation as to why anxiety and depression so often co-exist, according to the Anxiety and Depression Association of America, but you can find relief from both with the right treatment.
Why Anxiety Leads to Depression
Anxiety disorders are much more than just nervousness and worrying. They can cause terrifying fear about things that other people wouldn’t give a second thought to. Many people with anxiety disorders understand that their thoughts are irrational, but they still can’t stop them.
“It’s a cycle,” says Sally R. Connolly, LCSW, a therapist at Couples Counseling of Louisville in Kentucky. “When you get anxious, you tend to have this pervasive thinking about some worry or some problem and you feel bad about it. Then you feel like you’ve failed, and you move to depression.”
The two conditions have a complicated relationship:
- The incidence of developing depression in addition to an anxiety disorder is high — almost half of all people with major depression also suffer from severe and persistent anxiety, Connolly notes.
- “People who are depressed often feel anxious and worried, so one can trigger the other,” she says. “Anxiety often comes before depression.”
- There may be a biological predisposition to both depression and other anxiety disorders.
- People who have post-traumatic stress disorder (PTSD), an anxiety disorder, are particularly likely to also develop depression, according to the National Institute of Mental Health (NIMH).
“Especially with anxiety, more so than depression, there often is some family history, and so therefore we think that there may be some genetic predisposition to this,” Connolly explains. “Some people are just worriers and pass it down.”
Symptoms of Anxiety and Depression
These are signs that a person may suffer from both anxiety disorder and depression:
- Constant, irrational fear and worry
- Physical symptoms like rapid heartbeat, fatigue, headaches, hot flashes, sweating, abdominal pain, and difficulty breathing
- Changes in eating, either too much or too little
- Difficulty with memory, decision making, and concentration
- Constant feelings of sadness or worthlessness
- Loss of interest in hobbies and activities
- Feeling tired and cranky
- Inability to relax
- Panic attacks
The Road to Recovery
Both anxiety and depression should be treated together. Effective treatment strategies include:
- Cognitive-behavioral therapy (CBT), which is often used to treat anxiety disorder with depression. CBT can teach people to manage their fears, anxieties, and depressive symptoms by figuring out what’s really causing them; people also learn how to take control of their emotions.
- Antidepressant medications, which may be prescribed to help treat both conditions. These drugs are often used in conjunction with CBT. Selective serotonin reuptake inhibitors (SSRIs) are newer, commonly used antidepressantsthat offer fewer side effects than older antidepressants, according to the NIMH.
- Exercise, which can also help both depression and anxiety disorders. Exercisereleases chemicals in the body that make you feel good, and it can help you relax. Taking just a 10-minute walk may alleviate symptoms for several hours, the Anxiety and Depression Association of America states.
- Relaxation techniques, which include practicing meditation and mindfulness. Both can ease symptoms of both anxiety and depression and improve your quality of life, according to a large research review published in the March 2014 issue of JAMA Internal Medicine.
- Organizations offering mental health services, which can include a hospital or support group in your community. Check out the National Institute of Mental Health or the Anxiety and Depression Association of America for more resources.
Warning Signs You Shouldn’t Ignore
Loved ones of those struggling with anxiety and depression should be on the lookout for these warning signs of a mental health crisis:
- Poor daily self-care, such as refusing to perform personal hygiene habits, get out of bed, or eat
- Sudden and extreme changes in mood
- Becoming violent, threatening, or aggressive
- Abusing substances
- Appearing confused or having hallucinations
- Talking about suicide or about not having a reason to live
Treatment for anxiety disorders and depression needs to be administered and managed by a psychiatrist, Connolly says. “It’s really crucial for people with both [anxiety and depression] to have a good assessment to rule out bipolar disorder,” she says. Bipolar disorder, a condition in which emotions can swing from very low to very high levels of mania and depression, is treated much differently than anxiety disorder with depression.
No one has to suffer from anxiety disorder or depression, and certainly not both. People with anxiety disorder should speak with a psychiatrist, therapist, or other healthcare professional about their symptoms, and start treatment before depression has a chance to set in.