The Connection Between Depression and Anxiety
If you were in school studying to be a counselor, social worker, psychologist or psychiatrist, you would learn all about the various mental health disorders. You would read books about depression and hear lectures about anxiety, but you would most likely learn about these issues as if they existed in a vacuum; not influenced by other factors in life. Though this information is extremely useful, it does not represent real-world situations.
In reality, because people, symptoms and stressors do not exist in a vacuum, mental illness often presents with comorbidity. This means that two or more mental health issues are present at the same time. This happens when some dysfunction from one disorder triggers symptoms of another to present. If left untreated, even a relatively benign issue can become more damaging and greatly impact your life in a negative way.
Two mental health disorders that are often found together are depression and anxiety. For this article, depressive disorders including major depressive disorder, persistent depressive disorder and unspecific depressive disorder will all be referred to as depression and all anxiety disorders including generalized anxiety disorder, panic disorder, social anxiety disorder, phobias, unspecified anxiety disorder and obsessive-compulsive disorder will be referred to as anxiety for the sake of simplicity.
Some reports claim that the rate of comorbidity with depression and anxiety is as high as 85%, meaning that 85% of people with depression will also have anxiety. The rate is so high that the new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM5), the book that mental health professions use as basis for diagnosing mental illness, considered adding a diagnosis called mixed anxiety-depressive disorder for people with both anxiety and depression. In the end, the writers decided to leave them separate.
This seems like a wise choice because despite the frequency they are found together, depression and anxiety remain unique and need to be treated as such. Before you can plan treatment, you must first understand depression and anxiety, their similarities and differences and the interactions between the two.
Impact of Depression
It is helpful to learn the power depression it has over your thoughts, feelings, behaviors and physical symptoms. This is the impact of depression:
- Feelings – Depression creates feelings of sadness, anger, irritability, guilt, shame, worthlessness and resentment. Depression itself has become a feeling as many people state that they feel depressed.
- Thoughts – Thoughts during depression tend to be more pessimistic and negative. You are likely to think that the world is a terrible place filled with terrible people. You may believe that people only want to hurt you or use you for their own gain. You may be convinced things will never improve and that trying is futile.
- Behaviors – The stereotypical behaviors of people with depression are largely true. People will rest in their home, lacking energy and motivation to do the daily tasks that need completed. People with depression tend to sleep more than others and may leave the house less often.
- Physical symptoms – Aches and pains are common in people with depression. Headaches, stomach problems and back pain are common. These psychosomatic symptoms are depressions way of affecting every aspect of your body and mind.
Next page: the impact of anxiety, and lessening the impact of depression and anxiety on your life.
Impact of Anxiety
Feelings, thoughts, behaviors and physical symptoms associated with anxiety are somewhat different that depression, but search for overlap as you read through the following. This is the impact of anxiety:
- Feelings - Anxiety triggers feelings of worry, fear, confusion, irritability, apprehension, nervousness, anger and sadness.
- Thoughts - Thoughts are largely influenced by the feelings of fear and the idea that the worst is going to happen. People think that whatever behavior they do or whatever decision they make will lead to unwanted results. They think that people are judgmental, unfriendly and working against them. The world is a scary place to someone with anxiety so they will spend a lot of time at home in their “comfort zone." They think that life cannot possibly be desirable so they accept disappointment.
- Behaviors - People with anxiety are less likely to go places, especially ones out of their “comfort zone." These are the people that miss school or work often because the symptoms grow too strong. People with anxiety often appear tense or rigid. They will have difficulty sitting still and fidget with their hands and feet.
- Physical symptoms - Anxiety creates a long list of physical symptoms including stomach problems, muscle tension, excessive sweating, dry mouth and headaches. Acute anxiety in the form of a panic attack is associated with trembling, hyperventilating, dizziness, heart palpitations and feeling flushed.
Lessen the Impact
As you can see, there is a fair amount of overlap between depression and anxiety in regards to feelings, thoughts, behaviors and physical symptoms. As depression triggers anxiety or anxiety triggers depression, your body begins to misperceive and generalize symptoms of the first disorder and puts them onto the second.
The good news is that mental health professionals have very effective skills, techniques and interventions to limit the impact of depression and anxiety, whether they appear alone or together. Certainly, improving both is more difficult than improving either alone, but the best treatment plan can make a profound impact. Want to reduce depression while you reduce anxiety? Here’s how:
Detect
With depression and anxiety, you cannot directly change the feelings or physical symptoms that it causes. Because of this, you should focus your energies on thoughts and behaviors. In this case, detecting means working to gain awareness of your thoughts and behaviors that are fueled by the depression and anxiety.
Look through the depressed and anxious thoughts above. Do they sound like your thoughts? What other thoughts do you associate with depression and anxiety? Pay attention to them to understand how frequently they appear.
Debate
This step could also be called “challenge" because you take the thought you identified earlier and confront it. Here, you must work to objectively reflect on the thought to see if makes sense, while noting that your depression wants you to be more depressed and you anxiety wants you to be more anxious.
Is the world a terrible place? Will trying only bring about more failure? Keep in mind that your disorders make you see the world more negatively and unfairly. Use your rational mind to offer counter arguments and look for situations and instances that your thought was not accurate.
Lessen the Impact
Decide
Using the information from the debate, make a decision about the situation while considering your goal. Is your goal to find your “truth" or to be happy? Many times people believe “I feel it so it must be true." In reality, your truth is only your perception of the situation. Your truth will not match the truth of others since truth is subjective at times.
Choosing happiness means that you decide to believe the explanation that ignores depression and anxiety. Consider saying, “The world has a lot of beauty in it," or “Trying is the only way to change my situation." Where your thoughts go, your behaviors are sure to follow. Changing your thinking will increase energy and motivation since there is hope.
Recover
Depression and anxiety each affect your body negatively. Engage in pleasurable activities to recover from the assault. Start with small, low risk goals of getting out of the house and meeting friends for a bite to each. Take a long, hot bath or shower. Go for a walk or to the movies. Doing something outside of your “comfort zone" further challenges the unwanted thoughts you have. Chances are fantastic that only good things will come from your recovery-focused activities. Once momentum is established, you can stretch your comfort further.
Relax
Relaxation techniques are great for reducing anxiety and can act as damage control to limit the influence of future symptoms. Find techniques and interventions that work for you. Deep breathing, progressive muscle relaxation, guided imagery and others are extremely helpful when done with consistency. Try yoga or other exercise for another level of relaxation. Do not wait until your energy improves to try. Relaxation will boost energy and motivation.
Rational
Depression and anxiety grow by inserting irrationality into your brain. Depression tells you that you are 100 percent worthless. Anxiety tells you that walking out your front door will lead to certain doom. Choose to confront these irrational thoughts as improbable, illogical and baseless. This is similar to the debate step above but rationality must be extended throughout your life. If being rational is proving difficult, use a trusted friend’s opinion over your own. Depression and anxiety make you incorrect. Accept this fact.
Conclusion
Depression and anxiety work together to make your life less than you want it to be. Understanding the relationship and overlap of symptoms allows you gain insight regarding its method of attack.
Afterwards, use the three Ds and the 3 Rs from above to fight back and regain control of your mental health. Battling depression and anxiety is never an easy task, so be sure to involve your friends, family and mental health professionals to act as allies. It is a war worth fighting.