To be sure, depression and anxiety are related. This is because the number of people with depression who also experience symptoms of anxiety is nearly 85 percent. Roughly 50% of people diagnosed with depression will also be diagnosed with an anxiety disorder. Many experts consider ‘mixed anxiety and depressive disorder’ (MADD) as a separate category.
Depression Is Anxiety
Also, there are some who maintain that “depression is anxiety.” They feel that “all people with depression have anxiety, but not everyone with anxiety has depression.” For instance, David Hanscom, MD, writes in Psychology Today (Hanscom, 2019) that “Anxiety and depression are the same entity.” Her goes on to say, “Depression describes the constellation of symptoms created by relentless anxiety.” Hanscom thinks anxiety “is a descriptive term and should not be considered a diagnosis.” Rather, he feels “[anxiety] is a term that describes a heightened neurochemical state,” because anxiety is merely “the feeling generated by elevated stress hormones and the autonomic nervous system”.
Hanscom says that the root cause of depression is relentless anxiety. He gives the following reasons by considering the following symptoms of depression:
- Waking up in the morning and not being able to fall back asleep—this is usually from racing thoughts and it relates to anxiety.
- Then you can’t fall asleep—from your body being full of stress chemicals, which puts you on high alert, which isn’t conducive to falling asleep.
- Eventually, you have trouble concentrating—this is a combination of racing thoughts and insomnia.
- Loss of appetite and weight loss—adrenaline decreases the blood supply to the GI tract.
- Lack of energy—being full of these chemicals keeps your body on high alert, which wears you down.
- Multiple, diffuse physical symptoms—a direct effect of your body’s hormones on the different organ systems.
- Social isolation—anxiety blocks people from reaching out to others.
- Suicidal ideation, an action plan, and beginning to implement it—anxious distress makes people feel tense, restless, and have trouble concentrating because they worry so much, leading to suicidality.
Hence, Hanscom maintains that “what we are calling depression is really a set of symptoms created by sustained levels of stress chemicals (anxiety).”
Depression and Anxiety are Related but Different
But not all agree. Kathleen Smith, PhD, LPC, writing for Psycom.net (Smith, 2019), says that, “If you compare the two lists of symptoms [of depression and generalized anxiety disorder], you can see that there is some overlap… There are, however, some distinguishing features.” Sleep problems, trouble concentrating, and fatigue are common to both anxiety and depression. Irritability may also be present in forms of anxiety or depression (in place of low mood).
Kathleen notes that in depression people move slowly, and exhibit flattened or dull reactions. Those with anxiety are more keyed up, given their racing thoughts. Another distinguishing feature is that people with anxiety have fear about the future. Depressed people do not worry about the future since they believe that things will continue to be bad.
So it’s a complex picture. Depression and anxiety have some features that overlap, and some that don’t. Do the above two differences between depression and anxiety suffice to consider them as two different entities? To complicate things further, it’s possible for someone to experience depression and anxiety at the same time.
DSM-5 lists Major Depressive Disorder and Generalized Anxiety Disorder as two different diagnostic entities. So, clinicians will continue to distinguish them.
Does It Really Matter?
So, are depression and anxiety related? Or is there a clear-cut relation between depression and anxiety? But it may not matter that much to differentiate the two. Approaches to treatment are similar in both. In both conditions, psychotherapy, especially cognitive-behavioral therapy, is effective. And in both, we use antidepressants, especially selective serotonin reuptake inhibitors (SSRIs). In some, they try both psychotherapy and medication.
Lifestyle modifications are helpful in both. They include sleep hygiene, seeking social support, practicing stress-reduction techniques and exercising regularly. It helps to avoid smoking, alcohol, and recreational drugs. They worsen both conditions and interfere with treatment.
So, don’t worry so much about the labels. It is more important is to seek prompt treatment from a psychiatrist when you have symptoms of depression or anxiety.
Hanscom, D., 2019. Depression Is Anxiety. [Online]
Available at: https://www.psychologytoday.com/us/blog/anxiety-another-name-pain/201912/depression-is-anxiety
[Accessed 10 Jan 2020].
Smith, K., 2019. Anxiety vs. Depression: How to Tell the Difference. [Online]
Available at: https://www.psycom.net/anxiety-depression-difference
[Accessed 10 Jan 2020].