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When Depression and Anxiety Coexist

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When Depression and Anxiety Coexist


Clinical depression is characterized by major depressive episodes of intense symptoms, such as sadness, that can interfere with a person’s functioning. Anxiety entails excessive fear. It is considered a disorder when the symptoms are severe, prolonged, and the response is out of proportion and/or illogical. In the field of emotional health care, the two are distinct conditions that require precise diagnosis. In the real world, however, a lot of people can experience both at the same time.

Is this possible?  Yes, it is. Though the two conditions are distinct, they can occur together, and their symptoms can overlap. Research reveals that 60 to 70 percent of depressed people also have anxiety, while about 50 percent of those with chronic anxiety also experience depressive episodes. According to the National Institute of Mental Health (NIMH), panic disorder and other anxiety disorders often accompany major depression.


Depression and Anxiety: A Second Look

Depression and anxiety have always been thought to be two different emotional conditions. In recent years, however, clinicians and researchers are moving toward a new level of understanding. According to Psychology today, “Depression and anxiety are not two disorders that coexist. They are two faces of one disorder.” This means that “the disorders are two sides of the same coin.” The occurrence of the depression and anxiety is technically called “comorbidity” or double disorder.

The two emotional conditions are not the same, particularly the energy levels. Depression is accompanied by a low energy level, generating emotions, such as anger, helplessness, hopelessness, and distress. Anxiety, on the other hand, is often experienced as an explosion of energy due to fear or panic. They, nonetheless, share certain similar facets. For instance, they can leave you feeling overwhelmed and certain symptoms overlap, such as poor focus, irritability and sleeplessness. Another major similarity is the treatment – what can combat depression also works in the treatment of anxiety.  

Many people struggling say that they alternately move from the symptoms associated with depression and those with anxiety. They also claim a change in their behaviors when they are anxious and when depressed. One thing is common: when depression and anxiety go together, the comorbidity “impairs functioning at work and in relationships more, and it substantially raises suicide risk.”


The Two Sides of the Coin

Dr. David Barlow of the Center for Anxiety and Related Disorders, Boston University explains the link between the two. He says that “The genetics seem to be the same. The neurobiology seems to overlap. The cognitive and biological nature of the vulnerability is the same. It just seems that some people with the vulnerability react with anxiety to life stresses. Then some people, in addition, go beyond that and become depressed.”

Barlow also said that anxiety is a type of emotional condition that results in your feeling afraid, even before the dangerous thing happens. Depression is all that, including hopelessness, helplessness and the loss of interest in everything that is supposed to matter to you. There is a shutdown or slowing down of your cognitive, emotional and behavioral processes.


The Depression – Anxiety Link

Depression and anxiety are often referred to as the fraternal twins of mood disorders. There is no straightforward explanation for the link. Recent studies are showing, though, that at the core of the comorbidity are the malfunctioning of some shared mechanisms and neurotransmitters. Research has shown proof that this combination is a result of the activation of the brain’s fight-or-flight mechanism resulting in the excessive reactivity of the brain’s stress response system.

What leads to this or how it happens is only partially understood. What is known is the fact that this pushes the emotional centers of the brain into overdrive. From here on, an exposure to negative stimuli, anything that is associated with the eventful experience, can lead to the hijacking and the hyperactivity of the response systems.

Despite the inadequate explanation, the occurrence of the two conditions is widely observed among those with both conditions. For instance, 85 percent of depressed respondents in a study have GAD or generalized anxiety disorder while 35 percent have PTSD or post-traumatic stress disorder.


Who Is at Risk?

The genetic or family component is always a clue. Those who have depression and/or anxiety in their family history have a stronger likelihood of developing both. According to Dr. Joseph Himle, Associate Director of the Anxiety Disorders Unit at University of Michigan, “Looking at the family history of a person who presents with either primary anxiety or depression provides a clue to whether he or she will end up with both.”

Aside from genetic predisposition, other factors that can increase one’s risk for the development of depression and anxiety are age and the nature or the type of anxiety disorder. If you first develop anxiety by age 40 or older, your risk for depression is higher. Having experienced episodes of depression at a younger age, you become more vulnerable to panic attacks at 50 or older. There are also certain types of anxiety that have stronger links to depression. These are panic disorder, obsessive-compulsive disorder and social phobia.

Take note that anxiety frequently comes first by several years before depression. Since anxiety typically develops in late childhood or early puberty, prompt recognition of the symptoms and timely diagnosis and treatment provides ample time to prevent the onset or development of depression. There is but a small chance of outgrowing anxiety, unless the diagnosis is given properly, and the right treatment is provided. “But aggressive treatment of anxiety when it appears can prevent the subsequent development of depression,” says psychologist Michael Yapko, Ph.D.


Overcoming “Double Trouble”

Depression can be exacerbated by anxiety, then the comorbidity of anxiety and depression can become a tremendous challenge for anyone. Clinicians attest that the two conditions occurring at the same time are double trouble. The comorbidity can cause the symptoms to be more severe compared to just having any one of the two emotional conditions. Thus, the symptoms can become more chronic and difficult to resolve or treat.

Studies also show that the suicide rate is higher in persons with the comorbidity. One study even revealed that 92 percent of those with depression who attempted ending their lives are also beleaguered by severe anxiety. “Like alcohol and barbiturates, depression and anxiety are a deadly combination when taken together.”

This or any other worse outcome need not happen, though, because both depression and anxiety are treatable. As suggested earlier, the onset of anxiety, particularly the ones that are strongly associated with depression, presents an opportunity for early treatment. This opportunity should not be missed. Receive the professional help you need, for yourself or your loved one, from a qualified therapist independently contracted with Carolina Counseling Services – North Fayetteville Office – Fayetteville, NC.

Identifying depression from anxiety is not an easy thing to do, even for trained professionals. When depression and anxiety occur together, you must see a good behavioral health professional. If you or a loved one is exhibiting symptoms of both depression and anxiety, there is one place near home that you can visit for the assessment of your symptoms, as well as the diagnosis and the treatment of the comorbidity – Carolina Counseling Services – North Fayetteville Office – Fayetteville, NC. Call today!

Serving Areas: Carolina Counseling Services

Counties: Cumberland, Bladen and Sampson Counties, NC
Areas: Fayetteville NC, Ft Bragg NC, Pope Field NC, Sliver City NC, Linden NC, Bowmore NC, Autryville NC, Bunnlevel NC, Erwin NC, Dundarrach NC, Pineview NC, Rex NC, Lemon Springs NC, Johnsonville NC, Eastover NC, Stedman NC and Wade, NC
Zip Codes: 28311, 28395, 28390, 28356

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Carolina Counseling Services – North Fayetteville Office, Fayetteville, NC

422 McArthur Road, Suite 2
FayettevilleNC 28311

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Fayetteville, NC 28311

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  • Becky Clark, MSW, LCSW

    Specializes in: (Ages 18+) Anxiety, Depression, Individuals, Couples, Geriatrics, Criminal Justice, Stress Management, Loss and Grief related to death, disability, divorce, deployment, “empty nest”, retirement and other major life transitions
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    Location: Fayetteville, NC