What is the connection between anxiety and depression?
Afshan Mohamedali
Afshan Mohamedali, Ph.D. is a Licensed Clinical Psychologist at Afshan Mohamedali Psychology, PLLC.
Depression and Anxiety are Reactions to Internal Distress
Even though depression and anxiety can be diagnosed separately, they overlap, with one often a symptom of the other. Increasing depressive symptoms can exacerbate anxiety-related experiences. The reverse is also true. This has implications for treatment as well – treating one more directly can result in the improvement of the other.
Think about depression and anxiety as two possible reactions to internal distress. To some extent, these two conditions can be adaptive, keeping us distanced from the distress that can be too overwhelming. Given previous traumas, genetic predispositions, or compounded stress, a person can develop either set of symptoms. Depression as a reaction keeps someone in avoidance of distress, withdrawing from daily activities and others. Anxiety, on the other hand, can feel like taking on the problem head-on through ruminating thoughts that can appear as problem-solving.
I have found that many patients who present with anxiety can be prone to oscillating between anxiety and depression. Those experiencing anxiety-related symptoms are slightly more likely to present to treatment, given how motivating anxiety is for behavior and change. Anxiety can be overcompensation for depression – we’d rather feel anxious but at least feel like we are doing something “productive” than feel depressed and feel stuck and stagnant. So at times, treating anxiety can increase depression before achieving true symptom relief.
Of course, intense anxiety can simply cause depression, too. Intrusive thinking that increases distress is the hallmark of anxiety. These thoughts tend to be negative and self-deprecating. Repeated thoughts in this way can replace belief systems and cause a negative worldview and fragile sense of self. It would be only natural to then begin to feel hopeless and empty, hallmarks of depression.
Depression and Anxiety are Closely Related
If you think of our mental and emotional state on a continuum or a ladder, you’ll find depression, or freeze at the bottom of the ladder. Anxiety is the next rung up the ladder: fight or flight. And emotionally regulated, not anxious or depressed, is at the top of the ladder, or what’s known as rest and digest. Of course, there are varying levels of each emotional state along the way, but for clarity, we’ll just use the three.
People who are well resourced, have good coping skills, resources, and people in their lives to help them feel connected and at ease—move naturally from feeling depressed or anxious to a more regulated and emotionally balanced place.
For others, people who’ve experienced trauma and difficult life experiences, their nervous systems get stuck in one state or another or the nervous system is constantly moving back and forth between the depressed and anxious states.
Trauma survivors’ nervous systems continue to try to move them from depression through anxiety to a more regulated place, but because of the trauma reactions and responses, their anxiety builds. The constant or underlying anxiety is hard for their system to sustain, and so they fall back down the ladder into depression or fully shut down.
The constant moving between these two states is exhausting and frustrating.
The good news is that we can learn strategies to move through depression to anxiety and then up to the top of the ladder to an emotionally regulated place. Movement, meditation, psychotherapy, bodywork, yoga, natural therapies, brain spotting, EMDR, and IFS all help our brain and body learn how it’s feeling in the moment and ways to help it process from depression to anxiety and into a place of rest and digest, the top of the ladder.
Elizabeth Cush
Elizabeth Cush (LCPC) is a licensed clinical professional counselor. She is the owner of Progression Counseling.
Taylor Draughn
Taylor Draughn, Marriage and Family Therapist and Licensed Professional Counselor at Drug Helpline.
Anxiety is Often a Precursor to Depression
Anxiety and depression are two of the most common mental health disorders. Anxiety is often a precursor to depression, and people who suffer from one are at high risk of developing the other. Since their symptoms are very similar, they can sometimes overlap and feed off of each other, making it harder for someone suffering from both to cope and properly function in everyday life.
Both conditions are characterized by negative thoughts and feelings such as hopelessness and worthlessness, possibly leading to both mental and physical problems.
Fortunately, some treatments can help people struggling with anxiety and depression. Some people may need medication to get their symptoms under control, while others may benefit from therapy or lifestyle changes. No matter what approach is used, it is important to seek help if you are struggling with these conditions.
Anxiety Can Be a Symptom of Depression
Anxiety can occur as a symptom of depression. On the other hand, depression can occur as a result of [anxiety].
Anxiety stems from feelings of fear and being scared, either because of a traumatizing situation or because one has been triggered to react in that manner.
When anxiety occurs as a symptom of depression, it is easily treatable because if the depression is cured, then anxiety goes with it. On the other hand, if it is the cause of depression, the treatment period is relatively long and quite costly.
Tabitha Cranie
Dr. Tabitha Cranie, MD, from NWPH.net.
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