• The DSM-5 treats depression and anxiety as separate diagnoses, and the symptoms of anxiety and depression may seem at odds with each other.
• In practice, however, it can be difficult to separate anxiety and depression, and it is common for the two to go hand-in-hand.
• When the two issues co-exist, they can compound, resulting in ongoing waves of anxiety and depression.
• The most effective treatment options address both issues simultaneously.

How Depression and Anxiety Are Related

On the surface, depression and anxiety may seem at odds with each other. How can someone struggling with depression (generally regarded as a low-energy state) also be dealing with anxiety (a high-energy state)?

Following this line of thought, some may reason that the two issues are separate. However, the connection between depression and anxiety is strong, and many people struggle with both simultaneously.

While the relation between anxiety and depression is complex, there is a clear connection:

• About half of individuals diagnosed with depression also have a history of one or more anxiety diagnoses.
• Both anxiety and depressive issues are moderately heritable, suggesting a shared genetic component.
• They also share nongenetic risk factors such as early life adversity, trauma or neglect, current stress exposure, and neural function.
• Recent findings have shown that depression and anxiety are highly comorbid and their symptoms are frequently inseparable.

If you or someone you care about is struggling with both anxiety and depression, it can be a comfort to know you are neither alone nor an anomaly. Others are struggling with similar issues, and there is hope.

What Comes First—Depression or Anxiety?

Because the symptoms of depression and anxiety are difficult to separate, it is impossible to say that one always precedes the other. Instead they often develop in conjunction and symptoms of both may have been present to some degree leading up to a professional diagnosis. It is important to note, however, that chronic anxiety can lead to the onset of depression.

How Are Anxiety and Depression Similar?

Anxiety and depression are similar for the reasons listed above, as well as in their symptomatology:

• Chronic feelings of worry and fear that do not go away
• Difficulty falling asleep, staying asleep, or oversleeping
• Sudden, drastic changes in eating habits
• Lingering feelings of sadness, worthlessness, or that “something’s not right”
• An inability to feel joy or live in the moment
• Trouble making decisions or focusing on tasks

What causes anxiety and what causes depression? Read the Answers

How Anxiety Feeds Into Depression

When someone is struggling with symptoms of depression, it is helpful to be aware of how anxiety might be feeding into their thought patterns. Anxious thoughts commonly fuel depressive states because there is no easy way to eliminate or “control” them. Over time, chronic anxiety can cause an individual to feel like they have lost control of their inner lives. That loss of control can develop into a sense of hopelessness that is a characteristic symptom of depression.

When someone is struggling with depression, their thought patterns also have a tendency to create feedback loops that grow worse with time. The more depressed they feel, the more anxious they become as they struggle to get rid of their unpleasant emotional state. The harder they try, the worse their anxiety becomes as they fight a battle against their thoughts—a battle that cannot be won.

When individuals struggling with depression cannot control their thoughts and feelings, they feel more anxious about the apparent hopelessness of the situation, further fueling depressive states.

How To Treat Anxiety and Depression

When treating depression, it is generally necessary to also treat the underlying causes of anxiety. Since there are overlapping causes and symptoms, many of the same methods for treating depression are equally effective at treating anxiety and vice versa. As a result, depression and anxiety treatment centers often go hand-in-hand.

Some of the most effective treatment methods for treating both depression and anxiety include:

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) helps people gain a more positive perspective on life. Specifically, it empowers people struggling with depression and anxiety to view situations in the past, present, and future as they relate to their well-being today. It gives them tools to manage anxiety in healthy ways by changing their thought and behavior patterns, which in turn also helps them deal with depressive thoughts.

Psychodynamic Psychotherapy

Psychodynamic psychotherapy, also called psychoanalytic psychotherapy, emphasizes the psychological aspects of emotional suffering. A professional therapist works closely with the individual to practice self-reflection and self-examination. Eventually, the relationship between the therapist and the individual becomes a window through which to review problematic relationship patterns in life. Psychodynamic therapy is also a powerful tool for examining early life events as they relate to decision-making, behavior, and relationships in the present.

Medication Management

Like many mental issues, depression is prone to misdiagnosis and overmedication. As a result, it is critical to use medication in a way that is conducive to long term recovery. Depression medication is most effective when used acutely for short periods to bring individuals to a place of stability. From there, more sustainable recovery strategies can be employed. For example, aerobic exercise can be as effective at reducing anxiety and depression as medication.

It is also important to note that there are serious risks associated with the long-term use of benzodiazepines for treating anxiety.

Multifaceted Life Enhancement

Issues related to depression and anxiety can also be alleviated by practicing life enhancing activities such as:

• Yoga
• Meditation
• Art and art therapy
• Knitting
• Music therapy
• Poetry

By exploring opportunities for creative self-expression, individuals can learn to look at the world in new ways while also practicing skills to cope with unpleasant emotional states and redirect that energy in productive, meaningful ways.

Take a Multifaceted Approach to Well-Being With PCH

If you are exploring anxiety or depression treatment centers, you can be confident that the program will address both issues if it incorporates the above strategies. If you or someone you care about has struggled with depression or anxiety treatment programs in the past, find out what makes PCH different then discover if PCH is right for you.