Table of ContentsView AllTable of ContentsThe LinkHow They FeelDiagnosisCopingWhen Treatment-Resistant
Table of ContentsView All
View All
Table of Contents
The Link
How They Feel
Diagnosis
Coping
When Treatment-Resistant
Havingdepressionandanxietyat the same time is somewhat common. Research shows that 60% of people with anxiety will also have symptoms of depression. The rate is the same for those who have depression with symptoms of anxiety.
Anxiety and depression are two distinct conditions that can occur at the same time. This can make symptoms more complex. However, the same treatments can address both problems. They can often improve withpsychotherapy(talk therapy), drugs, or both.
This article describes the link between anxiety and depression. It also explains their symptoms, diagnosis, and treatment when they occur at the same time.
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Anxiety and Depression: An Indirect or Direct Link?
The relationship between anxiety and depression is complex. While depression is typically regarded as a low-energy condition and anxiety a high-energy condition, these disorders and their symptoms commonly occur together. The reason they are often linked is well understood, though several potential factors exist.
Many of the same factors that predispose you to anxiety also make you vulnerable to depression. Both are considered internalizing disorders, problems that are developed and maintained to a great extent within the affected person.
Like other internalizing disorders, anxiety and depression are linked to similar factors that include genetic risk andneuroticism(the tendency toward negative thoughts). They are also associated with several shared nongenetic risk factors such as early trauma and current stress.
Anxiety and depression have many overlapping symptoms because they both involve changes in the function of neurotransmitters likeserotoninin your brain. Your symptoms may meet the criteria of both disorders.
The relationship between anxiety and depression may not be a situation in which one causes the other, but the fact that they may be two sides of the same coin. Being depressed can often make you feel worried or anxious. Similarly, having an anxiety attack can make you feel hopeless with depression.
Related Causes/Risk FactorsWhile the exact causes of comorbid depression and anxiety are not known, the following risk factors increase your chances of having these disorders together:Lifetime history of anxiety or depressionAdversity during childhoodPoor parentingRecent major life eventsCurrent exposure to stressHigh neuroticismSubstance use disordersFamily history
Related Causes/Risk Factors
While the exact causes of comorbid depression and anxiety are not known, the following risk factors increase your chances of having these disorders together:Lifetime history of anxiety or depressionAdversity during childhoodPoor parentingRecent major life eventsCurrent exposure to stressHigh neuroticismSubstance use disordersFamily history
While the exact causes of comorbid depression and anxiety are not known, the following risk factors increase your chances of having these disorders together:
How Anxiety and Depression Symptoms Feel
Similarities
Symptoms common in both anxiety and depression include:
Differences
Worrying is normal in some situations. Anxiety differs from normal worrying because it involves excessive fear that can be debilitating. Symptoms that may be characteristic of anxiety include:
The key characteristics of depression involve a persistent feeling of extremely low mood and/or loss of interest in activities you once enjoyed. Symptoms that may be characteristic of depression include:
Help Is AvailableIf you or someone you know is having suicidal thoughts, call or text988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or they are in immediate danger, dial911.
Help Is Available
If you or someone you know is having suicidal thoughts, call or text988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or they are in immediate danger, dial911.
Anxiety, Depression, or Both: How to Diagnose Symptoms
Many symptoms of anxiety and depression overlap, making it harder to determine which disorder is causing the problem. When anxiety and depression occur together, symptoms tend to be more intense and persistent because they work together. This can make your condition harder to diagnose and more complex to treat.
Symptoms that might indicate that both anxiety and depression exist include:
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How to Cope With Comorbid Anxiety and Depression
There is no single treatment appropriate for every case of comorbid (co-occurring) anxiety and depression. Therapies typically include antidepressant drugsand/or a form of psychotherapy. Self-care can help you maintain your progress.
While research indicates that a combination of medication and therapy can provide the best results, your treatment plan may differ. Depending on your symptoms, you may be advised to start your treatment with either one of these therapies.
Self-Care
Self-care includes behaviors that support your physical and mental well-being. It involves actions that can help manage symptoms of anxiety and/or depression and complement therapy and/or medications.
The following strategies are ways to prioritize self-care:
In Therapy
Therapy is regarded as a key part of treatment for symptoms that involve anxiety and/or depression. Your results and the time it takes to achieve them depend on your symptoms and your unique situation.
The following types of therapy are used to treat anxiety and depression:
With Medication
The type of medication you receive depends on your symptoms and other factors regarding your overall condition. The following classes of medications are commonly used:
SSRIs include:
Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs increase levels of serotonin and norepinephrine. These drugs are also acceptable first-line treatments for comorbid anxiety and depression.
SNRIs include:
Tricyclic antidepressants (TCAs): TCAs boost levels of serotonin and norepinephrine. TCAs include:
Monoamine oxidase inhibitors (MAOIs): MAOIs were the first class of antidepressants. They are generally regarded as outdated because of their side effects, though they may be appropriate for treatment-resistant depression in its later stages.
MAOIs include:
Antidepressants Alone Don’t Lead to Higher Quality of Life, Study Finds
Treatment-Resistant Depression (With Anxiety)
Treatment-resistant depression(with anxiety) describes depression that hasn’t responded to an adequate trial of at least two different antidepressants. Research indicates that the situation is not uncommon. Between 29% and 46% of people with depression show partial or no response to treatments.
Therapies for treatment-resistant depression (with anxiety) involve the following:
Summary
Feelings of sadness and worry are normal. However, when these types of feelings intrude on your daily life, they may be signs of mental health problems.
Anxiety and depression are two of the most commonly diagnosed mental health problems. While they are two distinct conditions, they often occur at the same time.
When these disorders occur together, treatments are more complex. Symptoms can overlap and often worsen when more than one mental health problem exists. The good news is that treating these comorbid disorders is most effective when they are handled at the same time.
24 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Association on Mental Illness (NAMI).The comorbidity of anxiety and depression.Hartgrove Behavioral Health System.The relationship between anxiety and depression.Kalin NH.The critical relationship between anxiety and depression.AJP. 2020;177(5):365-367. doi:10.1176/appi.ajp.2020.20030305Hopwood M.Anxiety symptoms in patients with major depressive disorder: commentary on prevalence and clinical implications.Neurol Ther. 2023;12(1):5-12. doi:10.1007/s40120-023-00469-6Möller HJ, Bandelow B, Volz HP, Barnikol UB, Seifritz E, Kasper S.The relevance of ‘mixed anxiety and depression’ as a diagnostic category in clinical practice.Eur Arch Psychiatry Clin Neurosci. 2016;266(8):725-736. doi:10.1007/s00406-016-0684-7Cleveland Clinic Health Essentials.Anxiety vs. depression: which do I have (or is it both)?Mental Health Foundation.Generalized anxiety disorder.American Psychiatric Association.What is depression?Pennisi E.Gut microbe linked to depression in large health study.Science. Published online February 4, 2022. doi:10.1126/science.ada0998Harvard Health Publishing. Harvard Medical School.Medication or therapy for depression? Or both?National Institute of Mental Health.Caring for your mental health.David D, Cristea I, Hofmann SG.Why cognitive behavioral therapy is the current gold standard of psychotherapy.Front Psychiatry. 2018;9. doi:10.3389/fpsyt.2018.00004Coffey SF, Banducci AN, Vinci C.Common questions about cognitive behavior therapy for psychiatric disorders.Am Fam Physician. 2015;92(9):807-812. PMID: 26554473.International Society of Interpersonal Psychotherapy.Overview of IPT.Behavioral Tech Institute.What is DBT?Dindo L, Van Liew JR, Arch JJ.Acceptance and commitment therapy: a transdiagnostic behavioral intervention for mental health and medical conditions.Neurotherapeutics. 2017;14(3):546-553. doi:10.1007/s13311-017-0521-3Centre for Addiction and Mental Health (CAMH).Antidepressant medications.Coplan JD, Aaronson CJ, Panthangi V, Kim Y.Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches.World Journal of Psychiatry. 2015;5(4):366. doi:10.5498/wjp.v5.i4.366UpToDate.Patient education: medicines for depression (the basics).Columbia University Department of Psychiatry.Finding solutions when depression resists treatment.UC San Diego Health.Transcranial magnetic stimulation.American Psychiatric Association.What is electroconvulsive therapy?Nebraska Medicine.What is esketamine, and is it effective in treating depression?Yale Medicine.How ketamine drug helps with depression.
24 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Association on Mental Illness (NAMI).The comorbidity of anxiety and depression.Hartgrove Behavioral Health System.The relationship between anxiety and depression.Kalin NH.The critical relationship between anxiety and depression.AJP. 2020;177(5):365-367. doi:10.1176/appi.ajp.2020.20030305Hopwood M.Anxiety symptoms in patients with major depressive disorder: commentary on prevalence and clinical implications.Neurol Ther. 2023;12(1):5-12. doi:10.1007/s40120-023-00469-6Möller HJ, Bandelow B, Volz HP, Barnikol UB, Seifritz E, Kasper S.The relevance of ‘mixed anxiety and depression’ as a diagnostic category in clinical practice.Eur Arch Psychiatry Clin Neurosci. 2016;266(8):725-736. doi:10.1007/s00406-016-0684-7Cleveland Clinic Health Essentials.Anxiety vs. depression: which do I have (or is it both)?Mental Health Foundation.Generalized anxiety disorder.American Psychiatric Association.What is depression?Pennisi E.Gut microbe linked to depression in large health study.Science. Published online February 4, 2022. doi:10.1126/science.ada0998Harvard Health Publishing. Harvard Medical School.Medication or therapy for depression? Or both?National Institute of Mental Health.Caring for your mental health.David D, Cristea I, Hofmann SG.Why cognitive behavioral therapy is the current gold standard of psychotherapy.Front Psychiatry. 2018;9. doi:10.3389/fpsyt.2018.00004Coffey SF, Banducci AN, Vinci C.Common questions about cognitive behavior therapy for psychiatric disorders.Am Fam Physician. 2015;92(9):807-812. PMID: 26554473.International Society of Interpersonal Psychotherapy.Overview of IPT.Behavioral Tech Institute.What is DBT?Dindo L, Van Liew JR, Arch JJ.Acceptance and commitment therapy: a transdiagnostic behavioral intervention for mental health and medical conditions.Neurotherapeutics. 2017;14(3):546-553. doi:10.1007/s13311-017-0521-3Centre for Addiction and Mental Health (CAMH).Antidepressant medications.Coplan JD, Aaronson CJ, Panthangi V, Kim Y.Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches.World Journal of Psychiatry. 2015;5(4):366. doi:10.5498/wjp.v5.i4.366UpToDate.Patient education: medicines for depression (the basics).Columbia University Department of Psychiatry.Finding solutions when depression resists treatment.UC San Diego Health.Transcranial magnetic stimulation.American Psychiatric Association.What is electroconvulsive therapy?Nebraska Medicine.What is esketamine, and is it effective in treating depression?Yale Medicine.How ketamine drug helps with depression.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Association on Mental Illness (NAMI).The comorbidity of anxiety and depression.Hartgrove Behavioral Health System.The relationship between anxiety and depression.Kalin NH.The critical relationship between anxiety and depression.AJP. 2020;177(5):365-367. doi:10.1176/appi.ajp.2020.20030305Hopwood M.Anxiety symptoms in patients with major depressive disorder: commentary on prevalence and clinical implications.Neurol Ther. 2023;12(1):5-12. doi:10.1007/s40120-023-00469-6Möller HJ, Bandelow B, Volz HP, Barnikol UB, Seifritz E, Kasper S.The relevance of ‘mixed anxiety and depression’ as a diagnostic category in clinical practice.Eur Arch Psychiatry Clin Neurosci. 2016;266(8):725-736. doi:10.1007/s00406-016-0684-7Cleveland Clinic Health Essentials.Anxiety vs. depression: which do I have (or is it both)?Mental Health Foundation.Generalized anxiety disorder.American Psychiatric Association.What is depression?Pennisi E.Gut microbe linked to depression in large health study.Science. Published online February 4, 2022. doi:10.1126/science.ada0998Harvard Health Publishing. Harvard Medical School.Medication or therapy for depression? Or both?National Institute of Mental Health.Caring for your mental health.David D, Cristea I, Hofmann SG.Why cognitive behavioral therapy is the current gold standard of psychotherapy.Front Psychiatry. 2018;9. doi:10.3389/fpsyt.2018.00004Coffey SF, Banducci AN, Vinci C.Common questions about cognitive behavior therapy for psychiatric disorders.Am Fam Physician. 2015;92(9):807-812. PMID: 26554473.International Society of Interpersonal Psychotherapy.Overview of IPT.Behavioral Tech Institute.What is DBT?Dindo L, Van Liew JR, Arch JJ.Acceptance and commitment therapy: a transdiagnostic behavioral intervention for mental health and medical conditions.Neurotherapeutics. 2017;14(3):546-553. doi:10.1007/s13311-017-0521-3Centre for Addiction and Mental Health (CAMH).Antidepressant medications.Coplan JD, Aaronson CJ, Panthangi V, Kim Y.Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches.World Journal of Psychiatry. 2015;5(4):366. doi:10.5498/wjp.v5.i4.366UpToDate.Patient education: medicines for depression (the basics).Columbia University Department of Psychiatry.Finding solutions when depression resists treatment.UC San Diego Health.Transcranial magnetic stimulation.American Psychiatric Association.What is electroconvulsive therapy?Nebraska Medicine.What is esketamine, and is it effective in treating depression?Yale Medicine.How ketamine drug helps with depression.
National Association on Mental Illness (NAMI).The comorbidity of anxiety and depression.
Hartgrove Behavioral Health System.The relationship between anxiety and depression.
Kalin NH.The critical relationship between anxiety and depression.AJP. 2020;177(5):365-367. doi:10.1176/appi.ajp.2020.20030305
Hopwood M.Anxiety symptoms in patients with major depressive disorder: commentary on prevalence and clinical implications.Neurol Ther. 2023;12(1):5-12. doi:10.1007/s40120-023-00469-6
Möller HJ, Bandelow B, Volz HP, Barnikol UB, Seifritz E, Kasper S.The relevance of ‘mixed anxiety and depression’ as a diagnostic category in clinical practice.Eur Arch Psychiatry Clin Neurosci. 2016;266(8):725-736. doi:10.1007/s00406-016-0684-7
Cleveland Clinic Health Essentials.Anxiety vs. depression: which do I have (or is it both)?
Mental Health Foundation.Generalized anxiety disorder.
American Psychiatric Association.What is depression?
Pennisi E.Gut microbe linked to depression in large health study.Science. Published online February 4, 2022. doi:10.1126/science.ada0998
Harvard Health Publishing. Harvard Medical School.Medication or therapy for depression? Or both?
National Institute of Mental Health.Caring for your mental health.
David D, Cristea I, Hofmann SG.Why cognitive behavioral therapy is the current gold standard of psychotherapy.Front Psychiatry. 2018;9. doi:10.3389/fpsyt.2018.00004
Coffey SF, Banducci AN, Vinci C.Common questions about cognitive behavior therapy for psychiatric disorders.Am Fam Physician. 2015;92(9):807-812. PMID: 26554473.
International Society of Interpersonal Psychotherapy.Overview of IPT.
Behavioral Tech Institute.What is DBT?
Dindo L, Van Liew JR, Arch JJ.Acceptance and commitment therapy: a transdiagnostic behavioral intervention for mental health and medical conditions.Neurotherapeutics. 2017;14(3):546-553. doi:10.1007/s13311-017-0521-3
Centre for Addiction and Mental Health (CAMH).Antidepressant medications.
Coplan JD, Aaronson CJ, Panthangi V, Kim Y.Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches.World Journal of Psychiatry. 2015;5(4):366. doi:10.5498/wjp.v5.i4.366
UpToDate.Patient education: medicines for depression (the basics).
Columbia University Department of Psychiatry.Finding solutions when depression resists treatment.
UC San Diego Health.Transcranial magnetic stimulation.
American Psychiatric Association.What is electroconvulsive therapy?
Nebraska Medicine.What is esketamine, and is it effective in treating depression?
Yale Medicine.How ketamine drug helps with depression.
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