Can depression and anxiety coexist?
Although depression and anxiety are regarded as separate mental health conditions, it’s possible for them to coexist. Often individuals will fall into a vicious cycle, where anxious thoughts can trigger depression, and vice versa. However, it’s important to remember that – with the right support – both of these are treatable, with the methods used being largely similar. Discover more about the differences between anxiety and depression, how they’re linked, and how they can be treated here.
What is anxiety?
It’s normal for people to experience anxiety during periods of stress, however those with Generalised Anxiety Disorder (GAD) may find it difficult to control their worries to the point where daily life is disrupted. This can range from moderate to severe, so the symptoms displayed and treatment required will vary between individuals.
GAD can cause you to feel anxious about a number of issues and situations, as opposed to a single specific event. Those with GAD may feel anxious most days and often struggle to remember the last time they didn’t feel anxious. Another anxious thought may appear about a different issue, as soon as one is resolved.
Generally, the psychological and physical symptoms displayed as a result of GAD include:
- Feeling on edge or worried
- Having difficulty concentrating or sleeping
- Experiencing dizziness or heart palpitations
What is depression?
Just as many people will experience bursts of anxiety at certain points in their life, feeling down from time to time is also normal. However, depression is much more than this – which is when an individual experiences persistent sadness for an extended period of time.
The severity of depression can vary from individuals. However, some of the recognised symptoms include:
- Persistent low mood or sadness
- Low self-esteem
- Hopelessness
- Low sex drive (libido)
- Low energy
- Suicidal thoughts
- Avoiding hobbies and interests
- Not taking part in social activities
- Feeling anxious
What causes anxiety and depression?
Anxiety and depression can arise for various reasons, which will vary from person to person. In some instances, they may be caused by life stresses – whether that’s dealing with an illness, experiencing family, housing or money issues, relationship struggles, bereavement, or otherwise.
Sometimes, anxiety can lead to the development of depression. This is because those experiencing anxiety are often unable to rationalise their thoughts and feelings. Failing to regain control over the body and mind is one of the entry ways for depression, and so the cycle begins.
On the other hand, certain individuals may have been unhappy or anxious for most of their lives, which can be due to Adverse Childhood Experiences (ACEs). These are significantly stressful, or traumatic, events or situations that occur during childhood and/or adolescence, which can lead to both anxiety and depression.
Anxiety and depression can also indicate an underlying health condition, so your doctor may perform various tests in order to rule anything out. Where clinical depression is concerned, you may have a higher chance of developing it if you have a long-term, life-threatening illness, such as coronary heart disease or cancer.
How are depression and anxiety diagnosed?
If you think you have anxiety or depression, and it’s having an effect on your day to day life, it’s important that you book a doctor’s appointment. A healthcare professional can diagnose anxiety or depression, if not both, through questionnaires. These help to distinguish between the two mental health conditions, and can indicate the severity in each person.
The questionnaires that help clinicians diagnose the conditions and get an idea of how severe the symptoms are include:
- PHQ-9 Depression Test Questionnaire | Patient
- GAD7 & PHQ9 – Anxiety UK
- Depression and anxiety self-assessment quiz – NHS (www.nhs.uk)
Treatments for anxiety and depression
If anxiety, depression, or both are affecting your daily life, your GP should seek to get to the root cause, and also consider your nutrition and lifestyle. If the symptoms persist, then below are some approaches that might be considered:
Self-help for anxiety and depression
Although certain individuals may require treatment for anxiety and depression, there are lots of things you can do on your own to help relieve symptoms. It’s important to note that the following methods may not be beneficial to everyone, and that the root cause of a mental health condition may require a combination of self-help and treatment:
- Changing how you perceive your thoughts – By choosing which thoughts you give attention and meaning to, you can help yourself to find freedom from anxiety you may be experiencing. This involves understanding more about where your anxious experiences may be really coming from, and realising that you’re in control of the thoughts you give power to.
- Exercise – Being physically active isn’t only beneficial for your physical health, it can help your mind, too. Exercising can improve your self-esteem, help you to set achievable goals, and it causes a chemical reaction in the brain that boosts your mood. For more advice on how much exercise you should do, head over to our previous article.
- Sleep – Getting enough sleep each night is important for a number of reasons, but supporting brain function is one of them. A lack of sleep can affect your mood and the way you process information, potentially causing anxiety and depression to worsen. Find out how to improve your sleep here.
- Diet – Eating a healthy, balanced diet is also beneficial for your mental and physical health. Diets vary based on a number of different factors – whether that be age, gender, and how much exercise you do – but making sure to factor in something from each food group can provide you with the fuel you need to tackle the day.
- Reduce stress where possible – Anxiety and depression can be caused, or made worse by, elevated stress. This is why it’s important to reduce stress wherever possible, whether that’s practising mindfulness, doing yoga or other forms of light exercise, listening to calming music or engaging in a hobby you enjoy.
- Breathing exercises – If you find that you’re stressed most days, breathing exercises can help. Slow, controlled breathing can help to reduce anxiety or calm depressive or anxious thoughts – it only takes a few moments, and it can be done anywhere.
- Apps – There are various apps available for individuals with anxiety and/or depression, whether that’s for practising stress-relieving breathing, meditating, finding a therapist, and so on. Apps can help you to track your progress and break negative thought patterns, which can help combat a vicious cycle.
- Tackle practical issues step by step – It’s easy to become overwhelmed when you have depression and/or anxiety, but in order to establish the root cause, try to tackle practical issues one step at a time. For example, your relationship, worklife, or finances (if not all these factors) could be affecting your mental health. Chatting with a therapist or counsellor can help, as they’ll work with you to unpick where the majority of your stress is coming from.
Additional treatments
- Counselling or therapy – The NHS provides talking therapy services, which can be useful for unpicking the root cause of anxiety and/or depression. These services can also offer cognitive behavioural therapy (CBT), counselling, as well as guided self-help. A GP can refer you, but it’s also possible to seek help without a referral. Others may prefer to work with a private counsellor or therapist – there are many websites that can aid your search, such as Counselling Directory.
- Referral to psychiatry – As opposed to counsellors and therapists, a psychiatrist is a medical doctor who is able to prescribe medication and offer treatment for anxiety and/or depression, as well as other mental health conditions. You’d generally require a referral from your GP or another doctor in order to do this.
- Beta-blockers – These can be prescribed by your doctor if you’re experiencing panic attacks regularly, which can be produced by anxiety. Beta-blockers slow down the heart, which is done through blocking the action of adrenaline hormones, but it’s important to note that they don’t sedate or affect your thinking.
- Antidepressants – This type of medication is used to treat clinical depression (not mild depression) as well as generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD), and post traumatic stress disorder (PTSD). Although it’s not exactly known how antidepressants work, it’s thought that they increase the level of neurotransmitters in the brain – such as serotonin and norepinephrine, which are responsible for mood regulation. Although they can be helpful, it’s important to address the root cause of depression.
Takeaway
As with any mental health condition, it’s possible to treat both anxiety and depression once you understand the root cause. Of course, the road to recovery will differ between individuals, and you may need to try a number of different treatment options to see which works best for you, but ultimately there are resources that can help.
Another useful self-help technique can be downloading the Evergreen Life app and taking our Sense of Wellbeing Check. This covers a wide range of health-related topics – including questions about anxiety and mental health. Based on your answers, you’ll be given actionable steps you can take towards feeling better.
Reviewed by:
Anna Keeble – Head of Content
- Centers for Disease Control and Prevention (2021) Adverse Childhood Experiences (ACEs). Centers for Disease Control and Prevention.
- Mind (2021) Mindfulness. Mind.
- National Institute of Mental Health (2022) Depression. National Institute of Mental Health.
- NHS UK (2022) Beta blockers. NHS UK.
- NHS UK (2022) Breathing exercises for stress. NHS UK.
- NHS UK (2019) Causes – Clinical depression. NHS UK.
- NHS UK (2021) Overview – Antidepressants. NHS UK.
- NHS UK (2022) Overview – Generalised anxiety disorder in adults. NHS UK.
- NHS UK (2022) Psychiatry. NHS UK.
- NHS UK (2022) Stress. NHS UK.
- NHS UK (2019) Symptoms – Clinical depression. NHS UK.
