How to Cope With Anxiety and Depression

Do you sometimes worry so much that it interferes with your everyday activities? Or feel so blue that it completely clouds your outlook? Do you often experience these or similar feelings together? You’re not the only one.

According to the Anxiety and Depression Association of America (ADAA), anxiety disorders — which include generalized anxiety disorder, panic disorder, and social anxiety disorder — are the most common mental health problem among U.S. adults, affecting 18.1 percent of the population each year. And mood disorders — which include major depressive disorder, bipolar disorder, and seasonal affective disorder — are the leading cause of disability.

Moreover, the incidence of developing depression in addition to an anxiety disorder or vice versa is high. Many people with major depression also suffer from severe and persistent anxiety, notes Sally R. Connolly, LCSW, in Louisville, Kentucky. And some experts estimate that 60 percent of people with anxiety will also have symptoms of depression, according to the National Alliance on Mental Illness (NAMI).

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Anxiety and Depression: What Are the Possible Links?

Although clearly not identical emotional states, mental health research suggests that depression and anxiety often coexist because they can be caused by the same or similar factors. According to an article published May 2020 in the American Journal of Psychiatry, those overlapping causes can include:

• Genetic Factors Genetic factors contribute to 40 percent of the predisposition to depressive and anxious symptoms, with 60 percent being attributed to environmental, noninherited factors.” "Especially with anxiety, more so than depression, there often is some family history, and so therefore we think that there may be some genetic predisposition to this," Connolly explains.
• Environmental Factors Also referred to as social factors, these include experiences like trauma or neglect in early childhood, and current stressors such as relationship difficulties, unemployment, social isolation, and physical illness. People who have post-traumatic stress disorder (PTSD), an anxiety disorder, are particularly likely to also develop depression, according to the National Institute of Mental Health (NIMH).

• Pain Chronic pain, and particularly disabling pain syndromes such as fibromyalgia, irritable bowel syndrome (IBS), low back pain, headaches, and nerve pain, are closely linked to psychological distress, including both anxiety and depression, notes Harvard Health. In fact, they say, research suggests that “pain shares some biological mechanisms with anxiety and depression.”

Ultimately, the core of the double disorder is “a cycle,” says Connolly. "When you get anxious, you tend to have this pervasive thinking about some worry or some problem and you feel bad about it. Then you feel like you've failed, and you move to depression." Similarly, she adds, “people who are depressed often feel anxious and worried, so one can trigger the other."

Symptoms of Anxiety and Depression

According to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the standard classification of mental disorders used by mental health professionals in the United States, anxiety and depression can share several common symptoms, including, but not limited to:

• Being easily fatigued
• Difficulty concentrating or mind going blank
• Irritability
• Sleep disturbance (difficulty falling or staying asleep; restless, unsatisfying sleep)

Other signs that a person may suffer from both anxiety disorder and depression include:

• Constant, irrational fear and worry
• Physical symptoms like rapid heartbeat, headaches, hot flashes, sweating, abdominal pain, and/or difficulty breathing
• Changes in eating, either too much or too little
• Persistent feelings of sadness or worthlessness
• Loss of interest in hobbies and activities
• Inability to relax
• Panic attacks

Can Anxiety and Depression Be Treated Together?

Yes. No one has to suffer from anxiety disorder or depression, and certainly not both. People with anxiety disorder should speak with a psychiatrist, therapist, or other healthcare professional about their symptoms and start treatment as soon as possible. If you suspect you have both anxiety and depression, Connolly recommends getting a thorough evaluation from a psychiatrist as a first step. "It's really crucial for people with both [anxiety and depression] to have a good assessment to rule out bipolar disorder," she says.

• Cognitive Behavioral Therapy (CBT) CBT focuses on teaching people to challenge their negative thoughts to use coping skills and relaxation techniques to reduce stress. CBT is not only an established treatment for anxiety and depression, it is also the best studied psychotherapy for treating pain, per Harvard Health.
• Interpersonal Psychotherapy (IPT) IPT focuses on the connection between onset of symptoms and current interpersonal problems, such as unresolved grief, relationship disputes, and social isolation or withdrawal.
• Antidepressant Medication Antidepressants include selective serotonin reuptake inhibitors (SSRIs), such as Celexa (citalopram), Prozac (fluoxetine), (Lexapro (ecitalopram), Paxil (paroxetine), Zoloft (sertraline). SSRIs are often used in conjunction with CBT and other forms of psychotherapy for more severe anxiety and depression. Serotonin and norepinephrine reuptake inhibitors (SNRIs), which include Cymbalta (duloxetine),  Effexor (venlafaxine), and Pristiq (desvenlafaxine), are other options.
• Exercise Getting exercise can also help ease symptoms of both depression and anxiety, although why isn’t entirely clear, per the Mayo Clinic. One reason may be that exercise releases feel-good chemicals in the brain that enhance you sense of well-being. Another may be that it distracts you from your worries, fears, and other negative thoughts. Whatever the reason, walking for as little as 10 minutes may alleviate symptoms, the ADAA notes.
• Relaxation Techniques Mindfulness meditation — a way of training your mind to slow down racing thoughts, let go of negativity, and calm both your mind and body by sitting quietly and focusing on your breathing — can ease symptoms of both anxiety and depression and improve quality of life, according to a large research review published in March 2014 in JAMA Internal Medicine.

Important: If you or someone you know needs help coping with anxiety or depression, call the National Suicide Prevention Lifeline at 800-273-TALK (8255). The Crisis Text Line also provides free, 24/7, confidential support via text message to people in crisis when they text to 741741.