Anxiety and Depression Together?

BY R. Morgan Griffin

October 20 2010 5:00 AM ET

 Depression and anxiety might seem like opposites. We think: Depression saps you of energy; anxiety makes you keyed up and afraid. Depression makes it near impossible to get out of bed; anxiety leaves you sleepless, pacing all night.

But the truth is not so simple. In fact, depression and anxiety often go together. Mental health experts estimate that more than half of the people diagnosed with depression also have anxiety.

"We know that many of the symptoms of depression and anxiety disorders overlap," says Ian A. Cook, MD, the director of the Depression Research Program at the University of California, Los Angeles. "And we're learning from studies that there also appears to be a lot of overlap in the underlying brain mechanisms involved in these two conditions."

Unfortunately, the combination of depression and anxiety can be particularly severe, and many people don't get the correct diagnosis. The good news is that doctors have good treatments for tackling both conditions.

"When you're in the grip of depression and anxiety, it can feel like the misery will never end, that you'll never recover," says Dean F. MacKinnon, MD, an associate professor at the Johns Hopkins Hospital in Baltimore. "But people do recover. You just need to find the right treatment."

Understanding Depression and Anxiety

Although either depression or anxiety can be a disabling condition on its own, the combination can be particularly hard. "If you're already depressed, anxiety is a multiplier of suffering," MacKinnon says.

Depression can make feel people profoundly discouraged, helpless, and hopeless. Anxiety can make them agitated and besieged by physical symptoms -- a pounding heart, tightness in the chest, and difficulty breathing.

"People who have both depression and anxiety feel low, down in the dumps, and unmotivated," says Jerilyn Ross, MA, LICSW, president and chief executive of the Anxiety Disorders Association of America. "But their minds are also racing. They can't concentrate. They can't sit still. It's a very tough combination."

It's also tough to control. "It's important for people to recognize that when they have both depression and anxiety, it may be more difficult for them to get all the way well," Cook says. That's not to say they won't recover fully, but that it may take more work.

People diagnosed with both depression and anxiety tend to have



















  • more severe symptoms,
  • more functional impairment,
  • more trouble finding the right treatment, and
  • a higher risk of suicide.


Some people who are depressed have a distinct anxiety disorder, like panic disorder, social anxiety disorder, or generalized anxiety disorder, Ross says. Many others don't have full-fledged anxiety disorders but more general anxiety symptoms that accompany their depression.

The fact that depression and anxiety so often occur together has led some researchers to speculate -- controversially -- that they may not always be different conditions. "It's possible that in time, we'll come to see anxiety and depression together as representing a distinct illness separate from either condition by itself," Cook says.


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