Why These Conditions Often Occur Together And How To Treat Them When They Do
Everyone experiences pain at some point, but in people with depression or anxiety, pain can become particularly intense and hard to treat. People suffering from depression, for example, tend to experience more severe and long-lasting pain than other people.
The overlap of anxiety, depression, and pain is particularly evident in chronic and sometimes disabling pain syndromes such as fibromyalgia, irritable bowel syndrome, low back pain, headaches, and nerve pain. For example, about two-thirds of patients with irritable bowel syndrome who are referred for follow-up care have symptoms of psychological distress, most often anxiety. About 65% of patients seeking help for depression also report at least one type of pain symptom. Psychiatric disorders not only contribute to pain intensity but also to increased risk of disability.
Researchers once thought the reciprocal relationship between pain, anxiety, and depression resulted mainly from psychological rather than biological factors. Chronic pain is depressing, and likewise major depression may feel physically painful. But as researchers have learned more about how the brain works, and how the nervous system interacts with other parts of the body, they have discovered that pain shares some biological mechanisms with anxiety and depression.
In addition, two neurotransmitters serotonin and norepinephrine contribute to pain signaling in the brain and nervous system. They also are implicated in both anxiety and depression.
Anxiety May Try To Help But Then It Hurts What Should You Do
Posted July 8, 2014
Anxiety is a normal human feeling.
Anxiety is what you feel when you are faced with uncertainty. When you do not know what is going on or what you should do about it, you react with a feeling of anxiety.
What makes anxiety pass? Resolving the ambiguity. Figuring it out. What’s happening or what to do about it. Then the feeling is gone, and you are relieved. You may still have work to do or a problem that needs to be fixed, but the anxiety about it is finished.
When people suffer from depression they often also feel anxiety and spend too much time worrying, which increases their depression. The parts of their brain that are involved in that normal reaction to ambiguity are working overtime. And the thinking brain, low on energy due to depression, cannot stop that worry train. When they worry too much and can’t exert enough control, then the feeling of anxiety persists beyond any situation that includes some uncertainty. In fact, the anxious feeling can be present before any uncertainty. Then it creates the nagging sense in your gut that something is wrong, so your helpful brain, the one that wants an explanation for every feeling you have, goes on a search to figure out what might be the source of that anxiety.
There is a lot you can do about this. You can use your brain to change your brain. Here are 2 ideas to start out:
Margaret WehrenbergAuthor of The 10 Best-Ever Anxiety Management Techniques
Do Something You Have Control Over
Regaining some control in the moment could help overwhelming feelings feel a little easier to cope with.
You dont have to take any major action, but accomplishing a short task, such as making your bed, taking a shower, or unloading the dishwasher, can help boost a sense of accomplishment. It could also offer a temporary distraction.
You May Like: How To Stop Oversleeping With Depression
Can Depression Cause Anxiety
Depression and anxiety have a cyclic relationship. If someone experiences the symptoms of depression, that may lead to anxiety over the way theyre feeling. Or an individual might feel anxious much of the time, and, when this constant state of worrying begins negatively impacting their daily life or relationships, can lead them to feel depressed.
If youre wondering whether one disorder triggered another one, its difficult to know for sure. People may develop depression first and then anxiety afterwards , and this can make it seem like one caused the other. In reality, the causes of mental health disorders are complex and varied. However, its possible for an untreated anxiety disorder or depression to lead to other complications, including additional mental health disorders or substance abuse.
What Do The Terms Anxiety And Depression Mean
A key difference between anxiety and depression is that one refers to a single illness, and the other to a group of conditions.
- Depression is really one illness. It has lots of different symptoms . And it may feel very different to different people. But the term depression refers to a single condition.
- Anxiety is a term that can have a few different meanings. We all feel anxious sometimes and anxiety can be used simply to describe that feeling. But when we use anxiety in a medical sense, it actually describes a group of conditions.
Anxiety includes some less common conditions. These include phobias and panic disorders. But the most common is generalised anxiety disorder . Generalised anxiety disorder may affect between four and five in every 100 people in the UK. Well focus on generalised anxiety in this article.
Also Check: What Do I Do If I Think I Have Depression
Cbt For Black Girls And Women
Professors at Kent State University have developed culturally sensitive CBT methods to help Black girls and women process anger and anxiety from dealing with chronic racism and sexism.
Talk to a mental health professional or doctor if youre experiencing any of the following scenarios:
- Friends, family, or coworkers have expressed concern about your handling of anger or anxiety.
- You arent welcome in certain places of business because of how you express your feelings.
- Episodes of anger or anxiety are frequent and intense.
- You express anger in verbally or physically aggressive ways.
- Youre concerned that anger or anxiety may be making you depressed.
- Your anxiety has caused you to begin avoiding important events and encounters.
- Anger or anxiety has caused you to have thoughts of self-harm.
- You feel your anxiety is interfering with your ability to function or to enjoy your life.
Anger and anxiety are closely related. Because theyre both normal responses to perceived threats, they help us survive dangerous situations.
These two emotions spark similar hormonal surges in the body, and they also share similar psychological triggers.
If you experience anger or anxiety too often or too intensely, it can affect your mental and physical health and can lead to problems in your relationships. A therapist or doctor may recommend:
Does Anxiety Cause Depression
It depends. If your anxiety is a temporary emotional response, its not likely it may lead to symptoms of depression.
But if you notice that your signs of anxiety become a recurring experience, you may be living with an anxiety disorder. In this case, suggests that its possible that anxiety leads to depression, or makes the existing symptoms of depression feel worse.
In that case, depression may be a side effect of anxiety.
Heres why and how the untreated effects of anxiety may cause depression symptoms to develop:
Don’t Miss: How To Help A Depressed Spouse
Questions To Ask Yourself
Again, its very common to feel low or sad, stressed or anxious, or any combination of the above, on occasion.
All the same, youre the best person to recognize whats typical for you. If you start to experience new, uncomfortable feelings, changes in your energy and motivation, or any other unusual symptoms, it never hurts to connect with a mental health professional for more guidance.
You might wonder whether an online self-test for anxiety or depression could offer more insight about the changes youve noticed. Some people do find these a helpful place to start but a more personalized route might involve asking yourself a few questions:
- Do I spend a lot more time worrying than I have in the past?
- Do I feel sad, empty, or hopeless often?
- Have I lost interest in the things I used to enjoy?
- Have I started to avoid spending time with friends and loved ones?
- Do I worry about things I cant control to the point where I have a hard time thinking about anything else?
- Do I become irritable or annoyed more quickly than I have in the past?
- Do I often feel restless, on edge, or unable to relax?
- Do I cycle through dark, unwanted, or fearful thoughts I cant seem to stop?
- Is it difficult to fall asleep, get enough sleep, or wake up on time most days?
- Have I noticed unexplained pain, tension, or other physical symptoms?
- Do these changes affect my daily life or relationships?
If you answered yes to most of the questions above, it may be time to reach out to a therapist.
Treatment Of Anxiety And Depression
A treatment plan for co-occurring anxiety and depression should be designed to help the person manage and reduce symptoms of both disorders at the same time.
Several forms of psychotherapy are widely available and effective for both anxiety and depression.
- Cognitive Behavioral Therapy : This short-term therapy works to replace negative and unproductive thought patterns with more realistic and useful ones. This treatment focuses on taking specific steps to manage and reduce symptoms.
- Interpersonal talk therapy: This attachment-focused therapy centers on resolving interpersonal problems and symptomatic recovery.
- Problem solving therapy: This treatment helps people learn tools to effectively manage the negative effects of stressful life events.
Both anxiety and depressive disorders respond to treatment with selective serotonin reuptake inhibitor and serotonin norepinephrine reuptake inhibitor medications.
Long-term, combined treatment is typically recommended for people with co-occurring anxiety and depression.
2. American Psychological Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, American Psychiatric Publishing, Washington, D.C., 2013.
Recommended Reading: When Did Depression Start To Rise
Make Time For Rest And Relaxation
Mental health conditions like depression and anxiety can affect your energy and motivation, which often only adds to feelings of guilt and worry.
Remember, though: Depression and anxiety are health conditions. If you had the flu, youd need time to rest, right? Mental health symptoms require recovery time, too.
Instead of fixating on the things you think you should be doing, honor your needs by taking time for activities that soothe and relax you. Maybe this includes things like:
- watching a comforting movie or TV show
- re-reading a favorite book
Depression: Cause And Effects
Depression, like anxiety, may be caused by any number of factors, including:
- Social Learning
Depression is an emotional disorder, characterized either by periods of deep sadness or by a “lack of happiness.” Not everyone feels emotionally sad, but those that live with depression often have a hard time of imagining a world that’s happy. Some may even have a “flat affect,” which essentially implies no emotions at all.
Depression may be temporary, or a long-term emotional disorder. After an intense breakup, for example, it’s possible to have depression that may disappear as you learn to cope with the breakup. Anxiety makes it harder for that depression to disappear, because anxiety prevents healthy coping. Depression may also be a long-term disorder one that causes intense feelings of sadness, worthlessness, loss of interest in life, and other depressive symptoms.
Depression is the most common stand-alone psychological disorder, affecting as much as 10% of the population. However, anxiety disorders combined compromise a larger percentage of the population, with some estimates putting the number of people living with some form of anxiety as high as 18% or more.
Don’t Miss: Is Constant Crying A Sign Of Depression
Therapy For Anxiety And Depression
There are many different types of therapy that can be used to treat anxiety or depression alone. When both disorders are present, you may need to use a variety of these methods. Here are some types of therapy that work well for anxiety and depression:
- Cognitive behavioral therapy
- Acceptance and commitment therapy
- Psychoanalytic therapy
- Interpersonal therapy
There are also therapies designed for anxiety, such as exposure therapy, and techniques that are effective for depression, like behavioral activation. You may find it helpful to incorporate some extra therapeutic techniques into your treatment plan.
Does Chronic Stress Lead To Anxiety Or Depression
June 12, 2015 by Dr. Carlo
Stress is part of everyday life for everyonewe all have disappointments, make our mistakes, and endure daily mishaps. Perhaps you lost your keys today and it made you late for workmaybe you let a friend down and are now feeling guilty about itor maybe you are just experiencing a lot of pressure and deadlines at work. We neutralize these stressors by instituting our coping skills and relying on our natural support network. However, the overall goal is not to get rid of stress entirely, as stress is needed in healthy amounts to help us grow, develop, and learn new skills. Stress also helps us to perform optimally, as just the right amount of stress will push us to do better, such as preparing to take an exam, or preparing for a competition.
It does appear that anxiety and depression also share the same neurobiology. It starts with genetic vulnerabilities interacting with environmental triggers , and this interaction leads to abnormal brain processing circuits, which in this case manifests as increased reactivity of the amygdala to stressors and fearful stimuli. This hypothesis has been supported by a recent study by Swartz and colleagues , where study subjects with increased reactivity of their amygdala to fearful stimuli , when combined with a major life stressor, are at increased risk of developing either anxiety or depression up to 4 years later.
Figure 1. Negative Cycle of Anxiety
Figure 2. Negative Cycle of Depression
Don’t Miss: What Alcohol Is Not A Depressant
Whats The Difference Between Depression And Anxiety
Anxiety and depression are distinct mental health disorders. Each has its own set of symptoms.
For example, someone with anxiety may experience excessive fear or worry, while someone with depression may experience persistent feelings of hopelessness.
However, they are often interconnected. Someone with depression can experience anxiety symptoms as part of their mood disorder, and someone with a persistent anxiety disorder can develop depression over time.
Ways To Identify The Conditions
If you are experiencing signs and symptoms of anxiety and depression, one place to start is to speak with your primary care doctor. They can do an initial screening and may look for medical conditions that could be contributing to your symptoms. You will likely then be referred to a mental health professional for an official clinical diagnosis.
The mental health professional will use the standard reference manual for diagnosing recognized mental illnesses in the United States, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition .
The DSM-5 diagnostic criteria for depression and each anxiety disorder are different. A diagnosis might be harder to make when anxiety and depression overlap.
Read Also: What Is The Purpose Of Depression
Symptoms Of Anxiety In Men
Anxiety is more than having sweaty palms and butterflies in your stomach. Symptoms of anxiety can include ongoing feelings of worry, fear and impending doom that are so severe they interfere with your ability to work, maintain relationships and get a decent nights sleep. Physical signs of anxiety may include:
- pounding or racing heart
- thinking about death or suicide.
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 , an anxiety disorder, are particularly likely to also develop depression, according to the National Institute of Mental Health .
- Pain Chronic pain, and particularly disabling pain syndromes such as fibromyalgia, irritable bowel syndrome , 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.
Don’t Miss: Symptoms Of Major Depressive Disorder Dsm
How To Tell The Difference Between Mania And Anxiety
Depression isn’t just a single condition. Bipolar disorder, for example, can also cause what’s known as “mania,” which is a period of pronounced, intense energy that can also come with what resembles anxiety symptoms.
Commonalities Between Anxiety and Depression
One of the reasons that the two have a great deal in common is because both cause changes in neurotransmitter function – especially serotonin. Low serotonin levels play a role in both anxiety and depression. Dopamine and epinephrine play a role in both as well.
Because of these shared neurotransmitters, they can also share symptoms, and the two can contribute to the development of each other. The most common is anxiety eventually causing depression. Poor coping combined with intense anxiety symptoms can commonly lead to a feeling of hopelessness that creates depressive symptoms, and when left unchecked it’s possible that the depression becomes more severe.
It’s also important to note that both anxiety and depression – because of the neurotransmitters involved – can feel natural, and thus both often do not receive adequate treatment. Someone with depression rarely thinks to themselves “I have depression” because their mind genuinely believes the emotions they feel are “true.” Someone with anxiety often feels the same way, though with anxiety people are a bit more prone to realize they have a problem.