Depression and Anxiety: How to Deal When You’ve Got ’Em Both

Anxiety and depression are separate conditions, each with several varieties, or subtypes. For instance, people can feel anxiety broadly, as in generalized anxiety disorder, or more specifically, as in phobias or social anxiety.

Depression has many faces, too, the most common of which is called major depression — which might sound scary but is really just the catchall of depression diagnoses.

Anxiety and depression often work in tandem. Anxious thoughts can spiral toward depressing ones. If depression comes first, you might not feel up to completing daily tasks and then, as dishes and bills pile up on the kitchen counter, start to feel anxious.

If you’re feeling depressed and anxious — either at the same time or one after the other — you could have both depression and anxiety, or you could have one of them accompanied by symptoms of the other.

The risk factors for both include lifestyle, stress, environment, underlying medical conditions, history of trauma, and, of course, the genetic lottery — which means some of us are born more prone to anxiety and/or depression and some of us experience them after dealing with a trauma or loss.

Whatever the causes of depression and anxiety are for you, know that it’s not your fault and help is most definitely available.

Depression

Though each type of depression could show up a little differently, common symptoms include:

• feeling sad, pessimistic, or low regularly for at least 2 weeks
• irritability
• restlessness or its opposite, lethargy
• chronic feeling of guilt, hopelessness, or worthlessness
• frequent anxious and worried thoughts
• loss of enthusiasm for your favorite foods or activities
• extreme fatigue
• sleep changes, like waking earlier than usual or oversleeping a lot
• decreased appetite and/or unexplained weight loss
• difficulty concentrating or making decisions
• headaches, digestive upsets, or unexplained aches and pains
• thinking about suicide or self-harm

Anxiety

While each type of anxiety has some unique features, common anxiety symptoms include:

• consistent, bothersome feelings of worry or fear about daily life and/or the future
• rapid heartbeat
• grinding teeth
• irritability
• feeling overwhelmed
• tiring easily
• difficulty concentrating
• chronically tight muscles
• sleep issues, such as difficulty falling asleep or staying asleep

You probably noticed that the two conditions have many symptoms in common, like worry, irritability, and sleep issues. If you want to take a deeper dive into your symptoms, self-tests like these are great tools to get you started:

• anxiety and depression self-tests (5 minutes or less)
• anxiety self-test (10 minutes)
• depression self-test (20 minutes)

Just keep in mind that, while they can help you reflect on what you’re experiencing, self-tests are only the first step. It’s important to follow up with your doctor or mental health professional to get support for whatever you’re dealing with.

Getting a diagnosis isn’t one size fits all, but your primary care doc will probably want to talk about your symptoms, do an exam, and ask questions to get a clearer picture.

Sometimes there’s a physical cause of the problem. For instance, if you’re low in B vitamins, vitamin D, or iron or you have an underactive thyroid, you could have symptoms that look a lot like depression.

Your doctor might order blood or urine tests to check these numbers first. If the tests don’t suggest any other causes, they may refer you to a psychiatrist, psychologist, or other mental health professional who can offer a specific diagnosis with the help of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5).

Luckily, treatments for anxiety and depression run pretty similar courses, and addressing one condition often improves the other too. Your healthcare provider may recommend one or a combination of these strategies:

Talk therapy

One option here is cognitive behavioral therapy (CBT), a now-classic method that helps people redirect negative thoughts.

Interpersonal therapy focuses on relationships and communication skills, and problem-solving therapy is a technique that (just like it sounds) addresses your current problems from a practical standpoint.

Some people also find relief of symptoms of anxiety and depression through psychoanalysis.

Scrips

Your doctor might recommend medication for anxiety and depression. Antidepressants like selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) work by boosting feel-good chemicals in your brain. And they’re twofers: SSRIs and SNRIs can also reduce anxiety symptoms.

If anxiety is the more bothersome of the two, your doc might suggest something like buspirone or a benzodiazepine like Xanax.

Anxiety medications alone aren’t likely to make a big dent in symptoms of depression unless your depressed feelings stem directly from anxiety. Mood stabilizers — sometimes alone and sometimes in combination with antidepressants — can also be prescribed to help with anxiety and depression.

Move, move, move

It can be really hard to exercise when you’re depressed or anxious, but a hike, a jog, or your favorite yoga class will boost those feel-good endorphins and start shifting your perspective. If you’re not feeling up for much, even a short walk can help.

Avoid alcohol and caffeine

We know, we know. Alcohol and caffeine aren’t all bad. But since alcohol is a central nervous system depressant, to say that it doesn’t mix well with depression is a huge understatement.

And while alcohol does tend to dull anxious feelings while you’re enjoying that glass (or three) of pinot, its effect on brain chemistry means it often leads to a delayed anxiety spike.

Too much caffeine, of course, can also push anxiety to the next level and make sleep more difficult, thus intensifying depression. Try to stick to herbal teas and kombucha (or plain old water!) for a few weeks to see if it helps.

Sleep it off

You know how getting good quality sleep, along with the right amount of sleep for your body, can make you feel like a million bucks? Yep. But poor sleep, or not enough of it, is a huge risk factor for both anxiety and depression.

Try going to bed a bit earlier and practicing healthy sleep habits to help out.

Try a meditation or mindfulness practice

Yes, meditation is trendy and mindfulness is a buzzword… but don’t knock them just because they’re popular. Research shows that meditation could reduce symptoms of anxiety and depression.

Maybe give CBD a try

Everybody and their mom is talking about cannabidiol, or CBD, for anxiety and depression. There isn’t a ton of research about this yet, but when it comes to anxiety, specifically, a study found that rats are significantly less stressed when given CBD.

In humans, small studies have shown that CBD can have some benefits for people with social anxiety and post-traumatic stress disorder.

Lifestyle changes and complementary and alternative medicine (CAM)

Eating fewer processed, sugary foods and upping your intake of fruits, veggies, nuts, healthy fats, whole grains, fish, and lean meats can make a huge difference in the way you feel.

Good friends are good medicine: Make time in your busy life to nurture those quality connections! But don’t forget that most of us also need at least some alone time to recharge.

Some people find hypnotherapy helpful for treating anxiety, and biofeedback has been studied in connection with depression and PTSD.

Home care alone may do the trick if your symptoms are temporary and mild. But if you’re dealing with symptoms of anxiety and depression that affect your everyday life for 2 weeks or longer, talk to a doctor or mental health professional to get support.