When Anxiety Turns to Depression

Teen girl with anxiety

Anxiety and depression are separate mental health disorders but are intimately connected. Having an anxiety disorder is the strongest predictor that an individual will develop depression. Nearly one-half of individuals who have been diagnosed with depression will also experience a co-occurring anxiety disorder, as both of these disorders have similar triggers and underlying causes. Some common medications that treat depression, such as selective serotonin reuptake inhibitors (SSRIs), are also used to treat anxiety, as dopamine and serotonin play a role in depression and anxiety. One can say that anxiety and depression often go hand in hand.

Anxiety disorders are the most common mental health disorders affecting adults in the United States. They are defined as a group of disorders that cause a constant and overwhelming sense of fear and worry to the extent that this worry interferes with your everyday life. Anxiety disorders range from general anxiety disorder and panic disorder to separation anxiety disorder, specific phobias, and social anxiety disorder, to name a few. There is no specific cause that triggers an anxiety disorder. Still, mental health professionals believe that anxiety disorders are multifactorial, meaning that many underlying causes can lead to an anxiety disorder. These risk factors and triggers include childhood trauma, genetics, chronic health problems, stressful life events, a history of a mental health disorder, substance abuse or withdrawal, childhood sexual abuse, and low self-esteem.

Major depressive disorder, the clinical term for depression, is a mood disorder that results in feelings of a very low mood for at least two weeks. Like anxiety disorders, mood disorders such as depression are deeply rooted in the same risk factors and causes associated with anxiety disorders, such as trauma, adverse life events, genetics, drug misuse, withdrawal, etc. Other types of depressive disorders include postpartum depression, seasonal affective disorder, premenstrual dysphoric disorder, and persistent depressive disorder.


How anxiety can lead to depressed mood

For many individuals with an anxiety disorder, anxious feelings can lead to avoidance and isolation. In turn, isolation can result in a lack of opportunity for pleasurable experiences, which can progress to a low and somber mood. Individuals with anxiety will often avoid new scenarios and experiences, hide from social interactions, and avoid taking leaps of faith in their professional, social, and personal lives. As a result, these individuals often isolate themselves and experience feelings of loneliness, which triggers depression. On the other hand, individuals who have depression may have decreased energy and avoid doing things they enjoy. For example, when they attempt to re-engage in their hobbies after being out of practice, they may feel anxious about returning to the social world, leading to further anxiety. Additionally, those with depression will often neglect essential priorities, and once the depression starts to improve, feelings of anxiety will arise because so many essential life priorities have been ignored. The relationship between anxiety and depression is not just a one-way road, as depression can lead to anxiety, just like anxiety can turn into depression.

Individuals with anxiety will often experience the same symptoms as individuals with depression, such as trouble concentrating, fatigue, and sleep difficulties. However, the main difference between the two disorders is depression is marked by feelings of sadness, loneliness, and suicidal ideations, whereas anxiety is marked by feelings of fear and worry that interfere with everyday life.


Symptoms of depression

  • Significant unintentional weight loss or weight gain
  • Sleep difficulties
  • Psychomotor agitation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive guilt
  • Impaired ability to think or concentrate, and indecisiveness
  • Recurrent thoughts of suicide


Symptoms of anxiety

  • Restlessness
  • Easily fatigued
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbance


Treating depression while treating anxiety

Since depression often stems from anxiety and vice versa, mental health experts treat both disorders simultaneously, primarily focusing on treating symptoms of depression as a reduction in these symptoms will often lead to a decrease in anxiety symptoms.

It is important to remember that triggers such as drugs and alcohol, trauma, and stressful life events can trigger both depression and anxiety, and therefore treating the underlying triggers through therapy approaches can help build healthy coping skills to prevent and manage symptoms associated with anxiety and depression. Medication in combination with therapy can help reduce or minimize symptoms.

There is an overlap in medications and therapy approaches to treat anxiety and depression. Antidepressants are generally used to treat anxiety and depression. Therefore individuals will often see an improvement in both their anxiety and depression four to six weeks after starting these medications. Psychotherapy is the first-line treatment for both anxiety and depression. It helps individuals work through their unhealthy thought traps, which can help individuals with anxiety, minimize avoidant behavior, and learn to embrace underlying fearful triggers. Psychotherapy can help individuals with depression replace negative thoughts with positive thoughts, leading to an elevated mood and rewarding experiences.