When people think of depression, they often imagine someone who experiences feelings of sadness and has difficulty finding pleasure in daily activities. While this can be the experience for some people with depression, many also live with symptoms of anxiety alongside depression. Below, learn what it’s like to live with both, as well as ways to cope if you have a difficult time managing co-occurring symptoms of anxiety and depression. 

Depression and Anxiety: The Overlap 

So how common is it to live with both anxiety and depression? A recent review of nationwide survey data found that 68% of people with current depression met the criteria for a current anxiety disorder, and 75% had experienced an anxiety disorder at some point during their lives. Similarly, among those with a current anxiety disorder, 63% had current depression, and 81% had depression at some point during their lives. What can be concluded is that depression and anxiety occur together for a majority of people. In fact, the study authors concluded, “Comorbidity of depressive and anxiety disorder is the rule, not the exemption.”

Anxious Depression: Another Consideration 

While some people may experience anxiety and depression together as separate conditions, others will still live with a specific form of depression called anxious depression. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists “anxious distress” as a specifier for depression. To be diagnosed with depression “with anxious distress,” a person must show two or more of the following symptoms during most days of the current depressive episode: 

• A feeling of being tense or “keyed up”
• Extreme restlessness
• Having a hard time concentrating due to worrying
• Having a fear that something awful is going to happen 
• Feeling as if one might lose control of himself or herself 

A person is said to have mild anxious distress if they show just two symptoms, moderate anxious distress if they show three symptoms, and moderate/severe anxious distress if they have four or five symptoms. Someone who has four or five symptoms, in addition to motor agitation (ie: pacing), is said to have depression with severe anxious distress. 

The Experience of Living With Depression and Anxiety 

Having co-occurring depression and anxiety is a different experience from having depression without symptoms of anxiety. Research has found the following to be true about individuals who have both anxiety and depression: 

• Anxious depression tends to be more severe and persistent when compared to depression without anxiety. 
• Anxious depression places people at a higher risk of suicide when compared to non-anxious depression.
• Experiencing both depression and anxiety is associated with greater dysfunction than living with depression on its own. 
• Having both anxiety and depression is linked to lower levels of education and a higher risk of unemployment.
• People with anxious depression tend to have more frequent episodes of depression. 
• Individuals who have anxiety and depression do not respond as well to treatment.

Given what is known about people who live with both anxiety and depression, having both conditions can be quite debilitating. It can be difficult to hold down a job or function in important areas of life when one has both depression and anxiety, and usual depression treatment methods may not be as effective. 

Tools for Coping 

If you experience symptoms of both anxiety and depression, using some coping strategies may be helpful for managing the condition. Some healthy coping methods include:

• Making exercise a regular part of your routine: Exercise can improve your mood and make symptoms more manageable so that anxious depression doesn’t cause as much interference in your daily life. Physical activity can also be an excellent way to cope with a high-anxiety moment. Something as simple as a jog around the neighborhood can clear your head when you’re feeling tense. 
• Follow a consistent sleep schedule: Prioritizing healthy sleep improves mental health and can reduce symptoms of anxiety. Allow time for adequate sleep, and create a consistent schedule with a similar bedtime and wake-up time each day. If you have trouble falling asleep, practice healthy sleep hygiene by limiting screen time before bed, keeping the bedroom cool and dark, and stopping caffeine use after lunchtime. 
• Learn relaxation techniques: Regularly practicing relaxation techniques, such as yoga, meditation, deep breathing, or progressive muscle relaxation, can help you to calm your body so that anxiety symptoms are less severe. If you’re not familiar with these practices, there are many free videos on the Internet that teach them. Some counselors and therapists may even incorporate these techniques into sessions.
• Establish a support system: Having social support is important, especially when you experience a mental health condition. Establish a network of friends or relatives who are understanding of your needs and willing to listen when you have a hard time coping with symptoms. It can also be helpful to attend a local depression support group, where you can connect with others who are facing similar challenges. 

Seeking Treatment

While establishing healthy coping skills can be beneficial when you live with depression and anxiety, in many cases, it’s necessary to seek professional treatment. Research has shown that antidepressant drugs, including SSRIs and SNRIs are effective in treating anxious depression. Some patients may also take a benzodiazepine drug to help manage symptoms of anxiety. A doctor can help to determine the best medication regimen for your needs. 

Psychotherapy can also be beneficial for patients who have anxiety and depression. A specific modality called cognitive-behavioral therapy can be especially helpful, as it can help patients to overcome distorted thinking patterns that lead to anxiety and depression. 

Keep in mind that anxious depression may not respond as well to treatment as depression without anxiety, so some patients may not find adequate relief with medication and/or therapy. In this case, an add-on treatment called transcranial magnetic stimulation (TMS) may be helpful. This non-invasive modality uses a device placed over the forehead to stimulate areas of the brain involved in mood regulation. 

TMS was recently FDA-approved for the treatment of anxious depression. If you’ve tried several medications for treating depression and anxiety and have not experienced significant relief from your symptoms, you may be a candidate for TMS. Pulse TMS offers this service in the Los Angeles area. Contact us today to learn more about our services.