Differences Between Anxiety and Depression (and When to Seek Help)

While we have made strides in combating mental health stigma, it can still be difficult for people to get the help they need when it comes to depression and anxiety. This is partly due to the lack of mental health literacy in the US. A 2021 study that analyzed this topic during the first year of the COVID-19 pandemic found that mental health literacy among American adults is low and that people cannot easily identify mental health symptoms and appropriate treatment options.

However, you don’t need to read research in scientific journals to know that our society is struggling with mental health literacy. Just scroll through social media or watch shows on your favorite streaming platform. For example, some people may say they are “depressed” because they had a bad day – and I sympathize with you because we’ve all been in that state – but depression is much more serious.

“Depression is generally poorly understood, and short bouts of bad mood due to a bad day are often exaggerated as “depression,” psychiatrist Dr. Benjamin Janaway said in an email. “Depression, from a psychiatric standpoint, is well demarcated and includes an almost constant feeling of being overwhelmed, decreased energy, interest, and a host of other things such as eating, sleeping, socializing, and loss of hope, among others. ”

In general, depression and anxiety can be difficult to understand, and therefore it can be difficult to know if what a person is going through is just a part of life or if they may need professional help. According to Janaway, the analysis of experience and human behavior is one of the key points.

“In my own practice, my rule (and I don’t have many) is, ‘If a person needs help or he or another person is in danger, then we can call it a problem,'” Janaway said. “At the same time, we must also understand that emotions are part of the human experience, but it is the degree and severity that determines whether we need to act.”

Here’s what you need to know about the symptoms and treatment of anxiety and depression, which affected 25.4% of American adults aged 18 and over in 2019 .

What is anxiety?

Although I have struggled to improve my mental health for almost a decade , at times I have found it difficult to find words to accurately describe what I felt, and this is not unique to my experience. Jonathan Stea, a clinical psychologist and associate professor at the University of Calgary , explained that the word “anxiety” is a loaded term because people use it in different ways. For example, “anxiety” can be used colloquially in the language we use to describe everyday stressors, but its clinical meaning is different. In a nutshell, Stay said, anxiety is the expectation of a future threat.

Anxiety manifests itself in people through anxious thoughts and bodily sensations, such as sweaty palms or a rapid heartbeat. It can also influence people’s behavior when they experience anxiety. Some people may try to run away from the situation, freeze or avoid it. Before you start thinking that everyone in the world must suffer from clinical anxiety, it’s important to remember that anxiety is normal – to some extent.

“It is important to understand that the experience of anxiety is normal and is an evolutionarily adaptive response that we have evolved to protect ourselves from danger. We have to feel anxiety in some life situations,” said Stey. “The problem is that in some people, anxiety can become excessive, persistent, debilitating and disproportionate to the real threat – in these cases, the person may experience an anxiety disorder that can take many forms.”

Janaway, a psychiatrist, added that hormonal or chemical changes in the body can also cause anxiety. For example, a person with hyperthyroidism may be more agitated and have a faster heart rate. This is why psychiatrists always ask people to take blood tests to rule out physical causes first.

“You can’t fix an overactive thyroid with therapy,” he said.

What is depression?

As with anxiety, Stee points out that “depression” is another catch-all term. However, as mentioned above, clinical depression is much more than just feeling sad for a short amount of time.

“This may include normal, expected feelings of sadness or loss of interest or pleasure, say, after an identifiable stressor such as the loss of a job or relationship, and may also refer to psychiatric disorders when a person exhibits these symptoms along with clinically significant ones. distress, deterioration and loss of functioning,” he said.

In addition, Stea emphasized that depression is complex because depressive symptoms can appear in the context of various psychiatric disorders, such as bipolar disorder or substance-induced depressive disorder , among others.

Janaway also explained that depression is a pattern of emotional, physical, and social changes that occur in response to loss. And it can show up as a side effect of physical or chemical changes in the body due to disease, genetic risk, or medications.

“Most depressive episodes can only be explained by a combination of all of these factors, and reducing it to ‘one cause’ is inappropriate,” Janaway said.

In addition, people with severe depression may begin to lose touch with reality or project their experiences onto the outside world. This can lead to the formation of false beliefs and feelings that can be very difficult to live with. Suicide is also a risk of depression that psychiatrists take very seriously.

You can have both anxiety and depression at the same time

Understanding the difference between anxiety and depression can be confusing for some people, Stey said: get and maintain a positive mental attitude. health, learn how to get help and reduce stigma.”

Both Stea and Janaway noted that people can experience both anxiety and depression at the same time.

“Of course, if someone is afraid of the future, they will feel depressed, and if they are depressed and feel helpless, they will worry about moving forward in life. It starts to make sense from the story of how a person ended up in the situation that he is in, ”said Janaway.

However, he said that a person is usually dominated by one disorder, so doctors treat it first. Janaway emphasized that there is strong evidence that a combination of drugs and therapy, or each of them alone, is beneficial. Physicians must work with the patient to choose the right approach.

When to ask for help

As Stea and Janaway mentioned, anxiety and sadness are part of the human experience, which can make it difficult for people who are struggling to determine when they should seek help. “I generally recommend seeking help when a person begins to feel that their mental health issues are interfering with their lives,” Stey said. “In other words, when mental health issues start to feel insurmountable and debilitating, and they start to interfere with a person’s ability to function, then it’s definitely worth turning to.”

Janaway agreed, emphasizing that people should seek help when their experiences (such as being sad or anxious) or behaviors (which might include not eating, going out, or talking) are distressing. People should also consider whether others have become concerned about them.

“This could mean that people are worried about your safety, or that this is going on for too long, or that this is not normal for you,” the psychiatrist explained. “For example, feeling down and making plans to kill yourself after a breakup is not common.”

Treating Anxiety and Depression

Treatment approaches for anxiety and depression may look similar in some ways, but different in others. For example, Stea points out that cognitive behavioral therapy, or CBT, a form of talk therapy that teaches patients how to change negative patterns to make them feel better, is one evidence-based treatment approach used for both depression and depression. and with anxiety. disorders. The psychologist added that there are advanced avenues in CBT that focus on various issues, such as exposure-based anxiety therapy and behavioral activation strategies for depression.

When it comes to drugs, Janaway noted that, contrary to popular belief, psychiatry is not just about drugs and biology, but is “based on addressing the biological, psychological, and social problems associated with a ‘disorder’, ‘symptom’, or ‘problem’.” He explained that there are many evidence-based approaches to treat both anxiety and depression, but the specific type of medication or therapy can vary. Everything depends on the case.

Stea stressed that both mental health providers and patients should play an active role in the treatment plan.

“Treatment plans should be made in collaboration with patients and depend on many factors such as medical history, history of psychotherapy, and the specific mental health reasons people seek treatment,” Stea said.

The link between anxiety, depression and suicide

Talking about suicide can be difficult, but it’s important if we want to understand the risk anxiety and depression can pose to our loved ones. People with depression and anxiety are at higher risk of suicide, and mental health professionals don’t mess around in this area. They work to “help people protect themselves,” Janaway said.

“Suicide can have many motives,” he said. “Sometimes it’s about escaping pain and seen as ‘the only option’ (and in fact it’s never the case), or it can be a fantasy meant to give the person a sense of control over their own destiny, or it can even form a function of revenge or punishment on others.” “. He emphasized that no matter what a person’s motivation might be, “we have to ask ourselves if this is something the person ‘usually does’ and 100% of the time the answer is no.”

Stee also said that the causes of suicide are many and extremely complex. While mental health problems can be one of the many variables associated with suicide, other important social causes also increase the risk of suicide, including child abuse, racism, and poverty.

How to support loved ones struggling with anxiety and depression

Connecting with loved ones who may be struggling with anxiety and depression is one way to help them, Janaway says. You can also ask what help they need or recommend that they see a doctor.

“If you are very concerned about their safety, seek emergency help, go to the emergency room, or call your local crisis line. Never dismiss your concerns as unfounded and their symptoms as unimportant,” Janavey said. “Mental illness is complex, rebellious, and often hidden, so if you’re worried, take it seriously.”

In addition, it is important to seek help from experienced and licensed mental health professionals. You are probably not a professional, and social media gurus are also not the experts you should turn to when times are tough.

“It’s important to turn to conscientious mental health professionals, not armchair and fringe experts,” Stee said. “I know it sounds harsh, but the harshness is in line with the potential harm.”