Anxiety and Depression Are Tightly Linked: Why It Matters

*Trigger Warning: Mention of Suicide*

"I suffered chronic anxiety, without realizing it, for much of my childhood and early adulthood, and later developed severe depression. For me, the key to coming out of my deep depression was first tackling the perseverative thoughts that made me anxious all the time. When I overcame my gnawing anxieties, the depression just melted away.

During my long recovery, I had this weird feeling that my “brain muscle” (that’s how I thought about my mind and mood), which had atrophied under relentless, chronic stress of crippling anxiety, was, through rigorous “exercise” (therapy and meds) getting back into shape and better able to deal with the world. My brain fog slowly abated, my memory came back, and my social phobias faded into the background.

Along this journey of recovery, introspecting my feelings, I realized my anxiety and depression seemed like one disease, not two. Curious about what science had learned about the linkage between anxiety and depression, I did some digging. Here’s a very brief summary of what I learned.

Lumpers vs. Splitters

According to M. Taylor Wilmer and colleagues in a recent article in Current Psychiatry Reports, there are two opposing traditions in diagnosing mental disorders: Splitters, who focus on consistent differences among different diagnoses, vs. lumpers, who tend to view diverse signs and symptoms as part of a single disorder.

And although the DSM-V (Diagnostic and Statistical Manual of Mental Disorders ), in the tradition of “splitters,” clearly delineates depressive disorders from anxiety disorders (and further breaks down each of those into separate disorder subtypes), a growing number of researchers and mental health professionals are coming around to the point of view that anxiety and depression, if not the same disorder, are often different sides of the same coin.

Taylor Wilmer et al. pointed out that:

• Over half of depressed patients also exhibit some form of anxiety.
• Genetic risk factors correlated with depression and anxiety are similar.
• Anxiety and depression often have the same environmental risk factors (e.g., childhood trauma).
• Anxiety and depression are both associated with inflammation and excessive stress hormones.
• Anxiety and depression share co-morbidities like heart disease, diabetes, Parkinson’s disease, and dementia.
• Drugs such as SSRIs, anti-inflammatories, and psychedelics that reduce anxiety also reduce depression.

Why the Link Between Anxiety and Depression Matters

Understanding that anxiety and depression are sometimes so tightly linked can be useful for preventing, diagnosing, and treating the two disorders.

For instance, anxiety often strikes patients earlier in their life than later bouts of depression, raising the possibility that, at least for some people, there might be a causal link between early anxiety and later depression. Research into stress hormones (e.g., cortisol) associated with anxiety suggests that chronic exposure of the hippocampus, prefrontal cortex, and other mood-related brain structures to high cortisol levels inhibits neurogenesis and leads to shrinkage and dysfunction in structures needed to sustain mood. A clear implication is that early diagnosis and treatment of anxiety could lessen the occurrence of later depression and even suicide.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the National Suicide Prevention Lifeline, or contact the Crisis Text Line by texting TALK to 741741. To find a therapist, visit the Psychology Today Therapy Directory."

*Anxiety and depression are more closely linked than we realize and understanding this can really help with diagnosing and treating both. There are 2 different types of providers when it comes to treating anxiety and depression: lumpers and splitters. Some providers will split the disorders and treat them separately, while others will lump them together. I can understand both, but the treatments for both tend to be similar. I definitely think my anxiety feeds into my depression and vice versa. If I'm not feeling anxiety, then it's likely I am feeling more depressed. It's important to be open with your provider about how you are feeling and if you are having any thoughts of harming yourself, please reach out to emergency services. Do you feel as though you struggle with both anxiety and depression? Do you feel as though they feed into each other?*

#Anxiety #Depression #MentalHealth

Please find the full article at Psychology Today.

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