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Anxiety and Depression

One in four people in the UK experience a mental health problem each year. This means there’s a chance you may know somebody affected by either depression or anxiety, two of the most common mental health conditions. You may have heard these terms a lot, possibly used alongside each other. But how well do you understand them? And do you know the key differences between anxiety and depression

What do the terms anxiety and depression mean?

A key difference between the two definitions is that one refers to a single illness, and the other to a group of conditions.

Depression is essentially one illness. Although it has lots of different symptoms (see below) and may feel very different to different people, the term refers to a single condition.

Anxiety, on the other hand, is an umbrella term that encompasses a range of more specific conditions. The most prevalent of these is generalised anxiety disorder (GAD), which may affect between four and five in every 100 people in the UK.

But anxiety also spans several less common conditions, some of which you may have heard of. These include phobias, panic disorders, adjustment disorder and stress reaction.

Because of the wide range of conditions that fall under the ‘anxiety umbrella’, for the purposes of this article we’ll focus on generalised anxiety disorder.

What do anxiety and depression feel like?

Generalised anxiety disorder and depression are similar in that their main defining symptoms relate to someone’s mood and feelings, but they also have physical manifestations.

Mood and feelings

Depression is defined by having a low mood and/or a loss of interest or enjoyment in most activities, for two weeks or longer. These are seen as ‘core symptoms’ of depression. There are a range of other mood-related symptoms that a person with depression may experience, including:

  • guilt
  • helplessness
  • feelings of worthlessness, low self-esteem or low confidence
  • thoughts of death or suicide

Similarly, generalised anxiety disorder centres on two ‘core symptoms’: excessive anxiety and worry on most days for more than six months, and difficulty controlling these feelings of anxiety and worry. And again, there are further symptoms beyond these that someone may experience, such as:

  • feeling on edge or restless
  • irritability

With generalised anxiety disorder you may feel very worried about a range of everyday things, without there being one obvious logical cause for your anxiety.

Physical symptoms

On the physical side, there are actually quite a few symptoms that appear in both generalised anxiety disorder and depression, for example:

  • fatigue / tiredness
  • poor concentration
  • being fidgety or unable to sit still
  • difficulty sleeping

But there are also physical symptoms unique to both conditions. In depression, physical symptoms might include:

  • weight changes, often caused by changes in appetite
  • being slower in your movements

The physical effects of generalised anxiety disorder include:

  • muscle tension and aches
  • headaches
  • sweating
  • dizziness
  • bowel problems
  • a fast heartbeat and shortness of breath

All of these symptoms can potentially be signs of other problems with your physical health.

Can you have anxiety and depression at the same time?

So it’s a complex picture, with depression and generalised anxiety disorder having some distinct features, and some that overlap. To complicate things further, it’s actually possible for someone to experience depression and anxiety at the same time.

In fact it’s not just possible; it’s quite common. Around half of people with generalised anxiety disorder will also have depression. When the conditions coexist like this, they can be more severe and long-lasting than usual.

It’s also possible to be diagnosed with one of the conditions, and to have symptoms of the other (but at a level that on their own would not lead to a diagnosis). The way symptoms overlap make it hard to be precise with numbers. But estimates of the number of people with depression who also experience symptoms of anxiety range as high as 85 per cent.

Many experts actually view ‘mixed anxiety and depressive disorder’ (MADD) as a separate category in itself. This is where someone may have symptoms of both conditions, but not severe enough to have a formal diagnosis of either condition. However, this combination can still cause considerable distress and affect someone’s daily life.

Similarities in treatments

When it comes to depression and generalised anxiety disorder, one clear similarity is the way they are treated. For both conditions there are two main categories of treatment: psychological therapies and medicines.

Psychological therapies involve talking through your thoughts and feelings with a qualified professional. An example of this is cognitive behavioural therapy, which aims to address the way your thoughts, feelings and behaviours interact.

Medicines called antidepressants are used for both conditions and are effective for many people. The most common ones are called selective serotonin reuptake inhibitors (SSRIs), though there are lots of others the doctor might try.

Often, a treatment approach will involve a certain combination of both psychological therapies and medicines. This approach will be tailored to the individual and their specific situation. The doctor may also look to address lifestyle issues as part of the treatment, if they think these may be contributing to the depression or anxiety.

article by Nick Ridgman

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