Depression and anxiety—similarities and differences
Anxiety and depression are common disorders, affecting 4.1% and 10% of adults in the US in 2022, respectively. Mental health campaigns from organizations like the CDC, NIMH, and more are committed to raising awareness about the disorders. However, many people still aren’t aware of the difference between the two.
This may be because many with anxiety often develop depression and vice versa; roughly 60% of people diagnosed with anxiety also display symptoms of depression. Although depression and anxiety are different medical conditions, their symptoms, causes, and treatments can often overlap.
Symptoms of depression
According to the diagnostic criteria for depression as listed in the DSM-V, individuals experiencing a major depressive episode usually display five or more of the following criteria for two weeks or longer. Individuals experiencing a minor depressive episode usually display 2-4 for two weeks or longer.
The most common symptoms of depression include:
- Depressed Mood — In this case, a depressed mood is much more than sadness or low mood and lasts much longer.
- Lack Of Interest — A person who is experiencing depression usually has little to no motivation to do the activities they used to love doing.
- Marked Increase Or Decrease In Appetite
- Insomnia Or Hypersomnia — Patients with persistent insomnia often have trouble falling asleep or staying asleep through the night. Recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep characterize hypersomnia.
- Lack Of Energy — People with depression often report constant fatigue.
- Unfounded Feelings Of Guilt Or Taking Blame
- Trouble Concentrating
- Recurrent Thoughts Of Death, Suicidal Ideation — In severe cases, depression can be life-threatening, with suicidal thoughts or behaviors.
If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 988. Support is available 24/7. If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Symptoms of generalized anxiety disorder
While occasional anxiety is a normal part of life and may even be helpful in low doses, an anxiety disorder is often harmful to those experiencing its symptoms, both mentally and physically.
According to the DSM-V, an anxiety disorder diagnosis must include three or more of the following symptoms lasting more days than not for six months or longer:
- Excessive, Heightened Worry
- Restlessness, Edginess
- Fatigue
- Lack Of Memory And Difficulty Concentrating
- Marked Change In Appetite
- Anger And Irritability
- Sleep Disturbances- Including difficulty staying or falling asleep and restlessness while sleeping.
- Muscle Tension Without Physical Cause
Treating anxiety and depression
Treatment for depression and generalized anxiety disorder looks similar, with few exceptions. For example, extreme cases of comorbidity with other conditions like panic disorder, associated phobias, PTSD, etc., may (but not always) require specialized types of psychotherapy.
The diagnostic process
If you feel that you may have symptoms of anxiety, depression, or both, treatment begins with contacting your doctor. Usually, a doctor will complete a physical and perhaps order lab tests to assess whether your symptoms may be caused by something else. After your physical exam, your doctor may refer you to a psychiatrist for further consultation.
Upon speaking with your psychiatrist, you’ll likely be asked about any family history of mental health issues or specific concerns you have. From there, your psychiatrist will administer a self-assessment questionnaire and conduct a preliminary interview to gain more insight into your thoughts, feelings, symptoms, and other relevant information needed to arrive at a diagnosis. Depending on the nature of your symptoms, with permission, your therapist may want to speak to your close friends and family for a complete picture of your mental health and its effect on your relationships.
During this time, your psychiatrist will determine if your condition overlaps with other related disorders (called comorbidities) that will require specific treatment techniques.
After this assessment, the psychiatrist will cross-reference the info with the Diagnostic Statistical Manual of Mental Disorders (DSM-V) criteria on anxiety and depression. Once they’ve determined the diagnosis, a psychiatrist will usually refer the patient to a psychotherapist to work with the patient on a tailored treatment plan.
Psychotherapy
Several forms of therapy can be effective for treating anxiety and depression, the most common being cognitive behavioral therapy (CBT). It's important to note that while CBT can be effective for both conditions, the specific techniques and strategies used in any given case may vary depending on the individual's primary symptoms and the nuances of their anxiety vs depression presentation. The basis of CBT is rooted in the assumptions that:
- Psychological issues are likely a result of unhelpful or flawed ways of thinking.
- Psychological problems may also be the result of unhelpful or flawed learned behavior.
- People with psychological disorders can resolve them by developing coping mechanisms to recognize and address these unhelpful thoughts and behaviors.
CBT sessions are designed to help the patient:
- Recognize the cognitive “distortions” that lead to unwanted thoughts and behaviors, then reframe them to develop coping mechanisms that better align with reality.
- Learn to use problem-solving skills to cope with challenges as they arise.
- Learn to better understand the motivations and behaviors of others.
- Develop self-confidence in one’s abilities and relationships.
- Develop confidence to face fears instead of avoiding them.
CBT practitioners often help patients change unhelpful behavioral patterns by using role-playing exercises, mindfulness relaxation/meditation, and assigning tasks like keeping a daily journal outside sessions.
Medications
Your therapist may also pair with your psychiatrist to prescribe anti-anxiety meds, anti-depressants, mood stabilizers, or other kinds of medication if they feel it’s necessary. Research indicates that anxiety and depression respond well to treatment combined with SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors).
Lifestyle strategies
While you work with your therapist, they may recommend things you can do on your own to help lessen your symptoms and aid the therapeutic process:
- Meditation, relaxation techniques, mindful breathing.
- Develop a regular exercise routine, healthy diet, and sleep routine.
- Read any recommended self-help materials.
- Communicate with friends and family about your treatment strategies and ask for help if needed.
- Join a local or online support group as recommended.
Online therapy for depression and anxiety
Despite its importance, some people don’t seek treatment from a mental health professional for their anxiety and depression. The reasons for this are many, beginning with the fact that it isn’t always easy to recognize that you have a problem and need help in the first place. Because of social and/or familial stigma, some people are uncomfortable encountering others in the therapist’s office- or they may feel uncomfortable confiding in a therapist face-to-face.
Some have difficulty commuting to a therapist’s office, and some who live in remote rural areas may not have a nearby therapist at all. Problems fitting therapy into a schedule packed with work and family obligations are common, as are financial restraints.
Online therapy is an excellent solution to these barriers to treatment. Virtual therapy allows patients to attend appointments from home or anywhere with a reliable internet connection via text, phone, online messaging, and video chat. Platforms like BetterHelp connect patients to licensed, accredited mental health professionals with experience using psychotherapy techniques like CBT to treat a host of disorders. You can speak to a BetterHelp professional when it’s convenient for your schedule, and if you need help in-between appointments, they’re available to respond 24/7.
Several studies indicate that online therapy is as effective for treating conditions like anxiety, depression, trauma-related disorders, and more. Research also suggests that those who choose virtual therapy are more likely to adhere to their treatment plan.
Takeaway
What is the difference between anxiety and depression?
Anxiety and depression are both common mental health conditions, but they differ in their core features and symptoms. Understanding these differences is significant in diagnosing and treating each condition effectively.
The American Psychiatric Association indicates major depressive disorder (MDD) is one of the most common types of mood disorders. MDD is characterized by a persistent and pervasive low mood that may be accompanied by low self-esteem or a loss of interest or pleasure in normally enjoyable activities. The primary symptoms of MDD include persistent sadness, feelings of hopelessness, fatigue, changes in appetite and sleep, difficulty concentrating, and, in some cases, thoughts of death or suicide. MDD can significantly impair an individual's ability to function in daily life.
Generalized anxiety disorder (GAD), on the other hand, is marked by excessive, uncontrollable worry about everyday things. The feelings are often disproportionate to the actual source of worry and may occur even when there is no apparent reason to be anxious. People with GAD may also experience physical symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances.
While anxiety and depression symptoms can be similar (such as fatigue, difficulty concentrating, and sleep problems), the core experience of each is distinct. Anxiety in GAD is primarily characterized by excessive worry and physical symptoms of tension, whereas depression in MDD is primarily about persistent low mood and a lack of interest or pleasure in life. However, it's not uncommon for individuals to experience both anxiety and depression symptoms concurrently. When co-occurring, these two conditions can create significant challenges for individuals and require a specialized treatment approach.
Are anxiety and depression the same condition?
Anxiety and depression are distinct mental health conditions, though they can often co-occur and have some of the same treatment approaches. While both depression and anxiety symptoms can significantly impair functioning and well-being, they differ fundamentally in their primary characteristics and underlying causes.
Depression is generally characterized by persistent feelings of sadness and hopelessness. The root causes of depression can vary widely and include a combination of genetic, biological, environmental, and psychological factors. Anxiety, on the other hand, is primarily characterized by excessive worry and fear. The root causes of anxiety may also involve a combination of genetic, biological, environmental, and psychological factors.
Though both depression and anxiety symptoms can disrupt daily life, they are different in regard to how they manifest and impact individuals. However, the conditions may involve some of the same treatments, such as psychotherapy, medications, and lifestyle modifications. The overlap in treatment approaches is partly because these conditions often co-occur and can interact with each other and also because similar underlying mechanisms, such as neurotransmitter imbalances, may contribute to both conditions.
What are some differences between depression and generalized anxiety disorder?
The difference between depression and anxiety, specifically generalized anxiety disorder (GAD), is primarily in the core experiences of each condition. For many people, depression involves a persistent low mood and loss of interest in activities, while anxiety in GAD is marked by excessive worry about everyday things. Additionally, people with depression may experience physical symptoms such as fatigue and changes in appetite and sleep patterns, whereas individuals with GAD may primarily experience physical tension and restlessness.
The onset of each condition may also differ, with depression often developing gradually over time and GAD characterized by sudden onset and fluctuating symptoms. The duration of the conditions can also vary, with depression typically lasting longer than GAD if untreated.
Additionally, the underlying causes of these conditions can differ. While both may involve a combination of environmental and biological factors, specific risk factors for each condition can vary. For example, individuals with a family history of depression may be more likely to develop MDD, while those with a history of traumatic experiences or chronic stress may be at higher risk for GAD.
How do doctors know if you have anxiety or depression?
Diagnosing anxiety and depression requires a comprehensive evaluation by a healthcare professional, such as a doctor or therapist. During this process, the healthcare provider will ask about your symptoms, medical history, and any potential risk factors for these conditions. They may also conduct physical exams and run various tests to rule out other possible causes of your symptoms.
One primary tool used in diagnosing depression and anxiety is the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 provides standard criteria for diagnosing mental health conditions, including depression and GAD. Doctors and therapists will use this manual to determine if your symptoms meet the criteria for a specific diagnosis.
Self-assessment tools like the Beck Depression Inventory and the Generalized Anxiety Disorder 7-item scale (GAD-7) may also be used to help evaluate symptoms and track progress over time. However, these tools should not be used as a substitute for a professional diagnosis.
What are the signs of anxiety?
Anxiety disorders can manifest in various ways, and the specific signs may vary depending on the type of anxiety disorder. However, some common signs of anxiety may include the following:
- Chest pain or tightness
- Difficulty breathing or shortness of breath
- Racing heart or palpitations
- Tightness in the throat
- Restlessness or feeling on edge
- Difficulty concentrating or racing thoughts
- Excessive worry or fear about everyday things
- Avoiding certain situations or activities due to fear or anxiety
Physical symptoms such as muscle tension, fatigue, and sleep disturbances may also accompany anxiety. Individuals may also experience anxiety differently depending on their age, gender, and cultural background.
How do you know if it's anxiety or depression?
As both anxiety and depression can have some symptoms, it can be challenging to determine which condition an individual may be experiencing. Some key differences between anxiety and depression include the primary emotional experience (i.e., sadness for depression and fear/worry for anxiety) and physical symptoms (e.g., fatigue for depression and tension for anxiety).
Only a healthcare professional can accurately diagnose a mental health condition, so it's necessary to seek guidance if you're experiencing symptoms of anxiety or depression. A trained professional can help determine the underlying causes of your symptoms and provide appropriate treatment recommendations.
Is anxiety a form of mental illness?
Mental illness is a broad term that encompasses various conditions that affect an individual's mental health. These may include disorders that primarily affect mood (depression, bipolar disorder), thought processes (schizophrenia), or behavior (eating disorders). Anxiety falls within this spectrum as it can significantly impact an individual's thoughts, emotions, and behaviors.
Anxiety disorders are a group of mental health conditions characterized and include generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, panic disorder, and specific phobias.
Anxiety may also occur as a symptom of other mental health conditions, such as depression or post-traumatic stress disorder (PTSD). PTSD can develop after exposure to a traumatic event or experience, and individuals with this condition may experience symptoms of anxiety, including hypervigilance and difficulty sleeping.
While anxiety is a common emotional response to stressors in life, anxiety disorders are often more severe and can greatly impact an individual's ability to function in daily life. These disorders often require specific therapeutic interventions and sometimes medication for effective management and treatment.
Can you have anxiety and not depression?
As a mood disorder, depression can significantly affect an individual's overall well-being and may coexist with other mental health conditions. Likewise, someone can have anxiety without experiencing depression.
However, research has shown that there is a critical relationship between anxiety and depression, and individuals with one condition are at higher risk for developing the other. This relationship could be due to biological or environmental risk factors or the impact of one condition on the development of the other.
While everyone's experience with mental health conditions is unique, there can be a wide range of severity and overlap between symptoms. Problem-solving therapy, like cognitive-behavioral therapy (CBT), can be effective in treating both anxiety and depression by addressing negative thought patterns and behaviors. Additionally, certain prescription medications, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed for individuals with co-occurring anxiety and depression.
What medication is used for anxiety and depression?
Several types of medication may be used to help manage symptoms of anxiety and depression, including the following:
- Selective serotonin reuptake inhibitors (SSRIs): These medications work by increasing levels of the neurotransmitter serotonin, which can help control mood and reduce the symptoms of anxiety and depression.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs): Similar to SSRIs, SNRIs work by increasing levels of serotonin and norepinephrine in the brain.
- Tricyclic antidepressants (TCAs): This type of medication may be prescribed when SSRIs or SNRIs are not effective. TCAs increase levels of serotonin and norepinephrine while also blocking certain receptors that control mood.
- Benzodiazepines: These medications are typically used for short-term treatment of anxiety and can help reduce symptoms such as muscle tension and restlessness. However, they can be habit-forming and can cause withdrawal symptoms if stopped abruptly.
Only a healthcare professional can determine the appropriate medication and dosage for an individual, taking into consideration factors such as past medical history, current symptoms, and potential side effects. Regular check-ins and follow-ups are essential to monitor the effectiveness and any potential adverse reactions of medication.
It's important to note that medication is only one aspect of treatment for anxiety and depression. Therapy, lifestyle changes, and self-care practices can also play a significant role in managing these conditions. Seeking professional support and guidance can help individuals develop a comprehensive treatment plan tailored to their unique needs and experiences.
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