Separating Anxiety from Depression: An Easy Way to Determine

One could argue that depression is a mostly “dialed down” mental illness: Profound melancholy and hopelessness, low vitality, and a disconnected, disengaged sensation are typical symptoms.

On the other hand, anxiety might be thought of as a “dialed up” state since it frequently presents as tense muscles, a racing heart, and a stream of anxious thoughts and impulses.

What then accounts for the correlation between these seemingly disparate mood disorders? Nevertheless, they do. A 2020 overview published in The American Journal of Psychiatry found that nearly half of those who struggle with depression also experience anxiety. And the elderly are not exempt. About 25% of participants over 50 in an AARP study from 2023 reported that they had been informed by a medical professional that they had either depression or anxiety disorders.

The short answer is that social situations and contact with others are generally avoided by those who suffer from anxiety, and this can cause depression. Conversely, it is also true that someone who has prolonged depression may be more susceptible to anxiety. Anxiety and depression are also associated with biological, familial, genetic, and brain risk factors. In addition, a number of underlying medical disorders, including diabetes, heart disease, cancer, and others, can cause anxiety and sadness.

It can have crippling effects on an individual who has both illnesses. According to Mayo Clinic psychology professor Craig Sawchuk, “depression and anxiety kind of work together to create the cycle of feeling, thinking, and behaving that… keeps a person trapped.”

What you should know about each, their interactions, and how to end the cycle are as follows:

Anxiety: What is it?

You are largely aware of the response to that: It’s an overwhelming and irrational sense of dread that sets off intense feelings and bodily sensations, as though your body is bracing itself for battle or to flee as quickly as possible. Anxiety is a common yet sporadic guest in most people’s life. For example, it’s common to feel nervous before a speech or a first date. However, if dread is a regular reaction to low-risk situations, there may be a problem. Anxiety disorders may be indicated if you allow persistent fear and dread to control you to the point that you avoid social situations, grocery shopping, or leaving the house completely.

Depression: What is it?

A person is diagnosed with depression if they have low energy, hopelessness, constant melancholy, and an inability to enjoy life. Oftentimes, these symptoms coexist with altered sleep and hunger patterns. Additionally, they coexist with general malaise, or a feeling of being sick overall, which is frequently accompanied by exhaustion and diffuse pain. Agitation is a rare side effect of depression.

It’s important to consider whether your feelings of anxiety or despair are appropriate for the circumstances and transitory. For example, mourning the death of a loved one frequently entails intense pain and anguish. However, it’s usually time to see a medical professional if your depression persists and starts to interfere with your everyday activities.

Depression and anxiety can occur together, but one may manifest before the other. According to psychiatrist Mary E. (Beth) Salcedo, M.D., medical director of the Ross Center, a mental health facility in Washington, D.C., anxiety is more likely to manifest initially and frequently in childhood.

According to Sawchuk, there is frequently a “wear-and-tear effect” in those who have experienced worry for a long time. People may eventually reach a point when they are less linked to their social networks, at which point “they become more vulnerable to depression.” Anxiety may become more common in later life for someone who has had long-term depression, especially if their circumstances change. For example, someone with depression, who is already sensitive to stressful life events, is more prone to experience anxiety when faced with the uncertainty of a transfer.

How are the diagnoses for these two illnesses made?

The most prevalent mood disorders are anxiety and depression, yet few medical professionals check for these conditions in their elderly patients. The U.S. Preventive Services Task Force suggested in June 2023 that routine depression screenings be conducted for adults of all ages. The group advocated for annual screening of individuals under 65 for anxiety. Those who disagreed, calling anxiety disorders “pervasive and pernicious” in older persons who “should not be denied the opportunity to benefit” from current therapies, disagreed with the task force’s conclusion that there wasn’t enough evidence to support the idea that people 65 and older should undergo similar screenings. Speak with your healthcare practitioner if you would want to be screened.

In screening, common symptoms, mental patterns, and behaviors are questioned, typically using a brief questionnaire. It can assist in identifying the physical manifestations of anxiety and sadness, including as poor, restless sleep, memory loss, and persistent aches and pains, which are commonly written off as typical signs of aging, even by medical professionals. The Geriatric Depression Scale, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 are a few of the more often used questionnaires.

In order to rule out other medical conditions like low iron and thyroid difficulties, your doctor may suggest physical examinations and lab testing to assist determine whether or not you have a mood disorder. Since certain drugs might lead to anxiety and depression, medication use is also examined.

Options for treating sadness and anxiety

Fortunately, there are treatments available for anxiety and despair among senior citizens. Mani Santhana Krishnan, a psychiatrist and chair of the Faculty of Old Age Psychiatry at the Royal College of Psychiatrists in London, states that depression is a highly treatable disorder if it is diagnosed. Older folks “can lead a very normal life” following treatment.

Fortunately, there are treatments available for anxiety and despair among senior citizens. Mani Santhana Krishnan, a psychiatrist and chair of the Faculty of Old Age Psychiatry at the Royal College of Psychiatrists in London, states that depression is a highly treatable disorder if it is diagnosed. Older folks “can lead a very normal life” following treatment.

The truth is that determining which therapy is most effective will likely take some time. The methods of treatment for depression and anxiety are comparable. Speaking with a therapist is frequently sufficient for minor cases of the illnesses. For many people, cognitive behavioral treatment, or CBT, is beneficial. In CBT, the patient and the therapist collaborate to pinpoint maladaptive thought patterns and behaviors and develop more effective coping mechanisms.