Do You have Anxiety or Depression? | Depression vs. Anxiety

Symptoms of depression and anxiety can certainly look similar. As depression and anxiety often come hand in hand – it becomes very difficult for someone suffering from depression or anxiety to identify which condition can be attributed to their bothersome symptoms, and what course of action they need to take. This article will compare and contrast the differences between anxiety and depression, conditions that can mimic both, as well as treatment options.

Anxiety vs. Depression Symptoms

“Do I have anxiety or depression” may be a question you can’t identify on your own, as many of the day-to-day symptoms that impact a patient’s quality of life the most are the ones that overlap between both conditions.

Depressive SymptomsCombinationAnxiety Symptoms
Loss of interest in pleasurable activities (anhedonia)Sleep DisturbancesNervousness
Low self-esteemPoor ConcentrationPalpitations
GuiltAppetite DisturbancesIncreased Heart Rate (Tachycardia)
HopelessnessSocial WithdrawalHypervigilance
Suicidal IdeationsPhysical Symptoms (Upset Stomach, Headaches)

 Sleep disturbances, for example, are so frequent with anxiety disorders that they have been incorporated in their definitions [1], while, simultaneously, sleep disorders are also considered to be core symptoms of depression [2]. An example of a sleep disturbance would be racing thoughts. If you’re stressing about something (upcoming job interview, health, relationship issues), then this may be keeping you up at night and giving you ‘racing thoughts’. Another common symptom is irritability, which has been included as a qualifying symptom for GAD (general anxiety disorder) [3], while, on the other hand, it’s also assumed that there is a genetic predisposition that links depression and irritability [4].

However, some people may have both depression and anxiety simultaneously, or even other contributing disorders or conditions, which could then explain the influx of a variety of different symptoms.  Generalized anxiety disorder (GAD) can be accompanied by other psychiatric conditions. In fact, studies have supported that up to 90% of people with a history of GAD have at least one, comorbid psychiatric condition [5]. 

Major depressive disorder (MDD) is the most common comorbid condition, with approximately 62% of people with GAD suffering from depression in their lifetime [6]. Other psychiatric conditions that tend to occur with generalized anxiety include social phobia, panic disorder, and other specific phobias.

Are Depression and Anxiety Easy to Diagnose?

It can be difficult to distinguish and diagnose depression vs anxiety as they share many similarities. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) quantifies generalized anxiety disorder (GAD) as persistent, excessive worry most days out of the week for at least 6 months duration [7].

The DSM-5 outlines that major depressive disorder (MDD) must experience a marked change in mood, characterized by depressed mood or loss of interest for a minimum of 2 weeks [8].

There are similar disorders to both anxiety and depression. If the change in mood or symptoms are related to a life stressor (death in the family) or change in environment (living in a new city) in the past 3 months, your practitioner may diagnose you with an adjustment disorder. If anxiety is situational and not on a continuous, daily basis you may be diagnosed with a specific phobia (ex. social phobia, agoraphobia, aerophobia).

Can you have Both Anxiety and Depression?

Yes, you can experience both anxiety and depressive symptoms. In clinical practice it’s common that patients report that one condition can “feed” off the other (ex: anxiety creating the depression or the depression creating the anxiety). The condition – mixed anxiety and depressive disorder (MADD) – applies to individuals with both depressive and anxiety symptoms – but who do not fully meet the DSM criteria for depressive disorders or specific anxiety disorders. The prevalence of the disorder has been on the rise recently, with research suggesting it is the most prevalent psychiatric disorder in primary care [6].

What is the Main Difference between Anxiety and Depression?

Individuals with depression experience more feelings of sadness, worthlessness and hopelessness. You may feel less motivated to partake in enjoyable activities, experience brain fog and may deal with slowing of cognition and movement. Conversely, people with anxiety tend to feel like their mind and body are in overdrive and racing. Many of these individuals can experience palpitations, feel sweaty and may feel “on edge.”

Are there Conditions that Mimic Depression and Anxiety?

There are various medical conditions that present similarly to anxiety and depression, which is why your provider may ask you about your medical history, current medication usage and present/past substance usage.

1. Thyroid Issues

One of the most common medical conditions that can cause fluctuations in mood are thyroid issues. If an individual has hypothyroidism – low thyroid hormone levels – they can feel sluggish, struggle with brain fog and feel hungry frequently leading to weight gain. Conversely, individuals with hyperthyroidism – elevated thyroid hormone levels – may feel like their mind is constantly racing, struggle with palpitations and may lose weight secondary to poor appetite [9]. Your provider may order a thyroid panel in addition to  standard blood work if you are struggling with either set of symptoms.

2. Deficiencies

Vitamin deficiencies, particularly Vitamin B12 deficiency can also mimic depressive symptoms, in which case supplementation will improve the said symptoms [10]. But deficiencies can and should not be assumed based on symptoms. Your provider may order a Vitamin B12 level in addition to other vitamins and minerals including magnesium and folateAnemia can also lead to depressive symptoms [11], particularly in menstruating individuals, which is why a CBC (complete blood count) may also be ordered by your provider.

3. Certain Medications

Medications, including antihypertensive medications – particularly beta blockers [12]– can lead to depression in some individuals. These medications can be utilized in small doses to help individuals with anxiety, but larger dosages run the risk of decreasing heart rate and blood pressure too much, leading to depressive symptoms. Other medications, including oral contraceptives [13], acne medications (isotretinoin) [14], and corticosteroids [15] can lead to anxiety and/or depressed mood. 

4. Substance Abuse

Lastly, substance use and abuse can precipitate depressive and anxiety symptoms. Stimulating substances including amphetamines, cocaine and caffeine can precipitate anxiety symptoms [16]. On the other hand, alcohol and marijuana can lead to depressive symptoms in some individuals [17].

Are Anxiety and Depression Treated in the Same Way?

There are many similarities in which your practitioner may treat anxiety and depression, including medication management, psychotherapy, and brain stimulation therapies.

Medication for Anxiety and Depression

For both conditions, SSRIs (selective serotonin reuptake inhibitors) are typically utilized in the first line. It is a common misconception that “antidepressants” only treat depression – they also have indications for anxiety, panic disorder, social anxiety, OCD, and PTSD – among other psychiatric conditions. Your provider may also utilize other classes of medications, including mood stabilizers or antipsychotic medications to help address anxiety and/or depression. 

Furthermore, in individuals with comorbid panic disorder or specific phobias, we also may include a “rescue” medication for anxiety or panic attacks which can include antihistamines, beta blockers and benzodiazepines

Psychotherapy for Anxiety and Depression

In both conditions, psychotherapy or “talk therapy” can help significantly with addressing stressors and learning how to handle them in a healthy manner. There are various types of psychotherapy – with different treatment modalities targeted by therapists to address different concerns. Psychotherapy can be used in combination with medication management or as monotherapy.   

TMS for Anxiety and Depression

While some people respond favorably to antidepressants, there are individuals who experience side effects or suffer from treatment-resistant depression that may benefit from non-pharmacologic treatment. Transcranial Magnetic Stimulation (TMS) has the capacity to increase connectivity, blood flow as well as activity to the brain which can lead to a significant improvement in individuals with anxiety and depression

Dr. Griffith says “TMS is great for individuals that don’t benefit from antidepressants. TMS is a non-medication depression treatment and has better success rates when compared to antidepressants”

Disclaimer: At the moment of writing this article, TMS therapy has not been FDA-approved as an anxiety disorder treatment. However, research thus far has indicated positive improvements of anxiety symptoms in individuals receiving TMS therapy [18]. TMS has also been approved to treat symptoms in individuals with anxious depression [19].

Reach out today and figure out what treatment is the best for you.

Free Consultation
Kristen Schwartz, MPAS, B.S.

Physician Assistant (PA-C)
Medically Reviewed by Walter G. Griffith Jr., MD, PA

Kristen was born and raised in St. Petersburg, FL and received her Bachelor of Science degree from the University of South Florida. She then attended Florida Gulf Coast University where she received her Master of Physician Assistant Studies degree. Kristen has maintained a long-standing interest in psychiatry which was solidified while on rotations in the Fort Myers area. Kristen received her Certificate of Added Qualification in Psychiatry. Kristen provides compassionate, patient-centered care to all her patients. In her free time, she enjoys traveling, spending time with family as well as her 2 cats, Ernie and Apricot.

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