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Depression and Anxiety: Comorbidities in Mental Health

Meloncauli is a former nurse and anxiety management therapist. She hopes everyone can take something away from her articles.

Depression and Anxiety Often Go Hand-in-Hand

Depression or anxiety (or both) commonly exist alongside the primary diagnosis. It is highly likely that, even if you suffer from a standalone period of depression, there will be some anxiety involved. Equally, when one suffers from an anxiety disorder, the anxiety can lead one to become depressed. We’re not talking about being a bit down here, of course, but a diagnosed clinical depression. Is the comorbidity aspect of mental health generally recognized to the degree that it should be? How much do anxiety and depression play a part in the severity of the primary mental health diagnosis?

Do you suffer from anxiety and depression?

Do you suffer from anxiety and depression?

Depression and Anxiety: Mood Disorder Twins

It is so common to see depression and anxiety disorders together that some researchers actually believe they are not separate disorders at all. They can both be brought on by way of a response to something. For example, depression may be a reaction to life events, such as the loss of loved ones, relationship breakups, long-standing illnesses, and of course, mental health disorders.

It appears that some people may be more predisposed to become clinically depressed, but leading up to becoming depressed, it is likely a person will have had some level of anxiety. So, depressed people can be said to be reacting also to anxiety. Overanxious people, or those with anxiety disorders, are usually responding to stress or stressors in their lives.

Anxiety is usually filled with apprehension or fear about that which may happen. Depression can follow when the fear of what may happen becomes too much to bear or when life simply becomes unbearable because of anxiety’s disruptive nature. Panic disorder is a good example. We feel we have lost control when we can’t stop a panic attack. This leads us to avoid situations in which we may make a fool of ourselves. The more we detach ourselves from normal activity, the more despondent we can become, leading to depression.

Quality of life and control in our lives is important to us. Ironically, anxiety usually speeds us up whilst depression slows us down! Both doctors and patients alike can find it difficult at times to separate the two disorders because many of the emotional or mood symptoms of depression and anxiety disorders tend to overlap.

Comorbidity With Primary Mental Health Diagnosis

This is all bad enough, but what happens when depression and anxiety find their way into other mental disorders such as schizophrenia, bipolar disorder, eating disorders, and personality disorders? Those with schizophrenia can also suffer from social anxiety or social phobia. The psychotic symptoms of schizophrenia can induce a worry about how a sufferer may be perceived by people in the social context. A chronic fear of embarrassment can lead to an avoidance of social situations. Self-confidence takes a big knock and this, in turn, can promote isolation, and an isolated person with schizophrenia will be more likely to become depressed.

Isolation can compound any mental health issue. The more a person thinks about their mental illness and how it is affecting their lives, the more despondent they may become.

Bipolar disorder, for example, exhibits severe mood swings, and it is recognized that these moods are polar opposites — from depression to mania, hence the term bipolar. At times, there can also be extreme agitation and anxiety can become a part of both extreme moods.

My friend, who has rapid cycling bipolar, gets spells of severe anxiety and these spells tend to be just before she gets depressed. She sees this as one of her signs that depression is very near. For her, the anxiety can escalate to extreme proportions so she is afraid to leave the house. She begins to have obsessive anxious thoughts about what would normally be trivial matters. When she is in the manic phase, she also worries somewhat about how the anxiety affects her when she is depressed. I have seen the anxiety compound her depressed mood and even creep into her mania, though to a lesser degree.

Anxiety can be addressed, and doesn't always require pills.

Anxiety can be addressed, and doesn't always require pills.

Anxiety and depression have a lot to answer for! I do not have room in an article this size to talk about all the other mental disorders and the co-existence of anxiety and depression within those disorders, but it is true to say in the vast majority of cases, there will be an element of one, if not both.

When suffering a mental health problem, a feeling of isolation is not uncommon without the added anxiety and depression. These comorbid conditions only serve to exacerbate the isolation. Social inclusion and mental illness is still fraught with complications for a sufferer made worse by anxiety states and a despondency that equates to a level of clinical depression. We should be looking at just how much anxiety and depression actually make the primary diagnosis problem worse.

There may be times when someone is given an elevation in their dose of psychiatric medication when actually they wouldn’t need it if the worsening presentation turned out to be rooted in anxiety or a bout of reactionary depression. Anxiety certainly can be addressed and doesn’t always need medication. The severity of depression would dictate the use of medication.

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It is my opinion that professionals should be consistently monitoring any anxiety and depression within a primary mental health diagnosis. Address the anxiety and depression issues and at the least, the primary problem would not be antagonized so much.

Professionals should ideally be supporting sufferers with their mental health diagnosis but this should always include recognizing and addressing any related anxiety or depression problems. If a person suffering from a mental health disorder has better coping skills, the extent of suffering could only improve somewhat. Sadly, in psychiatry, doctors are quick to prescribe more pills to dissolve some of the anxiety and depression. Sometimes mood stabilizers are used, with lithium being a popular one for the treatment of bipolar disorder. Anticonvulsants are quite popular, too, for a range of mental health problems, with regard to spells of anxiety and depression.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


meloncauli (author) from UK on September 26, 2012:

Hi AnnaCia. Thanks for dropping by and leaving a comment. The lists of symptoms for these kind of problems tend to cross over too! Many people who have big anxiety problems actually worry that they have depression. It's hard not to have a measure of depression if anxiety is disrupting your life.

AnnaCia on September 25, 2012:

A wonderful hub. Thank you very much. Regarding looking for a primary condition that presents itself as anxiety or depression is a very important point. It is the problem I have been having until a month ago. Keep the good writing.

Boo McCourt from Washington MI on April 26, 2012:

My last depression was so overwrought with anxiety i was doing nothing at all, I was unable to function in any form at all. Usually there is anxiety but this time was so bad i could barely lift my arms, all i wanted to do was swallow anxiety tabs and sleep until it was over. Still working hard on coming out of this one, a new therapist and psych doctor are godsends!

meloncauli (author) from UK on April 16, 2012:

Thanks for your comment billybuc. If it helps one person, it's a bonus!

Bill Holland from Olympia, WA on April 15, 2012:

I have several friends who suffer from depression and/or anxiety and it is a constant struggle for them. I'll be sharing this excellent and informative article with them. Great job my friend!

Linda Rogers from Minnesota on April 11, 2012:

Excellent article meloncauli-I have learned quite a bit about anxiety and depressive states through my grauduate studies and my own experiences with it. I know my depression and anxiety very much overlap. Through the years I have learned some coping skills that have helped me. I think it's great that you point out the confusion of overlapping disorders. It can get really complex to figure out.

meloncauli (author) from UK on April 06, 2012:

That is sad. I have heard many similar stories over the years. Thanks for your response.

Jasmine on April 06, 2012:

I know a girl who suffered from typical adolescent depression. Her doctor prescribed some heavy anti-depressants after the first appointment (she was 17 then) and now, ten years later, she has bipolar caused by a chemical change in the brain because she misused those medications at an age when the body and the brain were still developing. Sad :(

Tim Mitchell from Escondido, CA on March 30, 2012:

Thank you Meloncauli

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