Depression and anxiety are two of the most common reasons people seek mental health care. Years ago, depression was the most common reason, by far. In recent decades, anxiety has caught up, sometimes surpassing depression as the most common reason people seek psychological help. Informed by decades of experience as a therapist, it seems clear to me that anxiety and depression can be interrelated; a dance of unpleasant emotional experience if you will. Over time, I have observed an inverse relationship between anxiety and depression for many people and in many cases.
As a therapist writing this blog, I should explain my view that anxiety is at the root of many mental health concerns, not just those classified as anxiety or anxiety-related disorders. While some professionals may disagree on a semantic level, the underlying role of anxiety across psychological issues is clear to me. Despite the connection between anxiety and a broad range of mental health concerns, the focus of this blog is narrowed to the connection between anxiety and depression. And while many people experience anxiety or depressiveness, I’m not necessarily talking about full-blown psychiatric disorders. Although some people have been diagnosed with both anxiety and depressive disorders, some people have only been diagnosed with one or the other. Many others are not diagnosed with either, although experience anxiety and depressiveness at clinical or subclinical (i.e., not meeting full criteria for a diagnosis) levels. I like to use the term “depressiveness” to refer to depressive symptoms which may or may not reach a level of clinical depression.
Anxiety is often the baseline
Anxiety is an extremely common human experience. Estimates upward of 35% of the population experience anxiety symptoms throughout the year. I would venture to say that almost everyone experiences some degree of anxiety at some point in their lives. In addition to the frustration of dealing with anxiety, experiencing anxiety on a daily or weekly basis can be exhausting. Perhaps as a subconscious way of trying to deal with anxiety, an increase in depressiveness can begin. An increase in depressiveness acts as a potential method of dealing with anxiety because the more depressed one feels, the less they put themselves out in the world and the less anxiety they might experience. For example, when we sleep or stay in bed more, there are fewer potential triggers to the anxiety that we might experience throughout the day. When we develop apathy or anhedonia, we tend to worry less. This represents a form of avoidance, which is usually an ineffective way of managing anxiety. Depressiveness can trigger anxiety too, and I’ll come back to that directional relationship later in this blog.
As the depressiveness increases, the intensity or frequency of anxiety can decrease. This might provide some temporary relief from anxiety, however in my experience people REALLY don’t like feeling depressed. At some point, people will either seek treatment or the depressiveness simply lessens with time and there is a brief period when people feel relatively good (e.g., lowered levels of anxiety and lowered levels of depressiveness). However, because too often people have not learned how to manage anxiety effectively (or even recognize anxiety as a concern to be managed) as the depressiveness has lifted and they engage with life more fully again, the anxiety increases which starts the whole cycle over again. A sample representation of the relationship between levels of anxiety and depressiveness can be seen in the chart below.
Not everyone experiences the connection between anxiety and depressiveness the way it is portrayed in the chart. Some people find the phase of heightened depressiveness lasts longer than the phase of heightened anxiety, or vice versa. Others might experience periods of heightened anxiety and heightened depression at the same time. Regardless, hopefully you get the idea that there is often a connection between anxiety and depression and for many people, learning how to effectively manage anxiety is the missing piece to breaking the cycle.
Can depression come first?
In some cases, clients have indicated that they believe depressiveness is the underlying issue because they perceive that they have experienced depressive symptoms or periods of depression more often and earlier in their lives than anxiety. In this situation, experiencing long periods of depressiveness can lead to anxiety as the symptoms of depression can have a direct impact on one’s functionality (e.g., ability to attend work or school consistently, ability to engage effectively in relationships, etc.). One might experience persistent worry (emotional component of anxiety) that they are not living up to some standard or expectation. In addition, depressiveness and/or anxiety can have a direct negative impact on our relationships, further fueling emotional distress.
Considering that certain thoughts or beliefs we may have and hold about ourselves (e.g., I’m not good enough) can contribute to both anxiety and depressiveness, it’s no wonder a strong relationship between the two can exist. The fact that certain beliefs can underlie both gives a clue about certain ways to go about learning to manage anxiety more effectively. Learning to manage anxiety more effectively can interrupt the cyclical relationship between anxiety and depressiveness and create the opportunity to live life more fully and more joyfully.
You can create a different experience
If you are struggling to manage anxiety or depressiveness, reach out to a local therapist. You can read more about how to find the right therapist for you in the blog I wrote to help navigate the process of identifying a therapist that is a good fit for you. If you are looking for a seasoned therapist or don’t know where to start your search, you can always reach out to Dr. Mike at INC Therapy for in-person sessions in Colorado Springs or virtual sessions in many states across the country. You can learn to break the cycle of anxiety and depressiveness if you learn to understand the cycle, learn effective skills and strategies, and put those to use on a regular basis.
Dr. Mike Ghali, owner of Individual and Couples Therapy, has been practicing therapy for over 20 years. He recently moved to Colorado Springs, CO with his family. While physically located in Colorado Springs, Colorado, where he holds in-person sessions, you can also schedule telehealth sessions with Dr. Mike from anywhere in Colorado or Florida.
If you’d like to schedule a free 15-minute consultation call INC Therapy, please click here., then click Schedule, and choose the available time that works best for you and your partner. If you have any questions, don’t hesitate to contact Dr. Mike at firstname.lastname@example.org. Please do not include sensitive clinical information in emails.