Key Takeaways
- Depression and anxiety frequently occur together, a pattern known as depression and anxiety comorbidity.
- Depression (major depressive disorder) impacts mood, motivation, and daily functioning, while anxiety is marked by ongoing worry and physical tension.
- Shared brain chemistry, genetics, stress, trauma, and overlapping symptoms help explain why these conditions often develop together.
- Early awareness of depression and anxiety symptoms makes it easier to seek timely and effective care.
- Anxiety and depression treatment often work best with therapy, medication, and lifestyle changes.
Depression and anxiety are two of the most common mental health conditions. While some people experience them separately, many face both at the same time. This overlap is known as ‘depression and anxiety comorbidity’ or ‘comorbid anxiety and depression’.
Depression and anxiety comorbidity occurs when a person meets the diagnostic criteria for both a depressive disorder and an anxiety disorder at the same time. This overlap can intensify symptoms and often requires an integrated treatment approach.
It is far more common than many people realize. Around 85% of people with depression experience anxiety, while nearly 90% of individuals with anxiety also develop depressive symptoms. These numbers highlight just how closely connected the two conditions are.
In this blog, we will explore why they happen together and how they’re treated, so you can recognize signs in yourself and your loved ones and find the right support.
Understanding Depression
Depression is more than just feeling sad. It is a mood disorder that affects thoughts, emotions, and daily life. People with major depressive disorder may experience:
- Feeling sad, empty, or hopeless most of the time
- Loss of interest in activities they once enjoyed
- Feelings of guilt or worthlessness
- Changes in sleep or appetite
- Difficulty concentrating
- Fatigue or low energy
In major depressive disorders, symptoms can be severe enough to make work, social life, and even simple daily tasks feel overwhelming. Persistent depressive disorder is a milder but longer-lasting form of depression.
Depression can overlap with anxiety, which is why some people experience both conditions at the same time.
Understanding Anxiety
Anxiety involves persistent worry or fear about what might happen. Unlike depression, which often causes low energy, anxiety can create restlessness and tension. Common symptoms include:
- Panic attacks
- Feeling on edge
- Avoiding certain situations
- Racing thoughts or constant worry
- Physical symptoms like a rapid heartbeat, sweating, or dizziness
Different types of anxiety disorders can occur alongside depression, including generalized anxiety disorder (43%), social anxiety (20%-70%), panic disorder (50%), and PTSD (48%).
Anxiety and Depression Symptoms (Combined)
When anxiety and depression occur together (comorbid anxiety and depression), symptoms can overlap and intensify. A person may experience:
- Difficulty concentrating
- Persistent sadness along with excessive worry
- Fatigue combined with restlessness and irritability
- Trouble sleeping due to both low mood and racing thoughts
- Physical symptoms such as headaches, muscle tension, or stomach issues
Recognizing these shared symptoms is important for choosing the most effective treatment approach.
Comorbid Depression and Anxiety vs MDD With Anxious Distress
Because depression and anxiety share many symptoms, mental health professionals explain their connection in a few clear ways:
Comorbid Depression and Anxiety
This is when a person meets the full diagnostic criteria for both a depressive disorder (such as Major Depressive Disorder) and a separate anxiety disorder (such as Generalized Anxiety Disorder or Panic Disorder). In simple terms, two distinct conditions are present at the same time.
MDD With Anxious Distress
It refers to Major Depressive Disorder with added anxiety symptoms. Doctors use the term “with anxious distress” when someone is diagnosed with depression but also feels tense, restless, worried, or fearful that something bad might happen. However, these anxiety symptoms are not strong enough to qualify as a separate anxiety disorder.
Mixed Depressive and Anxiety Features
In Mixed Anxiety-Depressive Disorder (MADD), a person experiences symptoms of both depression and anxiety, but neither set of symptoms is severe enough on its own to meet full criteria for a separate diagnosis. Instead, both types of symptoms occur together at a moderate level.
Understanding these differences helps healthcare providers choose the most accurate diagnosis and the most effective treatment plan.
Why Do Depression and Anxiety Often Occur Together?
There are several reasons why these two conditions occur together.
Shared Brain Chemistry
Both conditions involve similar brain chemicals, such as serotonin and norepinephrine.
Genetics
If mental health challenges run in your family, your risk for both depression and anxiety increases.
Stress and Trauma
Major life changes, chronic stress, or past trauma can trigger both conditions.
Symptoms Overlap
Fatigue, poor sleep, and difficulty concentrating are common to both, worsening each condition over time.
Some Questions to Ask Yourself
It is common to feel low, stressed, or anxious occasionally. But you are the best judge of what feels typical of you. If you notice new, uncomfortable feelings, changes in your energy, or other unusual symptoms, it can be helpful to reflect and reach out to a professional.
You might consider asking yourself:
- Do I often feel sad, empty, or hopeless?
- Have I lost interest in the things I used to enjoy?
- Do I spend a lot more time worrying than I used to?
- Do I often feel restless, on edge, or unable to relax?
- Do these changes affect my daily life or relationships?
- Have I started to avoid spending time with friends and loved ones?
- Do I become irritable or annoyed more quickly than I did in the past?
- Have I noticed unexplained pain, tension, or other physical symptoms?
- Do I cycle through dark, unwanted, or fearful thoughts I can’t seem to stop?
- Is it difficult to fall asleep, get enough sleep, or wake up on time most days?
- Do I worry about things I can’t control to the point where I have a hard time thinking about anything else?
If you answered yes to most of these questions, it may be time to reach out to a therapist. Professional support is especially important when symptoms last for two weeks or longer, interfere with your daily life, or affect your physical health.
Treatment for Depression and Anxiety
Treating depression and anxiety often works best with a combination approach. Because the two conditions can interact and intensify one another, an integrated treatment plan is typically recommended.
Therapy
Cognitive Behavioral Therapy, or CBT, is highly effective and helps people manage negative thoughts and develop coping skills. Psychodynamic therapy can also help by looking at how past experiences influence current emotions. This is part of anxiety and depression treatment.
Medication
Many medications can help relieve symptoms of both conditions. However, individuals experiencing both depression and anxiety may sometimes respond less to standard treatment, requiring adjustments, combination therapies, or closer monitoring. Exploring treatment options for major depressive disorders can help identify medications best suited to your specific symptoms.
Specific subtypes like depression with mixed features, or severe forms like psychotic depression, may require personalized care.
Clinical Trials
Participating in depression clinical trials can give access to new therapies, especially if standard treatments are not enough.
Lifestyle and Coping Strategies
Lifestyle changes can support recovery from depression and anxiety alongside therapy and medication:
- Exercise: Even short walks or regular movement can boost mood and reduce stress.
- Mindfulness and Meditation: Focusing on your breath or doing short mindful exercises can calm anxious thoughts.
- Grounding Techniques: Simple exercises can redirect attention from panic or racing thoughts.
- Social Support: Spending time with friends, family, or support groups helps reduce isolation.
- Sleep and Nutrition: Regular sleep and balanced meals stabilize mood and energy.
These habits complement professional care rather than replacing it.
When to Seek Help
It is time to reach out if depression and anxiety are interfering with your daily life, such as:
- Severe anxiety or panic attacks that affect daily routines
- Trouble functioning at work or school
- Thoughts of self-harm or suicide
- Using alcohol or drugs to cope.
Early support can make a real difference in recovery.
Conclusion
Depression and anxiety can feel overwhelming, especially when you live with both conditions and aren’t exactly sure which one you’re experiencing. It can affect your energy, focus, and motivation, making everyday life feel challenging.
Fortunately, there are many options for anxiety and depression treatment. A therapist can help you identify symptoms, understand possible triggers, and explore approaches that work best for you.
Additionally, Hightower Clinical is conducting clinical trials for major depressive disorders to discover better treatment options. By participating, you can advance mental health research and help build a healthier, more supportive world for emotional well-being.
FAQs
Can anxiety cause depression?
Yes. Long-term anxiety and stress can increase the risk of developing depression, though not everyone with anxiety becomes depressed.
What is the difference between anxiety and depression?
Anxiety involves excessive worry and fear about the future, while depression is marked by persistent sadness, low energy, and loss of interest.
Can a person have both anxiety and depression?
Yes. This is called comorbid depression and anxiety, and it is very common.
Which comes first, depression or anxiety?
Either can come first. Anxiety may trigger depression, or depression may increase vulnerability to anxiety.
What are the most common comorbidities with depression?
Common comorbidities include anxiety disorders, substance use disorders, PTSD, eating disorders, and chronic medical conditions.
