Dealing With Depression and Anxiety at the Same Time

Depression and anxiety are both pretty common as mental health conditions go, and for some of us—myself included—they exist together. In fact, some studies have suggested that between 20% and 40% of those with depression or anxiety have both.

They might manifest differently from each other. For me, I’ll have periods when my depression is the one that needs the most attention, whereas other times it’ll be my anxiety that feels worse.

It can feel as if I have anxiety on one shoulder and depression on the other, trying to steer me in different directions. My anxiety will be telling me to be productive and get things done, while my depression will urge me to stay in bed and hide from the world, and there’s no guarantee as to which one will come out on top.

While depression and anxiety can develop at any age, and at different times, they both arose for me during my early teenage years for various reasons. My anxiety at the time was mainly related to social situations—particularly school and interacting with peers—whereas my depression stemmed from my life being out of my control. I didn’t want to be 13 or 14, going to school five days a week, and I couldn’t wait to grow up. And, as it turns out, people with social anxiety may be more likely to develop depression earlier than people without the condition.

My history with depression and anxiety won’t be the same as everybody’s, but there are things we can all do if we experience both—so let’s take a closer look at how depression and anxiety interact, and how we can cope with them.

How Depression and Anxiety Interact

“Depression and anxiety are very closely related when you see the areas of the brain that they originate from—the amygdala,” says Gin Lalli, BSc HPD DSFH, a solutions-focused therapist. She describes it as the fight, flight, or freeze response, which is a survival response that goes back to our ancestors, explaining, “The problem is that response has not translated into modern day times so well. Fight now becomes anger, flight is anxiety, and freeze is depression.”

Both conditions can cause irritability, fatigue, trouble sleeping and difficulty focusing. However, explains Elena Touroni, PhD, a consultant psychologist and co-founder of The Chelsea Psychology Clinic, “They tend to differ in their emotional impact. Depression is more often linked with feelings of hopelessness, sadness, and a loss of interest in activities once enjoyed, whereas anxiety tends to involve worry, restlessness, and a sense of fear or dread about future events.”

But as you can experience both sets of symptoms at once, it can be difficult to work out which is more dominant at any one time.

Real Stories of Depression and Anxiety

Morgan, 25, says that her depression “tends to rule the roost,” and can make her anxiety worse as a result. “I tend to let routines go when I am having one of my worse periods of depression which leads to panic attacks because I’m all out of sorts,” she explains. However, they both developed at the same time, and she was diagnosed with both simultaneously.

It’s similar for 28-year-old Tom, who says his depression and anxiety alternate, with his anxiety then leading to the depression. “The spiraling can give me a sense of hopelessness although sometimes the lack of focus or motivation and the low feeling that comes with my depression can make me anxious about the future, paying rent, whether I’ll ever not feel like this… it’s all messy and hard to pick apart and separate,” he explains. We

Elisha, also 28, finds that her anxiety is worse, and explains that it presents itself in a lot of different ways, be it when she’s driving, or in her relationship, which she describes as being healthy and different to her past relationships. However, depression came first originally, something she puts down to entering adulthood. “My mom always used to warn me of the stark contrast between being a teenager and then turning 21-ish, and it got to a point where I was like ‘Oh yeah, you’re right!’,” she says.

“Depression and anxiety can create a vicious cycle” explains Dr. Touroni, “Anxiety often stirs up feelings of worry, stress, and fear about the future, while depression can make you feel hopeless, fatigued, and unmotivated. Together, they can amplify each other—worrying about things that feel out of control (anxiety) can lead to feeling defeated or low (depression).”

Depression and Anxiety In Daily Life

And in day-to-day life, this mix of depression and anxiety can make it more difficult to work on simple tasks, as we feel more exhausted or overwhelmed.

In the workplace, you might find that you’re procrastinating or feeling worried about your responsibilities—often both at once! You know that you’ve got plenty to work on, but you feel overwhelmed looking at your to-do list, and before you know it you’ve spent half the morning looking at cute cat videos on social media—I’ve been there. It can be difficult to focus, too, or plan your work day.

I’m fortunate enough to work from home full-time, which can help me on days when my depression and anxiety levels are high. I can sit in my office room on my computer with my cats beside me, and my partner also works from home a lot, so we can support each other.

Depression and anxiety can affect your relationships, too, be they romantic, familial, or relationships with friends or colleagues. You might withdraw or create emotional distance between yourself and the people in your life, which could lead to misunderstandings—and feelings of loneliness for yourself, too. This can be particularly true if living with depression and anxiety can make you irritable, which is quite common.

“Both conditions can create a sense of self-doubt and a feeling of being ‘too much’ for others, which often isolates people further,” Dr. Touroni explains. “The key is to recognize that these two conditions feed off each other, and by managing one, you can start to alleviate the symptoms of the other.”

Coping When You Have Both

There’s no two ways about it, living with depression and anxiety is difficult. However, there are some ways to cope.

Medication

Medication can be useful, but it can differ from person to person. “I never got on with medication really—Zoloft (sertraline) made my depression ten times worse, it felt like,” Elisha explains. “I do feel like I’ve tried on my own to make them both better. In time, I feel like my depression has just sort of let itself go but my anxiety just seems to present itself in so many different ways.”

Lee, 25, meanwhile, has tried various medications, and has been on Effexor (venlafaxine) for just over a year. “They’ve upped the dosage a few times now and I now take it three times a day,” she says. “They haven’t managed to find something that works for my anxiety yet, but I’ve found if I can manage the depression then that has a knock-on effect and I don’t struggle so much with the anxiety.”

Therapy

Dr Touroni advises seeking professional support to address both depression and anxiety holistically. She advises developing your own ‘toolkit’ of coping mechanisms, which might comprise a mix of therapy, lifestyle changes, and perhaps medication. She says that many of her clients have found cognitive behavioral therapy (CBT) useful because: “It addresses both anxiety and depression by helping to challenge negative thought patterns and manage overwhelming emotions.”

Sham Singh, MD, a psychiatrist at WINIT Clinic, says, “In dealing with anxiety and depression, I look at their underlying causes, which might be emotional or environmental, but at times even biological. This comprehensive approach will help not only in relieving symptoms but also in preventing their recurrence. The main idea of therapy would be to help the person elaborate a strategy to handle both anxious and depressive thoughts, usually starting with mindfulness and grounding techniques as ways to decrease the immediacy of the stressors.”

Lifestyle Changes

Making lifestyle changes can also help—for Lee, keeping routines is helpful for anxiety. “There’s less chance of getting anxious if I know what’s going to happen; but on the flip side, it makes it worse if something unexpected happens,” she explains.

You may decide to try mindfulness and grounding techniques yourself, too, whether they’re things you’ve explored in therapy or not. Dr. Touroni describes them as being “incredibly helpful” in managing anxiety, letting us focus on the present rather than spiraling into worrying about the future.

While Morgan is on medication for her anxiety and depression, she does this too. “I thrive on keeping routines, making set times to do things I love, and giving myself plenty of grace. I tackle one thing my depression wants me to avoid every day, like cleaning my room, to stop myself from getting too anxious,” she says.

“I’m still learning to live with both,” says Tom. “I find that I need to find a sense of hope in order to relieve the depressive feelings, whether that’s in exciting new work or projects, spending time with friends and feeling their love, doing something productive like a swim or run or a task I needed to get done or successful dating. But I can find, while the latter can be the biggest depression reliever in the moment, it can also amp up my anxiety so i tend to avoid that one for now.”

How To Talk To People About It (If You Want To)

Talking to people about our depression and anxiety isn’t always easy—often, people might just not be able to relate, even if they mean well.

“I try to talk to my loved ones up front about how I’m feeling but it doesn’t always land well,” Elisha explains. “At the same time I don’t always expect them to get it 100% but I find speaking to people I know have felt this way to be the most helpful.”

“I’ll be the first person to say I’m bad at talking to people about it. I try and pretend everything is fine until I’m literally breaking down and then it’ll all come out at once,” says Lee. “The best way I’ve managed to describe it is my head is being very loud and I’m struggling to actually make anything out because of the noise or the thoughts. I’m definitely working on talking about it more because I’m always encouraging my friends to talk and checking in on them, but I haven’t found the best way for me yet.

Morgan is an educator, and says, “I’m pretty open and honest about it, I think having done so much talking to my classes about mental health, it means that I have no shame when it comes to admitting I’m struggling. But on a day-to-day basis I mostly just make people aware (mostly about my anxiety because I do have anxiety attacks at times) and let them know if I’m having a particularly hard time.”

If you do decide to talk to people in your life, like friends, about depression and anxiety, it’s fine to bring it up in conversation, or ask them if you’d be able to have a conversation with them. Of course, it’s easier said than done, and I’ve often struggled to reach out—particularly because I internalized ideas that men are meant to be ‘strong’ and not discuss their feelings

But reaching out and talking to people is often the first step. We can often be pleasantly surprised with how our loved ones react. And if you don’t feel able to talk to people in your life, you may find support online from people going through the same thing as us.

Keep In Mind

“Most importantly, seeking support—whether through therapy, support groups, or talking to loved ones—is key to not feeling isolated in this struggle,” says Dr. Touroni.

Dr Singh says that he encourages his clients to be patient with themselves – and again, that any progress is great. “That, combined with therapy and proper self-care routines such as regular exercise and sleep, can go a long way toward recovery,” he says.

While living with depression and anxiety concurrently can be a real struggle, there are ways to cope, whether that’s opening up to loved ones, making lifestyle changes if we’re able to, or trying therapy or medication. It’s different for everybody, so it’s a good idea for us to try out different coping mechanisms and strategies to find something that works.