Depression vs. Anxiety: How It Feels, Symptoms, and Treatment – Verywell Health

Feeling down is normal, and everyone feels anxious from time to time. It’s a normal response to stressful situations. But severe or ongoing feelings of depression and anxiety can be a sign of an underlying mental health disorder.

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults every year. Around 16 million adults in the United States have major depressive disorder.

Determining the difference between depression and anxiety is challenging because they can be interdependent, and they share many symptoms, including nervousness, irritability, sleep trouble, and difficulty concentrating.

This article will discuss the differences between depression and anxiety, including symptoms and treatment.

Differences Between Depression and Anxiety

Depression and anxiety are mental health conditions that can affect how you think, feel, and act. Both disorders are influenced by levels of neurotransmitters (chemical messengers) in the brain, including chemicals like serotonin, dopamine, and norepinephrine.

Anxiety may occur as a symptom of depression. It’s also not uncommon for someone with an anxiety disorder to also suffer from depression. Nearly one-half of individuals who are diagnosed with depression are also diagnosed with an anxiety disorder.

Though depression and anxiety share some symptoms, each disorder has its own distinct symptoms that distinguish them as separate mental health conditions.

Symptoms

Despite the relationship between depression and anxiety, each disorder has its own emotional and behavioral symptoms that distinguish them from one another.

These symptoms can include:

Burnout

Although burnout isn’t an official medical diagnosis, what is generally referred to as burnout shares a number of symptoms with depression and anxiety. It can leave people feeling exhausted, empty, and unable to cope with the demands of life. While burnout may be mistaken for depression, they are two separate conditions.

Though there is an association between the two, research has revealed no conclusive overlap between burnout and depression or burnout and anxiety, indicating that they are different experiences.

Types of Depression and Anxiety

Depression and anxiety present in different ways, which are categorized as different types of disorders. These are based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the American Psychiatric Association’s reference manual for diagnosing mental illnesses.

Anxiety

Types of anxiety disorders according to the DSM-5 include:

Other mental health conditions share features with anxiety disorders. These include post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD).

Depression

Types of depression according to the DSM-5 include:

These disorders may have specific identifiers, such as:

• Psychotic features
• Peripartum onset
• Seasonal pattern

Effect on Women 

The menstrual cycle, pregnancy, and perimenopause are all associated with dramatic physical and hormonal changes. Certain types of depression can occur at different stages of a woman’s life.

• Premenstrual dysphoric disorder (PMDD): A more severe form of premenstrual syndrome. PMDD symptoms include irritability, anger, depressed mood, suicidal thoughts, bloating, breast tenderness, and joint or muscle pain.
• Perinatal depression: A mood disorder that can affect women during pregnancy and after childbirth. Mothers with perinatal depression experience feelings of extreme sadness, anxiety, and fatigue that may make it difficult for them to carry out daily tasks.
• Perimenopausal depression: Can occur during the menopause transition and presents with symptoms of irritability, anxiety, sadness, or loss of enjoyment.

Effect on Men 

Depression may manifest differently in men. Research has shown that some men with depression hide their emotions and may appear angry, irritable, or aggressive, while many women report sadness, weight changes, and sleep disturbance as their main symptoms.

Some men may turn to drugs or alcohol to try to cope with their emotional symptoms.

Studies show that while women tend to experience more suicidal thinking, men are far more likely to die by suicide and use more lethal methods.

Causes

Anxiety and depression are caused by a complex mix of environmental, biological, genetic, and situational factors.

Both disorders are affected by levels of neurotransmitters (chemical messengers) in the brain, including serotonin, dopamine, and norepinephrine.

Anxiety

Though the exact cause of anxiety disorders is still unknown, researchers suspect a combination of factors, including:

• Environmental factors: Experiencing a trauma might trigger an anxiety disorder, especially in someone who has inherited a higher risk to start.
• Genetics: If you have a close biological family member with an anxiety disorder, you are much more likely to develop the condition.

Depression

Various factors can increase the risk of developing depression, including:

• Brain chemistry: Abnormalities in brain chemical levels may lead to depression.
• Genetics: If you have a close relative with depression, you may be more likely to become depressed. Estimates suggest that depression is caused 40% by genetics.
• Life events: Stress, the death of a loved one, upsetting or traumatic events, isolation, and lack of support can lead to depression.
• Medical conditions: Ongoing physical pain and illnesses can cause depression. People often have depression alongside conditions like diabetes, cancer, and Parkinson’s disease.
• Substance use: Recreational drugs and alcohol can cause or worsen depression.

Diagnosis

Healthcare providers diagnose the many different types of anxiety and depression according to symptoms, causes, and duration. They use the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the American Psychiatric Association’s reference manual for diagnosing mental illnesses.

If you have symptoms of depression or an anxiety disorder, talk to your healthcare provider. They will start by taking a complete medical history and conducting a physical examination.

Depression Diagnosis

Clinicians use screening tools and questionnaires to assess people for depression. Healthcare providers and mental health professionals are specially trained to administer and interpret the results of these questionnaires.

The different subtypes of depression come with their own sets of diagnostic criteria in the DSM-5. You will be asked if you’ve experienced persistent feelings of sadness, low mood, and loss of interest in your usual activities for at least two weeks. You will also be asked about your sleep, appetite, and if you’ve had any thoughts of suicide.

Anxiety Diagnosis

While there is no definitive test for anxiety, if symptoms are present and persistent, your healthcare provider may conduct a physical assessment and diagnostic tests to rule out potential medical causes.

If no physical illness is found, you will be referred to a mental health professional to be evaluated for an anxiety disorder. They will use the DSM-5 to determine if you have an anxiety disorder. The diagnostic criteria for each anxiety disorder are different.

You may be asked questions about how often you experience feelings of worry or if you’ve noticed any physical symptoms such as restlessness, feeling tired, trouble concentrating, irritability, muscle tension, or trouble sleeping.

Treatment

Depression and anxiety are treatable, whether they occur together or separately. Most people benefit from psychotherapy (talk therapy), medication, or a combination of these.

Psychotherapy

For treating depression and anxiety, there are several types of talk therapy.

One of the most researched is cognitive behavioral therapy (CBT), which improves self-awareness of negative thoughts or behavior patterns. CBT is used to treat anxiety and depression, but the treatment itself can vary slightly based on the condition.

• In treating anxiety, the goal of CBT is to help the individual change how they react to situations that cause anxiety, and identify and modify thoughts that cause anxiety.
• In treating depression, one focus of CBT is on helping the individual become more engaged in activities that they value and have given up since becoming depressed.

Medications

A group of medications known as selective serotonin reuptake inhibitors (SSRIs) have been shown to be helpful for both anxiety and depression.

Other medications that may be used depending on the individual’s symptoms include:

Self-Care

If your symptoms are mild, self-help interventions can be a reasonable place to start.

Some self-care tips for people with anxiety and depression include:

• Getting enough sleep
• Eating healthy foods
• Keeping a regular daily schedule
• Getting out of the house every day
• Exercising
• Avoiding alcohol and recreational drugs
• Talking with family or friends about how you are feeling

Prevention

Anxiety and depression are not always preventable, but you can take steps to control or reduce your symptoms, and reduce the risk of recurrence. These include getting enough sleep, eating a healthy diet, and practicing regular self-care activities.

Other actions that may help prevent these conditions from developing, or prevent them from getting worse, include:

• Limit caffeine: Stop or limit how much caffeine you consume, including coffee, tea, cola, and chocolate.
• Seek help: Get counseling and support if you have experienced a traumatic or disturbing event. Doing so can help prevent anxiety and other unpleasant feelings from disrupting your life.

Reducing Mental Health Stigma 

People who experience depression and anxiety often face prejudice due to the stigma attached to mental health disorders.

Research has shown that stigma leads to delays in treatment. It also reduces the chance that a person with mental illness will receive appropriate and adequate care.

Here are some tips to help address the stigma associated with mental illness:

• Show people reliable information to help them understand your diagnosis and to dismiss any myths or misinformation about your condition, including opinions like “depressed people are lazy” or “anxiety doesn’t exist without panic attacks.”
• Engage with advocacy/support groups. An advocacy group uses the power of lived experience to influence public opinion and policy. You may even want to become an advocate yourself.
• Talk about your experience. Sharing your story can help improve people’s understanding of your condition and change their attitudes.

A Word From Verywell

Depression and anxiety are very common disorders, and they may be mistaken for one another due to an overlap of symptoms. Talk with your healthcare provider if you begin to experience signs of anxiety or depression and these feelings or changes last longer than two weeks. Finding the right treatment may take some time. Your healthcare provider will work with you to find the best option.

Frequently Asked Questions 

Who is at risk for depression and anxiety?

Everyone is at risk of experiencing depression or anxiety at some point in their lives, but studies show that women and adults under the age of 35 are more likely to experience anxiety than other groups. The proportion of adults who experienced any symptoms of depression was highest among those ages 18 to 29.

Does medication for depression and anxiety work?

A group of medications known as selective serotonin reuptake inhibitors (SSRIs) have been shown to be helpful for both anxiety and depression.

Anti-anxiety medications have also been shown to reduce anxiety among patients.

Note that you may need to try medication for six to eight weeks before you notice fuller effects.

How often is anxiety misdiagnosed as depression?

Anxiety disorders can mimic depression, so misdiagnosis is common. The two conditions can also coexist, further confusing the diagnostic process.

A study carried out in a primary care setting found misdiagnosis rates reached 65.9% for major depressive disorder, 92.7% for bipolar disorder, 85.8% for panic disorder, 71% for generalized anxiety disorder, and 97.8% for social anxiety disorder.

Be sure to communicate all your symptoms to your healthcare provider to ensure the most accurate diagnosis is reached.

What does anxiety feel like compared with depression?

Anxiety involves feeling tense, nervous, or unable to relax, with a persistent sense of dread or fear. Physically, you may have a churning feeling in your stomach, feel lightheaded or dizzy, and have rapid breathing or a fast heartbeat.

The classic signs of depression include feelings of sadness, hopelessness, and worthlessness, but some people with depression also feel restless or irritable, have trouble concentrating, and struggle to sleep and eat.