Anxiety vs Depression: What’s the Same and What’s Different?

Anxiety and depression are common mental illnesses and actually share many of the same symptoms. Additionally, a person can experience both an anxiety disorder and depression at the same time. So how do you know the difference between anxiety and depression?

Prevalence of Depression and Anxiety Disorders in the United States

Anxiety disorders are the most common kind of mental illness in the United States. In a person’s lifetime, he or she has a 28.8 percent chance of experiencing an anxiety disorder.

There are many types of anxiety disorders including social anxiety disorder (social phobia), panic disorder, generalized anxiety disorder and others. Prevalence rates of anxiety disorders vary by type with social phobia being the most common with an estimated lifetime risk of between 2.6-13.3 percent and panic disorder having a lifetime prevalence of between 4.1-6.6 percent. (Estimates do vary widely due to variances in methods of estimation.)

The estimated likelihood that one will experience depression in one’s lifetime also varies widely depending on the study. Lifetime prevalence rates of depression appears to be approximately 17 percent in the United States.

Anxiety Symptoms

Anxiety symptoms differ depending on the specific anxiety disorder in question. For example, in the case of panic disorder, symptoms can be so severe that the person experiencing them may end up in the emergency room fearing he or she is experiencing a heart attack.

Panic disorder symptoms include (but are not limited to):

• Heart palpitations

• Pounding heart

• Accelerated heart rate

• Shortness of breath

• Dizziness

• Fear of dying

• Chest pain

The above symptoms can make the fear of a heart attack understandable. Because of the severity and specificity of these symptoms, they are not typically mistaken for depression.

However, more general anxiety symptoms are different.

The following symptoms, typical of generalized anxiety disorder, include:

• Excessive anxiety and/or worry that is difficult to control

• Restlessness or feeling keyed-up or on edge

• Being easily fatigued

• Difficulty concentrating or mind going blank

• Irritability

• Muscle tension

• Sleep disturbance

Notably, suicidal ideation and completed suicide have been associated with generalized anxiety disorder as well but they are not specific diagnostic criteria.

Anxiety vs Depression Symptoms

Some depression symptoms are eerily similar to the above. This makes differentiating depression from anxiety difficult in some cases.

Depression symptoms include:

• Depressed mood

• Anhedonia (diminished interest or loss of pleasure in almost all activities)

• Significant weight change or appetite disturbance

• Sleep disturbance

• Psychomotor agitation or retardation (psychological and physical increase or decrease in agitation)

• Fatigue or loss of energy

• Feelings of worthlessness

• Diminished ability to think or concentrate; indecisiveness

• Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide

To be diagnosed with depression, a person must experience at least five of the above with at least one of them being a depressed mood or anhedonia.

How Depression and Anxiety Symptoms Are the Same

So, if a person reports experiencing the following:

• Suicidality

• Restlessness

• Fatigue

• Difficulty concentrating

• Sleep disturbance

That could be an indication of depression or it could be an indication of generalized anxiety disorder or, of course, the person could be experiencing both disorders at the same time.

While this can seem confusing, a bit more information can differentiate anxiety from depression.

Critically, the most important criteria (known as gateway criteria) for anxiety is excessive worry or worry that is difficult to control. In the case of depression, the gateway criteria is either a depressed mood and/or anhedonia. This means that in the above example, if the person is experiencing the former it is likely an anxiety disorder while if they are experiencing the latter it is likely depression. Those other experiences in the list are considered supporting criteria to the critical gateway criteria.

Of course, if a person is experiencing both excessive worry and/or anxiety along with a depressed mood and/or anhedonia then the person may be diagnosed with both depression and anxiety. Experiencing both disorders simultaneously is not as uncommon as you might think. According to the Anxiety and Depression Association of America, nearly half of those diagnosed with depression are also diagnosed with an anxiety disorder.

Additionally, it is important to look at the underlying cause of Anxiety and depression. Many mental health conditions and underlying learning disorders for example can cause secondary anxiety and depressive symptoms as the individual tries to deal with the issues caused by these conditions. It is important to look for underlying causes of both depression and anxiety so that you’re not only addressing the symptoms they cause, but the underlying factors.

Treating Anxiety vs Depression

According to Medscape, the treatment of anxiety and depression is typically a combination of psychotherapy and medication. Moreover, the medication and psychotherapy choices are often the same. Cognitive behavioral therapy (CBT) has been shown to be successful in both depression and anxiety disorders and antidepressant medication is the frontline medication choice for both depression and anxiety. Because of the wide range of antidepressants available, it’s often possible for a doctor to select one that can treat both disorders and a psychotherapist may also be able to address both disorders at the same time through therapy.

This does not mean that everything is necessarily the same for all people – sometimes different medications or therapies may be needed – but at least initially, simplified treatment choices are available.

Sources

Anxiety and Depression Association of America, Facts and Statistics. Accessed October 9, 2018.

Bhatt, Nita V. MD, MPH, Anxiety Disorders. Medscape. May 17, 2018.

Halverson, Jerry L. MD et al, Depression. Medscape. Updated August 29, 2018.

Kessler, Ronald C. and Bromet, Evelyn J., “The Epidemiology of Depression Across Cultures”. Annual Review of Public Health. July 16, 2014.