A wise mentor in graduate school once taught me that depression and anxiety were interrelated like siblings. At first, I wasn’t quite sure what she meant. After all, we hear about individuals who come into counseling with presenting complaints of anxiety or depression, but typically not both. When psychiatric patients are prescribed medication to alleviate unwanted symptoms, the medicine is geared towards treating depression or anxiety. So, can depression and anxiety be experienced simultaneously? Can a person suffer from only depression, and not anxiety, or vice versa?
In my clinical experience of working with clients in psychotherapy, any or all of the above can occur. Today, I’d like to highlight how depression and anxiety share an intertwining relationship where one symptom can cause or exacerbate the other.
Let’s think of an example of a young woman named “Gina” who finds out she has a new boss in her workplace. Her old boss was easy to get along with, but the boss had to leave town transferring to another job. Now Gina who has been struggling with anxiety related financial stress for the last year has to deal with the transition of establishing a good relationship with her new boss. Unlike Gina’s old boss who was supportive and empathic, her new boss is demanding and seemingly unfair about giving her credit for her achievements. Gina’s anxiety she was already having is now magnified because of this new environmental stressor she did not anticipate to add to her list of worries. Sounds familiar to you?
We say to ourselves, “ok, this is all I can handle. Anything else that is problematic that lands in my lap is going to make me lose control, and completely overwhelm me.” But now, you guessed it, one more thing to add to your laundry list of worries that can’t be ignored and has to be dealt with. But how?
What Gina doesn’t realize is that she has to figure out a way to get to know her new boss, and build a friendly yet professional relationship with her new boss. Gina’s fear of judgement, and worry that her work performance won’t meet her boss’s expectations is getting in the way of her productivity. In addition to financial worry, Gina now is ruminating about getting fired or demoted.
Gina can: be determined to find out the best communication strategy to get to know what her new boss is looking for; continue to talk to her, ask questions, get clarification that she is on the right track, and continue to demonstrate the same high quality of work performance she’s been able to maintain
She can allow her fears to cloud her focus leading to further worry; this worry then blocks her problem solving; inhibits her self-confidence; reinforces a sense of inadequacy. This can lead Gina avoid her boss as much as possible. Being reactive instead of proactive to build this important relationship is unproductive.
If Gina chooses option A , she will be self-empowered to minimize her anxiety, and take action to solve her inner conflict. Choosing option B will cause Gina to stew in her frustrations, and the negative thoughts will continue to fester.
Is Gina at risk for getting depressed if she chooses option B ? Emotionally healthy people are not afraid of gaining insight, and are willing to face their challenges. Our response to stress determines how we thrive and get past life’s challenges. Staying stuck in anxiety leads us to feel helpless, discouraged, and overwhelmed. As time passes, and no action has been taken to solve the dilemmas that are presented significantly raises one’s chances of struggling with depression.
When Gina puts herself in a position to get to know her boss better, she is giving her boss the chance to see Gina’s interpersonal strengths, effective communication skills, abilities to be social with others in the workplace, and eagerness to be successful. Perhaps when she understands her boss’ personality better, she may realize her boss is hard to get to know, but also more compassionate than expected. Even if Gina’s boss is hard around the edges, this relationship can challenge Gina for greater resilience, adaptability, and flexibility to work well with various personalities in the workplace.
Unresolved anxiety leads to depression. Remaining in a state of depression without knowledge of combatting depression, and overcoming creates the nasty vicious cycle of depression causing further anxiety, and anxiety causing deeper depression. In the case of Gina, we don’t know other factors that are affecting her emotional functioning such as: her upbringing in her family of origin, current personal relationship factors, genetic predisposing to anxiety/depression, and lifestyle habits. We don’t know how long Gina’s laundry list of problems run. What we do know is that Gina has choices, and her emotional response to her external stressors will prove instrumental in how she fares psychologically in the long run.
Approach don’t avoid problems
Start exploring problem solving today; procrastination only makes things worse
Anxiety is based on fears; fears stem from thoughts created in our mind
We may not be able to control what goes on around us, but we do have control over how we respond to what happens to us
Explore what is within your control to take immediate action to attack and overcome and minimize your challenges
Knowledge is power; getting access to information to resolve conflict will immediately reduce your worry
Don’t wait for the feeling of readiness to be proactive. Take the action, and let the feeling of anxiety alleviation to follow. If you wait for the feeling, you may never take the action.
Think out of your comfort zone. Break away from thought patterns that lead to worry or inhibition.
Take baby steps. This will prevent you from talking yourself out of follow through. Every effort you make, small or large accumulated into goals being reached. Even the smallest of steps taken in the right direction are a victory.
Don’t let the anxiety take control of you; you take control of the anxiety. Unresolved anxiety leads to further stagnation, lowered self-esteem, and stunted self-empowerment.
Some psychological considerations:
Realize that the anxious or depressing thoughts are not just being stored in your mind, but also affect your body. The mind and body are connected making it even more imperative to protect your emotional wellness. Symptoms of anxiety can cause all kinds of physical manifestations such as muscle tension, lethargy and headaches to name a few. Studies have shown that chronic stress can be a precursor to other medical illnesses. These conditions affect our quality of life, and potentially our longevity as well.
Worry is simply fear-based thoughts about something that hasn’t happened yet. Worries are no more than passing thoughts that obscure our inner peace. We all have inner peace that lies within us. It is the pattern of fear-based thoughts that obscure our inner peace. Our worries are thoughts that arise in our minds, and can’t even begin to reflect the depth of our being. Worries cannot sum up our personality, our life story, or our self-concept. Our mind and body hold on to these thoughts that are based on illusion. Fantasizing about a future occurrence that’s related to possible difficulty robs us of the present. When we can take the perspective of embracing inner consciousness, and connecting with our divine harmony, we can appreciate each moment of our day. This is the greatest gift given to each and every one of us.
Take a closer look at your patterns of worry in your life. Whether your concerns are related to your job, or perhaps a family member, relationship or your health…. be aware of how these patterns of fears affect your body. Work on goals of allowing your inner consciousness to take back what is yours…the gift of the present, inner peace, richness and joy that each day brings you. Remember to be thankful for what you have in your life, even the difficult lessons. It is through life’s challenges that we return to our inner purpose, and fulfillment of what that purpose is.
Some final thoughts…
Seek support from loved ones, if needed, guidance from a therapist, read books, talk to your friends, take steps to learn new approaches of how to build tolerance to life’s stresses. As I've mentioned in previously written articles, I am a strong advocate of meditation , yoga and journaling. All of these suggestions have been well documented with scientific research to help alleviate symptoms of anxiety and depression. Also, reflect on your lifestyle habits; diet, exercise, qaulity/qaunitity of sleep, work hours, etc.
With life experience, come maturity and more patience.
As we go through life, we will witness more unfairness, more tragedy, and more complexity. We must condition the muscle of insightfulness. What separates the mice from the (wo)men is the ability to be adaptable to change, to be comfortable with uncertainty, and to make more realistic expectations. In order to reach these goals, one must develop better coping skills to combat stress, be open to change one’s perceptions, to let go, and to move on. When we allow our inner wisdom to flow through our hearts, we can see the silver lining beyond life’s darkness. When the mind is free of worries, the eyes can see the big picture, and envision a brighter future. It is a divine right to know one’s own worth, to know one’s truth, and not need to prove it to anyone.
Better management of anxiety or depression begins with knowing where to put your energy, and knowing when to save it.