Mental Health Minute: Is it Anxiety or Depression?

Hi, I’m Dr. Kelly Smerz, and this is The Mental Health Minute. With this blog, I hope to provide you with informative, thoughtful information about mental health and mental health treatment from the lens of a practicing clinical psychologist. 

Is it Anxiety or Depression?

Anxiety and depression are close cousins. While they can be distinctive conditions, there is often significant overlap. Many who have anxiety will, at times, find it so exhausting that they tumble into depression. Likewise, depression can contain aspects of worry and tension that present as anxiety. As a psychologist, I often think of anxiety as a future oriented disorder, and depression as originating from the past. While they don’t split perfectly into this dichotomy, I find this is a good starting point for me clarify what is occurring and how to be of help. The worried thoughts of anxiety are frequently “What ifs” about a future event. What if this bad thing happens? What if I lose control? What if someone thinks poorly of me?” These worries, often known as catastrophic thinking, create physical and emotional tension and a sense of being on edge or filled with dread. Behaviors are then oriented around trying to regain a sense of control, a frantic sense of overwhelm, or a shut down and freeze-like response. 

Depression, on the other hand, often occurs when there is something about one’s past that has them stuck. Instead of “What ifs,” a person’s mind goes to “If onlys.“ Clinically, this can be in the form of regrets, sadness, anger, diminished self-esteem, and feelings of helplessness or hopeless. “If only (this thing) about the past had been different, my life now would be different.” Albert Ellis, a famous psychologist, also talked about “Shoulding all over oneself.” The combination of if onlys and should ofs can leave someone feeling extremely stuck. 

When treating individuals with anxiety, depression, or a combination of the two, I find that it’s most beneficial to treat both the symptoms and the source. Symptom based interventions target the emotions, the cognitive patterns, and the physiologic responses, that maintain the symptomatic loops of anxiety or depression. Treating the source typically involves deeper work that seeks to uncover from where and why these symptoms emerged. This type of therapeutic work tends to take a bit longer, but for most people, is also the key to the changes that are needed for long-term symptom relief, rather than simply symptom management. 

Anxiety and depression both occur on a spectrum of severity, and as I mentioned, can oscillate from one condition to the other and then back again. Please don’t wait to seek treatment until panic attacks hijack your well-being, or a deep depression robs you of your job for life. Treatment can help whether your symptoms are anxiety, depression, or a mixture of both, 

Thanks for reading The Mental Health Minute. 

Kelly Smerz, Ph.D.

Clinical Psychologist