Depression and Anxiety: Two Sides of the Same Coin

“I told the doctor I was overtired, anxiety-ridden, compulsively active, constantly depressed, with recurring fits of paranoia. Turns out I’m normal.” –Jules Feiffer

We all know about depression and anxiety. If we have not experienced it ourselves, most of us know someone who has. We have all basically accepted depression and anxiety as a normal part of life. But, what if it’s not? What if there’s an alternative?

Someone who is experiencing depressive symptoms is likely to identify themselves as having low energy or fatigue, insomnia or excessive sleeping, irritability, loss of interest in pleasurable activities, memory or concentration difficulties, overwhelming sadness, helplessness, and in extreme cases, suicidal thinking, just to name a few. Classic symptoms of anxiety are worry, fear, obsessive thinking, compulsive behaviors, insomnia, panic attacks, helplessness, and heart palpitations.  Obviously, this is not a complete list of feelings and sensations a person may have when experiencing depression or anxiety, but they are some of the most common symptoms. Despite the fact that depression and anxiety have some different symptoms, they are two sides of the same coin. Depression and anxiety go hand in hand, and when a person is suffering from depression, they are likely to experience some anxious feelings and vice versa.

Often depression and anxiety coincide with a life event. There may be an actual traumatic event or the depression/anxiety may be a response to a prolonged stressor in one’s life such as a difficult relationship, financial worries, or health concerns.  The common theme is that these stressors lead us to feel powerless and helpless. This is uncomfortable. Often people try to cope with these stressors by distracting themselves with work, parenting, alcohol, prescription drugs, shopping, or through food in an attempt to avoid the uncomfortable feelings they are experiencing…and to avoid feelings of powerlessness. It is not uncommon to develop physical symptoms in response to our feelings about these stressors. Some people seek help and get on an antidepressant, which can help alleviate some of the symptoms of depression or anxiety. While this can be helpful, and sometimes necessary, it doesn’t address the root case of what the person is experiencing on a fundamental level.

We all have feelings. Some of us are more comfortable expressing our feelings than others, but all of us know what it is like to feel happy or sad, for instance. Feelings in and of themselves are not good or bad, right or wrong, they just are. Feelings are there to tell us more about something. Fear is designed to warn us of potential danger, just as joy reminds us of the beautiful gifts life has to offer. Both of these feelings serve a purpose. They tell us more about what we are experiencing; they give us more insight and information. We have a tendency to label feelings as good or bad, positive or negative, instead of accepting them for what they are and how they serve us. We tend to avoid the “bad” or “negative” feelings, rather than embracing them and accepting what they are, and listening to what they are trying to tell us. We use many of the coping mechanisms listed above in order to avoid feeling sad, angry, lonely, or afraid. Often these feelings are indicating that something needs to change. That can feel scary and overwhelming. People often experience some relief when they allow themselves to sit back and listen to their feelings from a nonjudgmental place. When you do this, you can lean into the feelings, instead of running from them. The interesting thing is that when you run from those feelings, they keep chasing you. When you sit with them and observe them, they no longer have power over you. It’s a pretty empowering thing.

Interestingly, in collectivist cultures where there is more of an emphasis on community and cohesion within the group, depression and anxiety rates are lower. Psychologist Joan Chiao has done some fascinating research around depression and anxiety rates in collectivist cultures versus individualistic cultures. In the study published online in the journal Proceedings of the Royal Society B: Biological Sciences, they found that in collectivist countries where there was a genetic susceptibility, depression rates are significantly lower than in individualistic cultures. She says that there is an emphasis on giving social support to others in collectivist cultures, which lowers the presence of chronic life stress, protecting genetically predisposed individuals from developing various psychopathologies including depression and anxiety. This study highlights the fact that people feel alone in our more individualist culture. Many people think that they will “burden” someone with their feelings if they open up. Their solution, to hold it all in!

Depression and anxiety are labels for a set of symptoms that one is likely to experience in response to stressors. The ability to take the time to listen to those feelings, without criticism or judgment, and look at what those feelings are saying, is an imperative practice. Feelings are neutral; they only provide more information. Observe them. Lean toward them instead of running away from them. As demonstrated by the research done by Joan Chiao, opening up and talking to someone trustworthy, makes one feel more connected, which is a huge antagonist to depression. Therapy also provides a safe environment where one can talk freely and openly about experiences and feelings. The process of opening up to another human being, leads to a sense of connectedness, which often leads to the reduction in depressive and anxious symptoms.

1 Chiao,  J. Y., & Blizinsky, K. D. (2010). Culture-gene coevolution of  individualism-collectiveism and the serotonin transporter gene (5-HTTLPR).  Proceedings of the Royal Society B: Biological Sciences, 277(1681), 529-537.

This article first appeared in PWKY Magazine, February 2016.

Avery Neal, PhD is a practicing psychotherapist, international author and speaker. In 2012 she opened Women’s Therapy Clinic, which offers psychiatric and counseling support to women. She specializes in depression and anxiety at all stages in a woman’s life.

Dr. Neal is the author of, If He’s So Great, Why Do I Feel So Bad?: Recognizing and Overcoming Subtle Abuse, which has been translated and published in twelve languages. Her articles and interviews have been published by, American Counseling Association, Counseling Today, BookTrib, Best Self Magazine, Hitched Magazine, Bustle, POPSUGAR and PKWY Magazine, and her courses have been taken by over 18,000 people worldwide. The International Association of HealthCare Professionals nominated her as one of the top psychologists in Houston.