Anxiety and Depression

By TLC Guest Blogger: William Steele, PsyD, MSW

October is National Depression Awareness Month. The Center for Disease Control and Prevention (CDC, 2013) reports that an estimated 1 in 10 Americans report depression. A great deal of attention is given to depression, as should be the case. However, anxiety disorders are the most common mental illnesses in this country, affecting more than 40 million Americans, twice the estimated number who experience depression (ADAA, 2013). I always thought it curious that we view anxiety and depression as two separate disorders. The fact is 60 to 70 percent of those experiencing depression also have anxiety (Marano, 2011). Furthermore, the onset of depression is often preceded by childhood/adolescent anxiety disorder. Should anxiety and depression be two distinct disorders? More often than not the two coexist, and there’s growing agreement that they are not two separate disorders but two outcomes of facing life challenges. Actually, one nonprofit mental health advocacy group, Freedom From Fear, supports one week in May as National Anxiety and Depression Awareness Week. In Australia the entire month of October is Anxiety/Depression Awareness Month.

Anxiety is fear based, a constant worrying about what is going to happen next. Depression involves ongoing fear in addition to the belief that: “I will never get over this. I might as well give up.” They share many of the same genetics, neurobiology and symptoms, which make differential diagnosis difficult. However, the recommended interventions for both are the same, generally cognitive behavioral therapy, which TLC research suggests follow sensory-based interventions to be most effective (Steelev& Kuban, 2013).  The use of selective serotonin reuptake inhibitors (SSRIs) are also recommended for both, often on a trial basis to determine the most effective SSRI.

In summary, we ought to advocate for Anxiety/ Depression Awareness Month. Since anxiety generally precedes depression, more attention ought to be given to treating anxiety in early childhood and adolescence to help prevent later onset of depression. Assessment by symptoms alone can be misleading and make it difficult to differentiate anxiety from depression, suggesting we should evaluate the subjective experiences of individuals to support the presence of both depression and anxiety. The subjective experience common to both anxiety and depression is viewing oneself as incapable of coping with whatever is feared or appears to be hopeless. Engaging in sensory-based experiences that allow anxious and depressed children, adolescents or adults to alter their view of self as vulnerable and helpless to that of being resilient and empowered is what ultimately alters symptoms and behaviors. When these experiences result in shaping our thoughts (private logic) about self and life, it becomes much easier to engage new coping skills, involving changes in both our thought processes and behaviors. In essence we want these sensory-based, subjective experiences to enable individuals to view self as empowered and resilient.  When this occurs avoidant behaviors, common to both anxiety and depression, begin to diminish.

Anxiety and Depression Association of America (ADAA). Retrieved October 10, 2013 from http://www.adaa.org/about-adaa/press-room/facts-statistics

Center for Disease Control and Prevention (CDC). An Estimated 1 in 10 U. S. Adults Report Depression. (2013). Retrieved October 10, 2013 from http://www.cdc.gov/features/dsdepression/

Marano, H. (2-11). Anxiety and depress Together. Retrieved October 9, 2013 from http://www.psychologytoday.com/articles/200310/anxiety-and-depression-together

Steele, W. & Kuban, C. (2013). Working With Grieving and Traumatized Children and Adolescents: Discovering What Matters Most Through Evidence- Based Sensory Interventions. New Jersey, John Wiley and Sons.