Anxiety vs. Depression
Anxiety and depression are types of mood disorders. Among other things, depression causes feelings of sadness, hopelessness, and reduced energy. Anxiety creates feelings of nervousness, worry, or dread. Although the two conditions are different, you can have both at the same time. Agitation and restlessness can be symptoms of both depression and anxiety.
It’s normal to have feelings of anxiety or depression from time to time. But when these feelings happen often and they interfere with your life, you might have a disorder that’s treatable.
Your symptoms can help your doctor figure out which of these two conditions you have, or whether you have both. Some of the same treatments work for anxiety and depression.
What Is Depression?
Depression affects how you feel and act. When you’re depressed, you may have symptoms like:
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Sadness, hopelessness, or anxiousness
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Loss of interest in things you once enjoyed
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A lack of energy
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Eating more or less than you used to
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Sleeping too little or too much
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Trouble thinking or concentrating
For your symptoms to be considered depression, you need to have them most of the day, almost every day, for at least 2 weeks. And they shouldn’t have a medical cause, like a thyroid problem. Your doctor can check you for medical conditions that cause symptoms like those of depression.
What Is Anxiety?
Worry and fear are normal parts of life. But when these feelings don’t go away or they’re excessive, they can be signs of an anxiety disorder.
You may have a problem with anxiety if you often feel:
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Overwhelmed by worry
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Cranky or on edge
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Sweaty or shaky
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Like you’re out of control
Anxiety Types
There are a few types of anxiety disorders, each with its own symptoms.
Generalized anxiety disorder is when you worry about many different things.
Social anxiety disorder is excessive worry when you’re around other people.
Panic disorder causes sudden feelings of fear, with symptoms like chest pain and a pounding heart.
Phobias are intense fears of places or things, like closed spaces or animals.
Obsessive-compulsive disorder is when you have a pattern of thoughts or fears that causes you to repeat certain behaviors.
Posttraumatic stress disorder (PTSD) usually happens after you’ve been through something difficult or traumatic. It can show up as flashbacks, panic attacks, or anxious feelings when something triggers your memory of the event.
What Is Depression?
Depression is more than just feeling down or having a bad day. When a sad mood lasts for a long time and interferes with normal, everyday functioning, you may be depressed. Symptoms of depression include:1
- Feeling sad or anxious often or all the time
- Not wanting to do activities that used to be fun
- Feeling irritable‚ easily frustrated‚ or restless
- Having trouble falling asleep or staying asleep
- Waking up too early or sleeping too much
- Eating more or less than usual or having no appetite
- Experiencing aches, pains, headaches, or stomach problems that do not improve with treatment
- Having trouble concentrating, remembering details, or making decisions
- Feeling tired‚ even after sleeping well
- Feeling guilty, worthless, or helpless
- Thinking about suicide or hurting yourself
The following information is not intended to provide a medical diagnosis of major depression and cannot take the place of seeing a mental health professional. If you think you are depressed‚ talk with your doctor or a mental health professional immediately. This is especially important if your symptoms are getting worse or affecting your daily activities.
Treatment for Anxiety and Depression
Even if you decide that your anxiety or mood problem is a low-grade issue for you, it is still worth working on. Consider how much it is interfering with your life, and in what ways, to determine what kinds of interventions might be helpful.
Self-Help Approaches
If your symptoms are mild, tending to ebb and flow, or if you have had formal treatment previously and are concerned about relapse, self-help interventions can be a reasonable place to start.
These approaches can include self-help books and phone apps that adapt evidence-based psychotherapies or offer a way to practice skills that target a symptom (such as mindfulness meditation for anger or anxiety).
If your symptoms are persistent, are impacting your relationships and ability to fulfill various responsibilities, or are clearly noticeable to others, then more formal treatment is worth considering.
Psychotherapy
For depression and/or anxiety problems, there are several types of talk therapy. In structured psychotherapy, like cognitive behavioral therapy (CBT), the treatment approach for anxiety and depression can vary slightly. For both issues, CBT will teach you how to work with unhelpful thought traps. And, for either problem, CBT is likely to ask that you do more behaviorally.
For anxiety, the goal is to minimize avoidant behavior and to help you disconfirm a feared consequence. For depression, the goal is to help you experience positive emotion, a surge in energy (even if briefly), or another type of pleasant interaction with the world. The theory is that activating behavior, even when—or especially when—your energy or mood is low, can result in some type of positive reward.
In psychodynamic talk therapy, sessions for anxiety and depression may look more alike than different. You will be asked to speak freely about the past and the present in order to become aware of unconscious thoughts and conflicts underlying your symptoms.
Do not despair if you think you are experiencing separate, co-occurring anxiety and mood symptoms. There is an overlap in effective psychotherapies for these problems.
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Medications
A group of medications known as selective serotonin reuptake inhibitors (SSRIs) has been shown to be helpful for both anxiety and depression. Other medications that may be used depending on your symptoms include tricyclic antidepressants (TCAs), selective norepinephrine reuptake inhibitors (SNRIs), and anti-anxiety medications.
In the first year of the COVID-19 pandemic, global prevalence of anxiety and depression increased by a massive 25%, according to a scientific brief released by the World Health Organization (WHO) today. The brief also highlights who has been most affected and summarizes the effect of the pandemic on the availability of mental health services and how this has changed during the pandemic.
Concerns about potential increases in mental health conditions had already prompted 90% of countries surveyed to include mental health and psychosocial support in their COVID-19 response plans, but major gaps and concerns remain.
“The information we have now about the impact of COVID-19 on the world’s mental health is just the tip of the iceberg,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This is a wake-up call to all countries to pay more attention to mental health and do a better job of supporting their populations’ mental health.”
Multiple stress factors
One major explanation for the increase is the unprecedented stress caused by the social isolation resulting from the pandemic. Linked to this were constraints on people’s ability to work, seek support from loved ones and engage in their communities.
Loneliness, fear of infection, suffering and death for oneself and for loved ones, grief after bereavement and financial worries have also all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking.
Young people and women worst hit
The brief, which is informed by a comprehensive review of existing evidence about the impact of COVID-19 on mental health and mental health services, and includes estimates from the latest Global Burden of Disease study, shows that the pandemic has affected the mental health of young people and that they are disproportionally at risk of suicidal and self-harming behaviours. It also indicates that women have been more severely impacted than men and that people with pre-existing physical health conditions, such as asthma, cancer and heart disease, were more likely to develop symptoms of mental disorders.
Data suggests that people with pre-existing mental disorders do not appear to be disproportionately vulnerable to COVID-19 infection. Yet, when these people do become infected, they are more likely to suffer hospitalization, severe illness and death compared with people without mental disorders. People with more severe mental disorders, such as psychoses, and young people with mental disorders, are particularly at risk.
Gaps in care
This increase in the prevalence of mental health problems has coincided with severe disruptions to mental health services, leaving huge gaps in care for those who need it most. For much of the pandemic, services for mental, neurological and substance use conditions were the most disrupted among all essential health services reported by WHO Member States. Many countries also reported major disruptions in life-saving services for mental health, including for suicide prevention.
By the end of 2021 the situation had somewhat improved but today too many people remain unable to get the care and support they need for both pre-existing and newly developed mental health conditions.
Unable to access face-to-face care, many people have sought support online, signaling an urgent need to make reliable and effective digital tools available and easily accessible. However, developing and deploying digital interventions remains a major challenge in resource-limited countries and settings.
WHO and country action
Since the early days of the pandemic, WHO and partners have worked to develop and disseminate resources in multiple languages and formats to help different groups cope with and respond to the mental health impacts of COVID-19. For example, WHO produced a story book for 6-11-year-olds, My Hero is You, now available in 142 languages and 61 multimedia adaptations, as well as a toolkit for supporting older adults available in 16 languages.
At the same time, the Organization has worked with partners, including other United Nations agencies, international nongovernmental organizations and the Red Cross and Red Crescent Societies, to lead an interagency mental health and psychosocial response to COVID-19. Throughout the pandemic, WHO has also worked to promote the integration of mental health and psychosocial support across and within all aspects of the global response.
WHO Member States have recognized the impact of COVID-19 on mental health and are taking action. WHO’s most recent pulse survey on continuity of essential health services indicated that 90% of countries are working to provide mental health and psychosocial support to COVID-19 patients and responders alike. Moreover, at last year’s World Health Assembly, countries emphasized the need to develop and strengthen mental health and psychosocial support services as part of strengthening preparedness, response and resilience to COVID-19 and future public health emergencies. They adopted the updated Comprehensive Mental Health Action Plan 2013-2030, which includes an indicator on preparedness for mental health and psychosocial support in public health emergencies.
Step up investment
However, this commitment to mental health needs to be accompanied by a global step up in investment. Unfortunately, the situation underscores a chronic global shortage of mental health resources that continues today. WHO’s most recent Mental Health Atlas showed that in 2020, governments worldwide spent on average just over 2% of their health budgets on mental health and many low-income countries reported having fewer than 1 mental health worker per 100 000 people.
Dévora Kestel, Director of the Department of Mental Health and Substance Use at WHO, sums up the situation: ”While the pandemic has generated interest in and concern for mental health, it has also revealed historical under-investment in mental health services. Countries must act urgently to ensure that mental health support is available to all.”
