Waves of depression and anxiety (A brief guide)

From the article below, we will gather ideas about waves of depression and anxiety occurring together. 

Waves of depression and anxiety 

 To have both depression and anxiety is nothing impossible.  There are people who go through anxiety as well as  occasional waves of depression. 

According to the National Institute of Mental Health, major depression often accompanies panic disorder and other anxiety disorders. Even though depression and anxiety are two separate disorders, yet a few symptoms are common such as decreased sleep, lack of appetite or overeating, irritability etc.  

Understanding depression 

Depression is a mood disorder which characterizes feelings of excessive “blue”. According to the DSM 5 at least 5 of the following symptoms have to have been present during the same 2-week period (and at least 1 of the symptoms must be diminished interest/pleasure or depressed mood) :

  • Depressed mood: For children and adolescents, this can also be an irritable mood
  • Diminished interest or loss of pleasure in almost all activities (anhedonia)
  • Significant weight change or appetite disturbance: For children, this can be failure to achieve expected weight gain
  • Sleep disturbance (insomnia or hypersomnia)
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness
  • Diminished ability to think or concentrate; indecisiveness
  • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide

Understanding anxiety 

Generalized anxiety disorder characterized excessive worry, irritability and impaired concentration.

According to the diagnostic criterias of DSM 5, the symptoms are listed below:

A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). 

B. The individual finds it difficult to control the worry.

C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): Note: Only one item required in children.

  •   Restlessness, feeling keyed up or on edge. 
  •   Being easily fatigued.
  • . Difficulty concentrating or mind going blank.
  •   Irritability. 
  •    Muscle tension. 
  •   Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).

 D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). F. The disturbance is not better explained by another medical disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder).

Depression and Anxiety : goes hand in hand 

Are you experiencing waves of depression and anxiety at the same time? Even though the two are treated as separate mental disorders, an individual may experience both symptoms of depression and anxiety. Surveys show 60-70 % of individuals suffering from depression also show signs of anxiety.

The comorbidity of depression and anxiety can have serious effects not only on the person’s mental and physical health but also in injuring interpersonal relationships. Along with that, it can have serious repercussions in an individuals’s professional life. It may also make a person get inclined towards suicidal ideations. 

Over the past few years, a lot of evidence has claimed that depression and anxiety are not two separate disorders, rather two faces of the same disorder. David Barlow, Ph.D, director of the Center for Anxiety and Related Disorders at the University of Boston says, “They’re probably two sides of the same coin, the genetics seem to be the same. The neurobiology seems to overlap. The psychological and biological nature of the vulnerability are the same. It just seems that some people with the vulnerability react with anxiety to life stressors. And some people, in addition, go beyond that to become depressed.” According to him, “depression is a shutdown, where a person is unable to fight anymore and ends up giving up. Whereas, anxiety is a kind of looking to the future, seeing dangerous things that might happen in the next hour, day or weeks.” 

 Mental health professionals are at times unable to distinguish the symptoms of anxiety and depression. Even the treatments for both depression and anxiety happen in the same pattern as CBT(Cognitive Behavioral Therapy). SSRIs (selective serotonin reuptake inhibitors), the drugs used to treat depression have been proved to work in treating arrays of symptoms of anxiety too. According to physicians Edward Shorter of Canada and Peter Tyrer of England, the prevailing view of anxiety and depression as two distinct disorders, with multiple flavors of anxiety, is a “wrong classification” that has led the pharmaceutical industry down a “blind alley.” It’s bad enough that the separation of anxiety and depression lacks clinical relevance. But it’s also “one reason for the big slowdown in drug discovery in psychiatric drugs,” the two contend in a recent article published in the British Medical Journal . It’s difficult to create effective drugs for marketing-driven disease “niches.”

Who is at higher risk of having comorbidity?

One of the most important factors in predisposition of mental disorder is nature, i.e. genes. The occurrence of depression or anxiety or both may have its root as a family component.  “Looking at [what disorders populate] the family history of a person who presents with either primary anxiety or depression provides a clue to whether he or she will end up with both,” says Joseph Himle, Ph.D., associate director of the anxiety disorders unit at University of Michigan.

The type of anxiety disorder may also become a contributing factor for the comorbid condition. OCD, panic disorder and social phobia are quite closely associated with depression. 

Age of a person plays an important role too. A person who develops anxiety disorder at or after the age of 40 has more vulnerability to get depressed. “Someone who develops panic attacks for the first time at age 50 often has a history of depression or is experiencing depression at the same time”, says Joseph Himle, Ph.D., associate director of the anxiety disorders unit at University of Michigan.

One of the most serious environmental influences that gets a child depressed and anxious is parental overconcern.  “The largest group of depression/anxiety sufferers is Baby Boomers,” says Yapko. “The fastest growing group is their children. They can’t teach kids what they don’t know. Plus their desire to raise perfect children puts tremendous pressures on the kids. They’re creating a bumper crop of anxious/depressed children.”


Jerilyn Ross, LICSW, president of the Anxiety Disorders Association of America says  “the depression exists because the anxiety is so draining. Once you treat the anxiety, the depression lifts.”  It varies how the two are connected. In reference to the previous example, if depression occurs due to the draining nature of anxiety, then the root of anxiety treats the comorbidity. 

If a person is diagnosed with both depression and anxiety, the treatment is targeted and both simultaneously. “There’s increasing interest in treating both disorders at the same time,” reports Himle. “Cognitive behavioral therapy is particularly attractive because it has applications to both.” 

Antidepressants are also used to treat depression and anxiety. SSRIs are approved as a drug in anxiety disorders too. But which drug works best for whom cannot be predicted in advance. Therefore, in case of medication, trial and error is done by therapists while treating anxiety and depression.

Ross finds CBT 80-90% successful in getting people functioning well, “provided it’s done correctly.” Not all psychotherapy is CBT, which has a very specific set of procedures, nor is every mental health professional trained in CBT. “Patients have to make sure that is what they are really getting.”

Medication and CBT are equally effective in reducing anxiety/depression. But CBT is better at preventing relapse, and it creates greater patient satisfaction. “It’s more empowering,” says Yapko. “Patients like feeling responsible for their own success.” Further, new data suggests that the active coping CBT encourages creating new brain circuits that circumvent the dysfunctional response pathways.

Treatment averages 12 to 15 weeks, and patients can expect to see significant improvement by six weeks. “CBT doesn’t involve years and years of talk therapy,” says Ross. “There’s homework, practice and development of lifestyle changes. Once patients learn how to identify the trigger thoughts or feelings, or events or people, they need to keep doing that. CBT gives people the tools they need.”


From the article above, we have gathered ideas about waves of depression and anxiety occurring together. 

FAQs: Waves of depression and anxiety

What are the levels of depression?

Here’s a look at nine types of depression

  • Persistent depression. 
  • Manic depression, or bipolar disorder. 
  • Depressive psychosis. 
  • Perinatal depression.
  • Premenstrual dysphoric disorder. 
  • Seasonal depression. 
  • Situational depression.
  • Atypical depression

Is anxiety a risk factor for depression?

 To have both depression and anxiety is nothing impossible.  There are people who go through anxiety as well as  occasional waves of depression. 

According to the National Institute of Mental Health, major depression often accompanies panic disorder and other anxiety disorders. Even though depression and anxiety are two separate disorders, yet a few symptoms are common such as decreased sleep, lack of appetite or overeating, irritability etc.  

What is the most serious form of depression?

Just as with any type of depression, atypical depression is a serious mental health condition, and is associated with an increased risk of suicide and anxiety disorders.

What does a depressed person’s brain look like?

People with depression were shown to have thicker grey matter in parts of the brain

What are the risks of anxiety?

Anxiety disorders can cause rapid heart rate, palpitations, and chest pain.

What is ejaculatory anhedonia?

Ejaculatory anhedonia is the experience of normal ejaculation without pleasure or orgasm. 

What is an example of anhedonia?

An anhedonic mother finds no joy from playing with her baby or , might suddenly find they get no enjoyment from reading. 

What is alexithymia?

Alexithymia is a broad term to describe problems with feeling emotions. In fact, this Greek term used in Freudian psychodynamic theories loosely translates to “no words for emotion.” While the condition is not well-known.

What is the flattened affect?

A flat affect can be a negative symptom of schizophrenia, meaning that your emotional expressions don’t show. 

References :