Can anxiety cause depression?

Symptoms of anxiety and depression

Anxiety and depression have a lot of overlapping symptoms, such as insomnia, but those with anxiety may be more likely to experience feelings of panic and constantly ruminating on things that make them anxious, while someone with depression may suffer from a continuous low mood, low self-esteem and poor energy.

How depression and anxiety are linked

The two conditions can exist side by side. It’s common for people with depression to feel anxious about certain things, as depression can make it difficult to keep stressful situations in perspective. Dr Monica Cain, counselling psychologist at Nightingale Hospital London says anxiety can also trigger depression.

She says, ‘If anxiety is left untreated and you try to manage the worrying and catastrophising through avoidance, eventually those strategies are likely to stop working. That’s when you’re at high risk of depression.’

How anxiety treatment helps

If you treat your anxiety, you can stop it getting worse and prevent depression developing in the longer term. The gold standard treatment for anxiety is cognitive behavioural therapy (CBT), which teaches you to question your underlying beliefs, and think and behave differently so you don’t become overwhelmed by anxious thoughts.

For example, if you have health anxiety and worry about having a rare illness, CBT would train you to think more rationally and understand your symptoms are much more likely to be related to something less serious.

CBT doesn’t involve lots of delving into your past, but gives you an ongoing strategy to manage anxious thoughts. ‘If you have anxiety and depression, you can treat them both at the same time with a talking therapy, as your underlying beliefs are likely to be the same in the two conditions,’ says Cain.

You may also be prescribed drugs called selective serotonin reuptake inhibitors (SSRIs). They work by building up levels of serotonin, the ‘feel good’ chemical, in the brain. While CBT is the most appropriate ongoing treatment, if your anxiety is severe, medication is often what you need to tip the balance so you can seek help and commit to therapy.

Help yourself

Alongside professional help, there’s a lot you can do to support yourself. People with anxiety have high levels of stress hormones in their bodies and exercise is very important for helping to lower these.

It’s also worth trying meditation. Research from Boston University found that mindfulness meditation has a role in easing anxiety and helping you cope better with stress.

Preventing a relapse

If you’re prone to anxiety, it may raise its head from time to time so it’s important to know the signs and symptoms. ‘The earlier you recognise signs, the better,’ says Cain. ‘You may notice sleep disruption or changes in appetite as a very early warning sign.’

At this stage, it may be enough to look after yourself more carefully. This can involve making sure you get plenty of sleep and eat well, along with exercising. ‘Then look out for other signs,’ says Cain. ‘For example, if you notice a desire to isolate and avoid people, arrange a coffee with a friend to see how that feels.’

If symptoms persist or get worse, it’s a good idea to seek help from a professional. Even if you practise CBT skills very well, you might still have further episodes of anxiety and/or depression, and there’s no shame in seeking more help. A top-up course of CBT may be all you need to help prevent your anxiety getting worse and leading to depression.