When Anxiety and Depression Show Up Together

Whether they have been shared online, by a friend, or by a therapist, anxiety and depression are terms many are familiar with. Anxiety and depression are common diagnoses that can co-occur. Anxiety may look like “what if” thinking and worries about the future, while depression can look like sadness, hopelessness, and rumination about the past. Although these sound like vastly different presentations with one diagnosis causing worries and the other causing a lack of motivation, they share similar symptoms and concerns. Understanding how these diagnoses overlap can help you find strategies that bring more balance and support.

Anxiety and depression seem like opposites, but they are comorbid and more similar than someone would expect. Anxiety and depression can overlap in their symptoms or presentations. Someone who has both diagnoses might feel that they are constantly worrying while also experiencing sadness. They can also struggle with sleep and concentration. Somatic symptoms can also correlate with both, such as headaches and stomachaches, alongside a loss of interest in activities that used to bring joy. The mix of depression and anxiety can leave someone feeling stuck, worried about the future, but with no motivation to do anything about their worries. This often leads to overthinking, rumination, and avoidance. A low mood mixed with feelings of worry that interferes with daily life and functioning becomes a disorder. This can look like trouble at school, work, or at home. Due to a lack of motivation, one can skip out on work, seeing friends, or doing hw which increases anxiety based on the consequences. This feeds into the cycle because when severe anxiety occurs, people avoid important things, feel closed off, and have less enjoyment in life, which then leads to depression. Receiving support early on can make an impactful difference in one’s experience with anxiety and depression. 

People with depression can often feel anxious or worried, with the feelings of anxiety triggering sadness. There are many overlapping symptoms, so people will often meet the criteria for both diagnoses. Someone might have trouble focusing, completing tasks, showing irritability, tiredness, and negative thoughts. Depression presents as low energy and sadness, while anxiety involves worry and distress. There are different types of negative thoughts and behaviors, with everyone having different triggers, whether it is family, school, or life changes. There is a common feeling that your mind won’t stop ruminating and worrying, but you have no energy to do anything about it. For example, feeling anxious about an essay you need to do to apply for a program, but not feeling motivated enough to get started on it. This can leave you feeling stuck, like two diagnoses working against each other. It can be overwhelming and challenging to have these mixed emotions, causing you to be highly self-critical or hold negative core beliefs. Depression and anxiety can also cause automatic negative thoughts related to core beliefs such as “I am unlovable”, “I am not smart”, or “No one likes me”. In addition to core beliefs and negative automatic thoughts, one can face cognitive distortions such as jumping to conclusions or all-or-nothing thinking. 

As discussed in this blog, anxiety and depression are common diagnoses that frequently co-occur, leading to worry, rumination, hopelessness, and sadness. If you have been feeling stuck between worry and sadness, you don’t have to figure it out on your own. Therapy can provide a supportive space to understand what’s happening and begin coping.