Anxiety, Depression Symptoms, or Both?
They Occur Together up to 50% of the Time
Some material in this blog is from E. Hendriksen, PhD,
Savvy Psychologist September 25, 2015
Anxiety and depression are often seen together. Like two surly friends, they seem to hang out together because no one else wants to. Nearly 50% of people diagnosed with depression are also diagnosed with an anxiety disorder, and vice versa. This is a big departure from where we considered a patient either depressed or anxious. When they co-exist a diagnosis of Mixed Anxiety and Depression Disorder (MADD) is now being given. This newfound emphasis on mixed disorders has been gaining prominence in recent years.
Anxiety & Depression Share 5 Symptoms
1.) Irritability. Anxiety, by its very nature, makes people “edgy”. When you’re already amped up, every additional provocation can increase that irritability. However, depression can also manifest as irritability, especially in men. And while we usually associate depression with psychomotor retardation, it can also manifest as agitation, or irritability.
2.) Insomnia. With any illness, mental or physical, exhaustion always makes it that much more difficult to recover. Insomnia from anxiety usually means having trouble getting to sleep. People who are depressed usually don’t have trouble getting to sleep. However, early morning awakening, is classicly a part of depression. Once awake, it can take hours to get back to sleep if at all. In mixed anxiety depression you may see both types of insomnia together.
3.) Difficulty concentrating. With either depression or anxiety, the ability to concentrate, to sit quietly and read a book, can be very hard. Zoning out during movies becomes the norm, and it can even be hard to stay engaged in conversation. Trouble focusing comes in slightly different versions. With anxiety you’re easily distracted by worries. With depression difficulty concentrating can be both emotional (indifference or even revulsion) or it can be more of a cognitive problem. It may be associated with other cognitive problems such as decreased short-term memory, difficulty making even minor decisions and so on. Another cause of distractibility, ADD and ADHD, can co-exist with either depression or anxiety.
4.) Restlessness. Whether it’s a bouncing leg, hand wringing, or teeth grinding—anxiety seldom comes without motion. With depression, some people experience “psychomotor agitation”–they pace the room, bite their nails, or fidget incessantly. With mixed anxiety depression disorder, others with depression feel weighed down by a ton of bricks, and some people may feel both slowed down and restless at the same time.
5.) Lack of Joy. It’s hard to have fun and enjoy yourself when you’re anxious, depressed, or both. In depression, this lack of ability to experience joy is a core symptom called “anhedonia”, which literally means “without pleasure.” Depression also saps energy and motivation, so even doing what you ordinarily love to do can seems pointless and not worth the effort. Anxiety is a type of fear. And when someone experiences fear as utterly real and overwhelming—it’s pretty much impossible to relax and enjoy oneself.
Luckily, there are some solutions that both anxiety and depression have in common. The following 3 things can be worked on whether you have depression or anxiety or both: better sleep, more exercise, and less stress.
1) Better sleep. People with depression and anxiety are often chronically tired, either waking up in the middle of the night or way before the alarm goes off in the morning. A good portion of the sleep challenges are part of the disorders, but you can minimize the damage with good sleep hygiene: go to bed only when you’re sleepy, wake up at the same time every day (even on weekends) and get out of bed if you can’t sleep to avoid associating your bed with wakefulness (even if it’s 2 am). Several recent studies have shown that decreasing insomnia in depression, in and of itself, can significantly reduce depression.
2) More Exercise. Exercise may be the last thing you want to do when you’re depressed. And it’s probably not at the top of your list if you’re anxious. However, study after study show that aerobic exercise can reduce depression, particulary if it is not too severe, and also help prevent depression from recurring. One study found that 30 minutes a day, four times a week for six weeks was sufficient. Another study showed 30 minutes a day for 10 consecutive days led to significant reduction in symptoms. A 2014 review of eight different studies found exercise to be helpful for anxiety as well, though it found that medication was still the most effective modality, at least in the short run.
3) Decreased stress and fear. This is where The Dubin Clinic can assist in your recovery from the symptoms of anxiety and depression. The Dubin Clinic offers Direct Neurofeedback, a newer and faster type of neurofeedback compared to Traditional Neurofeedback. Direct Neurofeedback can reduce (temporarily at first) the symptoms of anxiety and lift those of depression during the first session.
Traditional Neurofeedback sees depression as under-arousal of the nervous system and anxiety as an over-arousal. As such there are two separate “protocols” for depression and anxiety: training the brain to generate higher frequency brain waves in depression and training to lower brainwave frequencies with anxiety.
We have found Direct Neurofeedback shows results more quickly than traditional neurofeedback, take fewer and shorter sessions and frequently be more effective. Instead of “training” the brain, Direct Neurofeedback sends a tiny signal back to the brain and “dis-entrains” the brain where it’s stuck. It allows the brain to get out of frozen, stuck patterns very quickly. It’s like re-booting a frozen computer.
Anxiety in particular, even with symptoms as severe as those seen in PTSD, are, much to our initial amazement, usually not difficult to reduce effectively with Direct neurofeedback. Direct neurofeedback rapidly diminishes the fight or flight (sympathetic) part of our peripheral nervous system while enhancing the “rest and digest” (parasympathetic) part of our peripheral nervous system. Symptoms almost always noticeably improve in the first session. It is quite remarkable to witness.
Symptoms in mild to moderate depression can also show very rapid improvement with Direct Neurofeedback. More severe depression, usually medication resistant may be difficult to treat. However depression is assessed over 4 sessions and it’s usually quite clear whether Direct Neurofeedback will be beneficial in these severe cases. It does not take a lot of time or money to decide if it is worth the effort to continue.
Please contact us at (310) 498-8310 for more information on how Direct Neurofeedback can be a part of your plan in reducing anxiety and lifting depression. Schedule your complimentary first session today.