How to identify the signs of anxiety and depression

Comorbidity | Compare symptoms| Depression symptoms | Anxiety symptoms | Overlapping symptoms | When to see a doctor | Treatment | Bottom line

50 million Americans—that’s 1 in 5 people in the country—have a mental health condition like anxiety or depression. While these conditions are very common, it’s easy for those experiencing mental health challenges to feel isolated and alone. 

Anxiety and depression can impact pretty much every aspect of your life, from your career and relationships to your self-esteem and overall well-being. What’s more, the two conditions often co-occur, making them hard to differentiate at times. In this article, you’ll learn the link between anxiety and depression as well as symptoms, diagnostic criteria, treatments, and coping skills for each condition. 

What’s the link between anxiety and depression

“Both anxiety and depression are mediated through the same mood neurochemicals, particularly serotonin,” says Peter Zafirides, MD, a board-certified psychiatrist and founder of Central Ohio Behavioral Medicine. Along with dopamine, serotonin is a chemical that influences happiness—in particular, focus, happiness, and calm.

“There is evidence suggesting a shared genetic risk between anxiety and depression,” says Anandhi Narasimhan, MD, a board-certified child, adolescent, and adult psychiatrist in Los Angeles, California. In fact, according to a robust 2022 longitudinal study, genetics account for about 40% of an individual’s risk of anxiety and depression, while environmental factors account for the rest. Many physicians believe in a biopsychosocial model in which biology, psychology, and the environment all impact mental health.

What’s more, the two conditions often occur at the same time. “When anxiety and depression coexist, the term often used is ‘comorbid’ or ‘co-occurring disorders,’” Dr. Zafarides explains. He says that in most cases, individuals will present with symptoms that are suggestive of both a depressive disorder and an anxiety disorder. In fact, according to a 2020 meta-analysis, approximately 85% of individuals diagnosed with major depression also experience symptoms of generalized anxiety disorder (GAD), the most common anxiety disorder.

What are the symptoms of anxiety and depression?

Anxiety is a feeling of worry or unease—like something bad is going to happen. “Depression is a persistent state of depressed or irritable mood,” Dr. Narasimhan says. Here, we discuss the symptoms of each of the two mental health conditions.

Depression symptoms

Also known as clinical depression, major depressive disorder, or major depression, depression is a mood disorder characterized by a long-term sad mood that interferes with normal daily functioning. According to the Centers for Disease Control and Prevention, 1 in 6 adults will experience depression during their lifetime. 

Symptoms of depression last for at least two weeks and include:

• Feelings of sadness, hopelessness, helpless, worthlessness, or guilt
• Lack of interest in previously enjoyable activities 
• Irritability, frustration, and restlessness
• Difficulty falling asleep or staying asleep
• Sleeping too long or waking too early
• Increased or decreased appetite
• Headaches, muscle aches, pain, or stomach problems
• Forgetfulness and difficulty concentrating or making decisions
• Feeling tired even after getting lots of sleep
• Thoughts of suicide or self-harm

Depression can also cause behavioral changes, including:

• Increased anger 
• Feeling on edge
• Feeling detached or withdrawn
• Negative attitude
• Participation in high-risk activities
• Increased impulsivity
• Use of drugs or alcohol
• Isolation from friends and family
• Decreased work performance
• Decreased sexual desire or performance

Other types of depression may result in additional symptoms including:

• Persistent depressive disorder, or dysthymia, is characterized by less severe depression symptoms lasting two years or more.
• Perinatal depression is a common condition during or after pregnancy, and postpartum depression starts after a baby’s birth. In addition to common depression symptoms, individuals may experience difficulty forming an emotional bond with their baby, persistent doubts about their ability to take care of the baby, and thoughts of harming themselves or the baby.
• Seasonal affective disorder (SAD), or seasonal depression, is a mood disorder triggered by the change in seasons. It typically occurs in late fall and early winter. Though less common, SAD can begin in the summer. Symptoms are similar to those of typical depression.
• Depression with symptoms of psychosis is a severe type of depression. Symptoms include delusions or hallucinations.
• Bipolar disorder causes depressive episodes that alternate with manic episodes occurring with unusually elevated moods.

RELATED: What causes depression?

Anxiety symptoms

It’s normal to feel uneasy or anxious from time to time, particularly in response to stress. However, individuals with anxiety disorders have excessive fear and anxiety that doesn’t go away. These conditions affect up to 30% of adults during their lifetime. 

Symptoms of general anxiety include:

• Feeling wound-up, on edge, or restless
• Fatigue
• Difficulty concentrating
• Irritability
• Headaches, muscle aches, pain, or stomach problems
• Uncontrollable worry
• Difficulty falling or staying asleep

Other anxiety disorders may result in additional symptoms including:

• Panic disorder causes panic attacks—untriggered periods of extreme fear, discomfort, and loss of control. Panic attack symptoms include a racing or pounding heart, sweating, trembling, and feeling out of control.
• Social anxiety disorder causes extreme anxiety and discomfort surrounding social interactions. Individuals with social anxiety may avoid social situations, fear public speaking, or worry about being judged/rejected.
• Phobias involve an overwhelming fear of or aversion to specific situations or objects. For example, a person may be afraid of heights, flying, public speaking, receiving vaccinations, having blood drawn, or animals/insects like spiders.
• Separation anxiety causes fear of being away from loved ones and is more common in children.

RELATED: Stress vs. anxiety | Anxiety attack vs. panic attack

Overlapping symptoms

“There’s a significant overlap in symptoms between anxiety and depression,” says Dr. Zafarides. Shared symptoms include:

• Restlessness
• Irritability
• Difficulty concentrating
• Sleep disturbances
• Headaches, muscle aches, pain, or stomach problems

While symptoms can overlap, their manifestation may vary, says Dr. Zafarides.  “Anxiety tends to heighten the body’s fight-or-flight response, leading to increased alertness and agitation. On the other hand, depression often involves a lack of energy and motivation,” he explains. 

RELATED: Anxiety vs. depression

When to see a doctor

Consult a healthcare provider if symptoms persist for an extended period, significantly impact daily life, or you are having thoughts of self-harm. If you or a loved one are feeling distressed or having thoughts of suicide, call or text the Suicide & Crisis Lifeline at 988, or visit 988lifeline.org to chat online any time of day.

“Any time emotional symptoms begin to take away from your quality of life is the right time to seek help,” Dr. Zafarides notes. A healthcare provider can assess your symptoms to develop a treatment plan that could have you feeling well quickly. 

“It never hurts to talk to someone if you are going through a stressful period in life so the professional can evaluate your coping skills,” Dr. Narasimhan says. 

In diagnosing depression and/or anxiety, your healthcare provider will conduct a thorough history, physical exam, blood tests, and possibly other tests (such as an echocardiogram and drug screening test) to rule out other medical conditions or substances that could be causing your symptoms. 

Rating scales are often used to assess symptoms of anxiety and depression, says Dr. Narasimhan. Let your healthcare professional know if you have experienced a serious life event if you have experienced trauma in the past, and what symptoms you are experiencing. Often, patients with anxiety or depression are referred to a mental health professional such as a psychologist or psychiatrist for treatment.

Diagnosing anxiety vs. depression

To meet the criteria for generalized anxiety, patients must experience anxiety and worry that are difficult to control and impair daily functioning for six months or longer.

The American Psychiatric Association maintains a diagnostic guide for mental health conditions called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To diagnose depression, a patient must have at least five depression symptoms (including depressed mood or loss of interest in previously enjoyed activities) for at least two weeks.

Your healthcare provider will conduct an interview to determine the duration and frequency of your symptoms.

Treating anxiety and depression

“Traditional medical approaches include an evaluation by a mental health provider and treatment with a combination of medication and therapy,” says Dr. Zafarides. Management of anxiety and depression should incorporate the following treatment options:

• Therapy: Supportive therapy (talk therapy) and cognitive-behavioral therapy (CBT) are effective for both conditions.
• Medication: Anti-anxiety and antidepressant medications may be prescribed. Selective serotonin reuptake inhibitors (SSRIs) are effective in treating both depression and anxiety. They include Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Celexa (citalopram), and Lexapro (escitalopram).
• Lifestyle changes: Exercise, adequate sleep, and a balanced diet play crucial roles.

“I cannot emphasize how important lifestyle changes like exercise really are,” says Dr. Zafarides. He recommends a combination of aerobic and resistance training and exercise, adding that meditation and yoga also boost mood. 

RELATED: Natural remedies for anxiety

Managing anxiety and depression symptoms naturally

In addition to medication and psychotherapy, the Anxiety and Depression Association of America recommends these strategies for managing symptoms:

• Get exercise: As little as 30 minutes of vigorous exercise throughout the day is enough to experience mood-boosting benefits.
• Eat healthy: A diet rich in fresh fruits and vegetables, whole grains, low-fat dairy, and lean protein protects mental health. It’s also helpful to avoid sugary, fatty, highly processed foods, and alcohol.
• Get enough sleep: Seven or more hours of sleep nightly is recommended for adults.
• Try journaling: Writing down your thoughts and feelings can help you identify negative thought patterns and behaviors.
• Don’t obsess: Ruminating about things that happened is a common aspect of depression. Limit such thoughts or redirect yourself by engaging in a healthier activity.
• Stay connected: Time with friends and family members reinforces you aren’t alone. Online or in-person support groups are also helpful.
• Do something fun: Even small activities like savoring a cup of tea or listening to your favorite music can boost your mood.
• Practice self-compassion: Give yourself some grace rather than being overly critical.

RELATED: The best diet for mental health

The bottom line: Anxiety and depression are treatable together

Anxiety and depression both can cause difficulty concentrating, irritability, and sleep disturbances, disrupting your life and negatively impacting your overall well-being. They often coexist, and many people with symptoms of one disorder will experience symptoms of the other. It’s important to note that everyone’s experience with anxiety and depression can vary, and a healthcare professional should make a diagnosis.

If symptoms interfere with your daily functioning or you are feeling suicidal, seeking help from a medical professional is critical (and may be life-saving), says Dr. Zafarides. “Like any illness, early intervention often yields more positive outcomes,” he says.  If you are having thoughts of self-harm, seek out emergent mental health care.