What Causes Anxiety Disorders
Anxiety disorders are like other forms of mental illness. They dont come from personal weakness, character flaws or problems with upbringing. But researchers dont know exactly what causes anxiety disorders. They suspect a combination of factors plays a role:
- Chemical imbalance: Severe or long-lasting stress can change the chemical balance that controls your mood. Experiencing a lot of stress over a long period can lead to an anxiety disorder.
- Environmental factors: Experiencing a trauma might trigger an anxiety disorder, especially in someone who has inherited a higher risk to start.
- Heredity: Anxiety disorders tend to run in families. You may inherit them from one or both parents, like eye color.
Management Of Depression In The Primary Care Setting
The aggressive and appropriate management of depression in the primary care setting is crucial, not only from a clinical perspective, but from a health economics perspective as well. Untreated or inadequately treated patients are more likely to have negative medical consequences of their depression, including a substantial risk of suicide and longer, more treatment-resistant episodes of depression. Such patients will continue to use valuable health care resources inappropriately, including significantly more general medical services.
Thus, the challenge for clinicians is to make a rapid and accurate diagnosis and then to ensure adequate and effective treatment. Not surprisingly, a study from the early 1990s showed that only 30% of depressed patients seen at a tertiary care center were given any antidepressant medication, and as many as 50% were treated incorrectly with anxiolytics rather than antidepressants. Furthermore, when evaluating the results of the Medical Outcomes Study in depressed patients given minor tranquilizers and antidepressants, Wells et al. noted that more patients used minor tranquilizers and that of those who were taking antidepressants, 39% were taking inappropriately low dosages.
Listen To Soothing Music
Listening to music can have a very relaxing effect on the body.
Slow-paced instrumental music can induce the relaxation response by helping lower blood pressure and heart rate as well as stress hormones.
Some types of classical, Celtic, Native American and Indian music can be particularly soothing, but simply listening to the music you enjoy is effective too .
Nature sounds can also be very calming. This is why theyre often incorporated into relaxation and meditation music.
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Why These Conditions Often Occur Together And How To Treat Them When They Do
Everyone experiences pain at some point, but in people with depression or anxiety, pain can become particularly intense and hard to treat. People suffering from depression, for example, tend to experience more severe and long-lasting pain than other people.
The overlap of anxiety, depression, and pain is particularly evident in chronic and sometimes disabling pain syndromes such as fibromyalgia, irritable bowel syndrome, low back pain, headaches, and nerve pain. For example, about two-thirds of patients with irritable bowel syndrome who are referred for follow-up care have symptoms of psychological distress, most often anxiety. About 65% of patients seeking help for depression also report at least one type of pain symptom. Psychiatric disorders not only contribute to pain intensity but also to increased risk of disability.
Researchers once thought the reciprocal relationship between pain, anxiety, and depression resulted mainly from psychological rather than biological factors. Chronic pain is depressing, and likewise major depression may feel physically painful. But as researchers have learned more about how the brain works, and how the nervous system interacts with other parts of the body, they have discovered that pain shares some biological mechanisms with anxiety and depression.
In addition, two neurotransmitters serotonin and norepinephrine contribute to pain signaling in the brain and nervous system. They also are implicated in both anxiety and depression.
What Else Should I Ask My Healthcare Provider
If you have an anxiety disorder, ask your provider:
- Whats the best treatment for me?
- Do I need medication? What type?
- How long should I take medication?
- What type of psychotherapy will work best?
- What else can I do to manage my symptoms?
- What other conditions am I at risk for?
A note from Cleveland Clinic
An anxiety disorder can make it difficult to get through your day. Anxiety disorder symptoms include feelings of nervousness, panic and fear. You may also have physical symptoms such as sweating and a rapid heartbeat. But you dont need to live like this. Several effective anxiety disorder treatments are available. Talk to your healthcare provider to figure out your diagnosis and the best treatment plan. Often, treatment combines medications and therapy. Anti-anxiety medications and antidepressants, together with CBT, can help you feel your best.
Last reviewed by a Cleveland Clinic medical professional on 12/17/2020.
References
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What Might Indicate That Both Anxiety And Depression Are Present
Traits that may signal the presence of both anxiety disorder and depression include:
- Irrational worries or fears that wont go away
- Physical symptoms, such as fatigue, headaches, rapid heartbeat, labored breathing or abdominal pain
- Difficulty going to sleep or staying asleep
- Changes in eating habits either too much or too little
- Trouble remembering, making decisions or concentrating
- Constant feelings of sadness or worthlessness
- Loss of usual interest in activities or hobbies
- Feeling often tired and cranky
- Inability to relax and live in the moment
- Suffering from panic attacks, including the sense of losing inner control2
Minimal Improvement At Six Weeks Requires A Change In Treatment
Except for PTSD and OCD , patients whose illness shows little improvement in depression or anxiety despite six weeks at a maximum-tolerated dose should be switched to an alternative medication or psychotherapy. Failure of one SSRI does not preclude trial with a second SSRI, but two SSRI treatment failures should definitely lead to a medication switch with a different mechanism of action.
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If Youre Up For It Go For A Walk Around The Block
Research suggests exercise can be an effective treatment for depression because its a natural mood booster and releases feel-good hormones. However, for some people, exercise or a gym can trigger anxiety and fear. If thats the case for you, look for more natural ways to move, such as walking around your neighborhood or looking for an online exercise video you can do at home.
What Are Ssris And Snris
Selective serotonin reuptake inhibitors like Zoloft and Prozac, and serotonin and norepinephrine reuptake inhibitors like Effexor and Pristiq are antidepressant medications, but they can help with anxiety symptoms as well. For this reason, many providers will prescribe an SSRI or SNRI if you have a combination of depression and anxiety.
SSRIs and SNRIs are not an instant fix for symptoms associated with an anxiety disorder, nor do they even provide immediate relief, Alonzo said. They work by interacting with the neurotransmitters and receptors in your brain, which can help regulate mood, sleep and energy levels. It is important for patients to understand that these medications may take four to six weeks for full effect.
Some patients may respond better to one of these medications than others. If after taking the medication for two weeks and symptoms have not improved, talk to your provider to have your medication regimen adjusted. Treatment trials with more than one medication are not uncommon.
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Why Does It Matter Whether You Have Anxiety Depression Or Both
It can be valuable to understand whether you have anxiety, depression, or both. For example, the right diagnosis can help you and your provider put together a treatment plan. This treatment plan is as unique as you are. It should target the symptoms that bother you the most. If you have anxiety and depression, your provider will take this into consideration. In fact, your provider may even be able to recommend a treatment that is helpful for both conditions. Treatment options might include medication or a type of therapy.
Further, its important to have the correct diagnosis because some medications are better for depression, while others are better for anxiety. And there are even some that are good at treating both at once.
Finally, having a diagnosis to describe your personal experience is helpful and empowering. It can help you connect with family, friends, and peer groups that can offer support.
Whats The Outlook For People With Anxiety Disorders
Anxiety disorders can often go undiagnosed and untreated. Fortunately, treatment can help. The right treatment can help improve your quality of life, relationships and productivity. It can also support your overall well-being.
You dont need to live with constant worry and fear. If you notice symptoms of an anxiety disorder, talk to your healthcare provider. Its best to get diagnosed and treated as soon as possible. Doing so can limit the problems that anxiety disorders can cause. Often, a combination of medications and counseling for anxiety can help you feel your best.
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Anxiety: What It Is What To Do
- By Francesca Coltrera, Editor, Harvard Health Blog
While anxiety symptoms vary widely, odds are good that at some point youve experienced occasional physical and emotional distress signals such as panicky breathing, your heart pounding in your chest, trouble sleeping, feelings of dread, or even loops of worry. Thats normal.
Experiencing anxiety is normal, says Dr. Gene Beresin, executive director of the Clay Center for Healthy Young Minds at Massachusetts General Hospital. A certain amount of anxiety can even be helpful. The problem is that sometimes the systems underlying our anxiety responses get dysregulated, so that we overreact or react to the wrong situations.
Foods To Help Fight Depression
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
One of the most overlooked aspects of mental health is nutrition. Food plays a significant role in our physical health, as well as our mental and emotional health. When you are struggling with depression, it can feel a bit overwhelming to think about eating the right foods. However, some of these small changes in your diet may help to decrease your symptoms and have a positive effect on your daily life.
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What Strategies Are Often Used In Treating This Dual Diagnosis
Evidence-based research suggests that both anxiety and depression be treated at the same time.
Effective strategies often used in treating these co-occurring conditions include:
- Cognitive Behavioral Therapy CBT is often used to treat people with both disorders. Fears, anxieties and tendencies toward depression are managed by seeking out their root causes. Once uncovered, patients learn how to take control of their emotions and life.
- Antidepressant medications Often combined with CBT, these may be prescribed in treating both disorders. Selective serotonin reuptake inhibitors are new antidepressant drugs that produce fewer side effects than their predecessors.
- Exercise This can be very helpful for both disorders. Physical activity causes feel-good chemicals to be released in the body. This aids in relaxation and feeling of well-being.
- Relaxation techniques This typically involves meditation or mindfulness. These techniques can often help to remedy both disorders and improve quality of life.2
What Lifestyle Changes Are Recommended For Anxiety And Depression
More info on this topic
Lifestyle changes are simple but powerful tools in treating depression and anxiety, and they are an essential component of an integrated approach to treatment. In some cases, lifestyle changes alone can help depression or relieve anxiety, so it makes sense to start with them right away. But if you are suffering from moderate to severe depression or anxiety, also seek professional help right away. And if you dont see relief from symptoms of mild depression in a few months, likewise seek professional help.
Lifestyle changes that can help include the following.
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Stress Is Not Anxiety Or Depression
Stress is not the same as anxiety or depression but for some people, being stressed for a long time can lead to anxiety or depression, and it can affect a persons physical health, particularly cardiovascular health.
When we talk about being stressed, it usually means were upset or tense about something thats happening in our lives. Stress is a normal part of daily life. Its a natural physical and mental response that is designed to help people cope effectively with emergencies.
Some stress can be a good thing. It can help us get motivated to get things done, but health problems from stress happen when it is regular and doesnt let up.
Symptoms Of Anxiety And Depression
According to the current Diagnostic and Statistical Manual of Mental Disorders , the standard classification of mental disorders used by mental health professionals in the United States, anxiety and depression can share several common symptoms, including, but not limited to:
- Being easily fatigued
- Sleep disturbance
Other signs that a person may suffer from both anxiety disorder and depression include:
- Constant, irrational fear and worry
- Physical symptoms like rapid heartbeat, headaches, hot flashes, sweating, abdominal pain, and/or difficulty breathing
- Changes in eating, either too much or too little
- Persistent feelings of sadness or worthlessness
- Loss of interest in hobbies and activities
- Inability to relax
- Panic attacks
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When You Eat Should Be Part Of Your Diet Plan For Depression And Anxiety
When you eat is an important part of a good diet plan for depression and anxiety. Follow your appetite.
It is common to turn to comfort foods when facing depression, anxiety, or both. This is fine if youre making nutritious choices and doing it when youre hungry. Many times, though, when were depressed, anxious, bored, or otherwise not feeling in our best mental shape, we seek out food despite not being hungry.
Its bad for mental health, too, to skip meals. The brain requires a steady supply of nutrients and a stable blood sugar level to keep moods stable. Many nutritionists recommend eating five or six small meals rather than three large ones to avoid blood sugar spikes and drops as well as dips in the nutrient supply.
The best diet plan for depression and anxiety isnt complicated, nor is it a potentially-dangerous fad diet promising miracle cures. The most effective diet involves balanced, wise nutritional choices to fuel your brain to do its work. Paying attention to how and when you eat are important components of an effective plan, too. Intentionally eat your way to relief from depression and anxiety.
Brain Foods That Help Depression And Anxiety
When youre in deep depression or anxiety, getting the right foods may be the last thing on your mind. Or you may be eating yourself deeper into depression with the wrong types of food without even knowing it.
According toDrAxe, your body would naturally crave for foods that are high in carbohydrate, fats or sugar as a response to the stress you are going through.
While you may satisfy your food craving, the choice of food that you take could aggravate your stress level which leads to a prolonged state of depression and anxiety.
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