Do you have depression or anxiety? The answer to that question isn’t always obvious, even to health and psychology experts. For one thing, nearly half of people diagnosed with depression also suffer from anxiety, according to the Anxiety and Depression Association of America. (Approximately 40 million Americans suffer from anxiety; about 21 million American adults and children from depression.) Furthermore, the two conditions share many of the same symptoms—feelings of hopelessness, restlessness and persistent anxiety, to name a few.
No one knows why depression and anxiety often occur in conjunction or even the causes of each, says Dr. Michael A. Tompkins, a psychologist at the San Francisco Bay Area Center for Cognitive Therapy in Oakland, Calif., and author of Anxiety and Avoidance. “What we do know is that people at risk for developing an emotional disorder are those predisposed to have a far greater range of emotional responses than others do. That is what is inheritable,” Tompkins says.
We also know that anxiety often precedes depreassion. “If you are anxious in childhood, you are at greater risk for developing depression,” says Tompkins. “If you are afraid of so many things—crowds, driving, meeting people—that anxiety may ultimately be so wearing and exhausting that it leads to hopelessness and depression,” adds Beverly D. Flaxington, human behavior coach, hypnotherapist and author of Self-Talk for a Calmer You. “Anxiety can lead people to give up.”
Although the lines between the two conditions are often blurred, fundamental differences do exist. Here’s how to tell whether you have depression or anxiety.
Dwelling on the past vs. fearing the future.. “In depression, thoughts are generally about the past, about something that has happened that someone feels powerless to change so the future looks dark,” says Tompkins. “Anxiety is about things that haven’t happened, about how to control future events.”
Activity vs. passivity. “Anxiety is a more active mental process, like anticipation about what may happen,” says Flaxington. “Depression is a passive mental process, an acceptance that things are hopeless.”
Withdrawal vs. panic. “The features of depression are feelings of worthlessness, guilt, fatigue, trouble focusing, lack of motivation, thoughts of harming oneself and social withdrawal,” says Tompkins. Anxiety often centers on situations that a person avoids, and may include panic attacks, he says.
Differences in physical symptoms. Anxiety can include physical symptoms like getting sick to your stomach, heart palpitations, headaches, irritable bowel and clammy hands in reaction to certain events, such as being enclosed in a small space or in a crowd, says Flaxington. People who are depressed have no energy or drive. They may have interrupted sleep or no appetite—or they may overeat. “People who are anxious are physically aroused, agitated, restless,” says Tompkins. “Depression is more about slowing down. Physically, you feel like you are wearing a wet felt hat.”