Depression and Anxiety:  
How To Compare and Tell the Difference

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David Carbonell, Ph.D., believes that many people are confused by the 2 diagnoses, especially if they are given both diagnoses.  Dr. Carbonell believes that “Anxiety Disorders are characterized by a sense of doubt and vulnerability about future events. The attention of anxious people is focused on their future prospects, and the fear that those future prospects will be bad. Anxiety Disorders are characterized by a variety of symptoms involving anxious thoughts, unexplained physical sensations, and avoidant or self protective behaviors.”

Symptoms of Depressive Disorders:

* Feeling sad, and/or hopeless
* Lack of interest and enjoyment in activities that used to be fun and interesting
* Physical aches and pains without physical cause; lack of energy
* Difficulty concentrating, remembering, and/or making decisions
* Changes in appetite and weight
* Unwelcome changes in usual sleep pattern
* Thoughts of death and suicide

The difference between the two diagnoses is that a person with depression has a low mood, low-energy behaviors and negative thinking.  A person with anxiety disorder is overwhelmed with fear and anxiety about something that may happen in the immediate, near, or distant future.  Anxious thinking or worry is a primary symptom over having a depressed mood or depressed functioning for those with anxiety disorders, where Dr. Carbonell explains that, “Depressed people are not so preoccupied with worrying about what might happen to them in the future. They think they already know what will happen, and they believe it will be bad, the same bad stuff that's happening to them now.”

Bipolar disorder is a very different diagnosis from depression and anxiety, which is characterized by sudden or rapid shifts in mood.  These moods can be very high (manic) to very low (depression with or without suicidal thoughts).  In the manic phase, people may experience racing thoughts, difficulty staying on task, preoccupation with risk taking behaviors, elevated mood, delusional beliefs, less need for sleep or food or both, rapid speech, and impulsivity.  In the depressive phase, a person may experience the symptoms of depression such as feeling hopeless or helpless, marked feelings of sadness, a decrease in physical activity and loss of interest in activities that were once enjoye in addition to decreased energy and motivation, a change in eating and sleep patterns, and for some, suicidal thoughts, plans or attempts. 

Why People Get confused

It is easy to become confused about the 2 diagnoses: depression and anxiety.  This is very common in general, but very common for those who have both diagnoses.  The 2 diagnoses have several overlapping characteristics.  In addition, medications used for depression can also be used for anxiety.  Those with depression are often prescribed anti-depressant medication, and a group of anti-depressant medications known as the Selective Serotonin Reuptake Inhibitors (SSRI) have been demonstrated to be helpful with both anxiety and depression.  This is a preferred method of treatment by many physicians or psychiatrists.  There are two major types of antidepressants, which include tricyclics and selective serotonin reuptake inhibitors (SSRIs) - SSRIs such as fluoxetine (Prozac) can be used to treat depressive symptoms, anxiety symptoms or a combination of both.  Being prescribed an antidepressant does not necessarily mean you have depression if it is being used to treat the anxiety symptoms.

Those With Anxiety Can Also Feel Depressed

It's also common for people who are having a difficult time with an anxiety disorder to feel depressed as a result of the way anxiety is interfering with their lives. The author states, “It's my experience that most patients who experience this will find that their depression lifts naturally as a result of doing better with anxiety, and no special treatment for the depression is necessary. “

There are times when someone with anxiety also needs treatment for depression.  This occurs when the client has become so depressed in response to heightened levels of anxiety that they become unwilling or unable to work on the anxiety disorder.  This would then be an opportunity to use medication or cognitive behavioral methods, or a combination of medication and therapy to help the client manage the depressive symptoms and anxiety symptoms.  

Talk to A Professional

It may be challenging to understand if you have depression, anxiety or both.  Seeking out a professional evaluation can help you to understand your symptoms.  If you are already in treatment, speak with your doctor or therapist, so that you understand the symptoms, diagnosis and treatment protocol.  

- Kim B.

Insightful Comments

I appreciate the facts presented in this article because I have often times struggled with understanding when it comes to depression and anxiety.  I know have I have been depressed at times in my life, and I feel that I have had some anxiety issues at different times. However, rarely could I have easily identified the difference between the two.

I have faced depression in many situations of life, when as a child and adolescent, I faced depression from the abandonment by my parents. Next, as a teenager, I faced a degree of depression when I graduated from high school, but maybe it was actually anxiety!  As a young adult I faced the clear experience of depression at the loss of my maternal Grandfather who was my father figure throughout my childhood. At about the same time, I also went through an ugly divorce that pressed me into what I felt like was a deep dark pit for weeks.

As I spent a few weeks travelling Russia in my mid-twenties on a volunteer missionary experience, I returned home thankful for my nation and it’s values. However, I was near bed-ridden with despair over how the Russian people were forced to live.  As I have aged through life, I have faced depression when forced to leave a job that I really loved and enjoyed, and I have faced depression with long, unavoidable separation from my wife. 

I had many instances in my life, where a specific event caused me to experience sadness, which was not necessarily "depression" per-se: The loss of a pet; the break-up of a high school relationship; the time I was stood-up by my date for the Senior Prom, I went anyway all James Bond-like; the two times I wrecked my car, both on the way to a date. However, I was briefly saddened by these events and not really depressed.

In my experience, anxiety seems to follow depression and despair:  


I was afraid my next pet might suffer the same fate as my first. Stay away from milk trucks.

I was afraid my next girlfriend might treat me as rudely as the last, or worse. And I was right.

I was afraid to step into the life of college. I was afraid that it would be cold compared to my high school experience, and although it was indeed more cold than my high school days, this was mainly because I chose to be a spectator rather than a participant - That was my responsibility.

I was quite careful in the relationship arena after my divorce. Thankfully, that has paid off and the result is I have a wonderful wife, of nearly twenty years, and three beautiful children.

I am still fearsome of new employment opportunities because I do not want to be mistreated once again, but I  remember that I must work to provide for my family and to stimulate my intellect.

Knowing the difference and how to tell the difference between depression and anxiety will equip me to face the challenges of life head on. I hope it will for you as well.

- Bergen

Anxiety and Depression: Telling Them Apart. (n.d.). Retrieved December 18, 2014, from http://www.anxietycoach.com/anxiety-and-depression.html