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When Anxiety and Depression Team Up and Wage War Together in Your Head

It’s hard to explain the complex relationship between the common psychological conditions, but there are definitely some memes that can help

Hank can’t remember a time when he wasn’t anxious. Growing up, his parents struggled with money and their financial concerns rubbed off on him. Throughout his adolescence, he used food to cope with his anxiety, which led to weight gain, lower self-esteem and eventually depression. By the time Hank reached middle school, it felt like his anxiety and depression were bashing it out in his head. “Both of them were full-on kicking,” the 29-year-old tells me, joking that “my favorite part of having both is that treating one will often make the other worse.”

To that end, the things that immediately relieved his anxiety, like alcohol or Xanax, made his depression worse. At the same time, one of the common side effects of antidepressants is anxiety, at least temporarily. 

Though it’s common to want to categorize people as either anxious or depressed, these conditions aren’t mutually exclusive — about 60 percent of people with anxiety experience symptoms of depression, and vice versa. “It’s very common for depression and anxiety to coexist,” confirms psychotherapist Brent Metcalf, adding that they can have overlapping symptoms. For instance, his clients who struggle with depression as their primary diagnosis often worry about what other people think of their symptoms. He’s also seen anxiety have such devastating effects on people’s lives that they’ve fallen into depression. 

It can be difficult for people like Hank to differentiate symptoms of anxiety and depression on their own, but experts say distinguishing between the two is critical. For example, while psychotherapist Erena DiGonis realizes how debilitating anxiety symptoms can be, “depressive symptoms are more likely linked with suicidal ideation or intent, so I take depression very seriously.” (The main difference between these two beasts is that, anxiety typically deals with a sense of worry and anxious individuals tend to avoid certain social situations and relationships because of their symptoms, whereas people with depression tend to feel hopeless and often have low self-esteem. )

Interestingly, though, DiGonis has similar recommendations for people who feel they may be experiencing either condition. Outside of talking with a therapist, she suggests taking inventory of your diet, exercise and sleep habits. Light therapy and breathing exercises like box breathing can also be good, basic ways to start taking action to feel better, she says. 

For men struggling with anxiety and depression, Metcalf recommends “watching for anger or irritability,” he says. “When men are depressed, it can often come out as anger, and people often don’t consider depression or anxiety as a factor.” 

The anger Metcalf references is mostly absent from memes about the depression-anxiety combo, but DiGonis believes that they still help to increase awareness about how common it is for anxiety and depression to occur simultaneously — even if they don’t get it exactly right. Case in point, DiGonis critiques the meme above as follows: “I’d change the ‘my anxiety’ side to the more common things I hear, like, ‘My anxiety is thinking that I’m never good enough, and what if I embarrass myself and no one will ever like me?’” Similarly, she’d change the other side to read, “‘My depression telling me that I’m a worthless person and not worthy of being liked.’” 

Harsh. 

That said, not everyone with depression and anxiety finds these memes relatable. “I see stuff like this all the time and I’d say it never resonates with me,” says Scott, a 34-year-old who has experienced both conditions at the same time. If he had to describe what this experience is like for him in meme form, it would go something like this: A side-by-side image of his depression — a disheveled person who can’t get out of bed — and his anxiety — that same person frantically running to work at the last possible second. “In those moments of feeling like I couldn’t bear to drag myself there, anxiety about job security or how much PTO I’d taken lately would almost always win out,” he tells me. 

That’s the tricky thing about anxiety and depression interacting. If they conspire often enough, one might actually seem to solve the other. But as time goes by, that is almost certainly not the case. In fact, any time you think you have one or the other beat — or dare to forget about them for a minute — they’ll be sure to remind you that they’ve been right there waiting the whole time.