Depression & Anxiety - Comorbidity in Mental Health
It is common with most, if not all mental health disorders, that either a level of depression or anxiety exists (or both), alongside the primary diagnosis. It is highly likely that even if you suffer with a standalone period of depression there will be some anxiety involved. Equally, when one suffers from an anxiety disorder, the anxiety can lead one to become depressed. We’re not talking being a bit down here of course but a diagnosed clinical depression. Is the co morbid aspect in mental health generally recognised to the degree it should be? How much do anxiety and depression play a part in the severity of the primary mental health diagnosis?
Depression and anxiety - mood disorder twins
It is so common to see depression and anxiety disorders together that some researchers actually believe they are not two separate disorders at all. They can both be brought on by way of response individually speaking. For example, depression may be a reaction to life’s events such as loss of a loved one, relationship break up, long standing illness and of course that includes a mental health disorder.
It appears that some people may be more predisposed to become clinically depressed but leading up to becoming depressed it is likely a person will have had a level of anxiety. So, depressed people can be said to be reacting also to anxiety. Overanxious people or those with anxiety disorders are usually responding to stress or stressors in their lives.
Anxiety and Depression
Have you had an Anxiety Disorder and/or Depression?
Anxiety is usually filled with apprehension or fear about that which may happen. Depression can follow when the fear of what may happen becomes too much to bear or when life simply becomes unbearable because of anxiety’s disruptive nature. Panic disorder is a good example. We feel we have lost control when we can’t stop a panic attack. This leads us to avoid the situations where we may make a fool of ourselves. The more we detach ourselves from normal activity, the more despondent we can become, leading to depression.
Quality of life and control in our lives are important to us. Ironically, anxiety usually speeds us up whilst depression slows us down! Both doctor and patient alike can find it difficult at times to separate the two disorders because many of the emotional or mood symptoms of depression and anxiety disorders tend to overlap.
Can Anxiety Cause Depression?
Comorbidity with primary mental health diagnosis
This is all bad enough, but what happens when depression and anxiety find their way into other mental disorders such as schizophrenia, bipolar disorder, eating disorders, and personality disorders? Those with schizophrenia can also suffer with social anxiety or social phobia. The psychotic symptoms of schizophrenia can induce a worry about how a sufferer may be perceived by people in the social context. A chronic fear of embarrassment can lead to an avoidance of social situations. Self-confidence takes a big knock and this in turn can promote isolation, and an isolated person with schizophrenia will be more likely to become depressed.
Isolation can compound any mental health issue. The more a person thinks about their mental illness and how it is affecting their lives, the more despondent they may become.
Bipolar disorder for example exhibits severe swings in mood and it is recognised that these moods are polar opposites, from depression to mania (hence the term bipolar). At times there can also be extreme agitation and anxiety can become a part of both extreme moods.
My friend who has rapid cycling bipolar gets spells of severe anxiety and these spells tend to be just before she gets depressed. She sees this as one of her signs that depression is very near. For her the anxiety can escalate to extreme proportions so she is afraid to leave the house. She begins to have obsessive anxious thoughts about what would normally be trivial matters. When she is in the manic phase she also worries somewhat about how the anxiety affects her when she is depressed. I have seen the anxiety compound her depressed mood and even creep into her mania though to a lesser degree.
Anxiety and depression have a lot to answer for! I do not have room in an article this size to talk about all the other mental disorders and the co-existence of anxiety and depression within those disorders, but it is true to say in the vast majority of cases, there will be an element of one, if not both.
When suffering a mental health problem, a feeling of isolation is not uncommon without the added anxiety and depression. These comorbid conditions only serve to exacerbate the isolation. Social inclusion and mental illness is still fraught with complications for a sufferer made worse by anxiety states and a despondency that equates to a level of clinical depression. We should be looking at just how much anxiety and depression actually make the primary diagnosis problem worse.
There may be times when someone is given an elevation in their dose of psychiatric medication when actually they wouldn’t need it if the worsening presentation turned out to be rooted in anxiety or a bout of reactionary depression. Anxiety certainly can be addressed and doesn’t always need medication. The severity of depression would dictate the use of medication.
It is my opinion that professionals should be consistently monitoring any anxiety and depression within a primary mental health diagnosis. Address the anxiety and depression issues and at the least, the primary problem would not be antagonized so much.
Professionals should ideally be supporting sufferers with their mental health diagnosis but this should always include recognising and addressing any related anxiety or depression problems. If a person suffering a mental health disorder has better coping skills the extent of suffering could only improve somewhat. Sadly, in psychiatry, doctors are quick to prescribe more pills to dissolve some of the anxiety and depression. Sometimes mood stabilisers are used, lithium being a popular one for the treatment of bipolar disorder but anticonvulsants are quite popular too for a range of mental health problems with regard to spells of anxiety and depression.