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March, 2010:

Anxiety and Depression

In medical terms, Anxiety and Depression are said to be co-morbid conditions. This means that they often co-exist. In fact they can so commonly accompany one-another in the same person that they can be difficult to tell apart. They are obviously both subjective states with physical and cognitive components. So how are they different? They are actually often quite different. Anxiety is the body’s preparation to deal with something that is perceived as threatening. So cognitively it is experienced as a sense of danger, impending threat, and a desire to escape or avoid. The body prepares to “flee” or “fight”. This involves the body getting ready for action – muscle tension, heart rate increasing, sweating, rapid breathing etc. So the body is actually speeding up. Depression is usually experienced as sadness, and cognitively a sense of hopelessness, or low self worth, a lack of pleasure or interest. The body generally “slows down”, a sense of lethargy, lack of energy, and a desire to withdraw. However because they co-exist, these subjective experiences tend to blur together. Sometimes their symptoms are more similar. For example, Depression can be experienced physically as a sense of agitation. The avoidance associated with Anxiety can lead to a generalised withdrawal. Depression can often be regarded as the body’s attempted solution to prolonged anxiety. If the threat or danger is perceived as being more than the body can cope with, and if it lasts sufficiently long, the body can “shut down” so that it doesn’t have to deal with the threat or danger. Therapy requires that both the Anxiety and Depression are dealt with. Cognitive Behaviour Therapy is an effective therapy for both conditions so they can both usually be addressed at the same time. They do not always co-exist though. Sometimes the Anxiety is a clearly distinct disorder and sometimes Depression is clearly a Mood Disorder with biological or genetic factors involved. Cognitive Behaviour Therapy should still be considered, but medication is also more likely to be prescribed, particularly for Depression.