Some people get anxiety without depression and some people get depression without anxiety. But for many, anxiety and depression go hand-in-hand and often occur together.
Anxiety is often the forerunner to an episode of depression. Anxiety is predominantly caused by worry. Worrying about what has happened, what is happening right now, or what will happen. Anxiety is basically fear. When we fear something, things happen to the mind and body. This can be triggered by all sorts of things; for example, a sudden encounter with a tiger, or a thought such as “They will fire me for taking so much time off work”.
When you are frightened, the body prepares itself to fight or flee. This is the “fight or flight response”. Adrenalin and cortisol levels increase in your bloodstream, your heart starts beating faster, you get knots in the stomach, tightening of the chest, blood rushes to the head and muscles, and you become all tingly as the minor blood vessels fill up with blood. You become alert. All these responses are physiological responses, i.e. physical changes are happening in your body as you prepare to fight or run away. It is an evolutionary response designed to make you more efficient at fighting or running away to give yourself a better chance of survival.
But if there is no actual threat to your life (there isn’t a tiger about to pounce on you!), you don’t have to run and you don’t have to fight. You generally just carry on doing what you are doing at the same pace. And all these newly released stress hormones washing round the body aren’t used up. They are not converted into physical activity. They stay in the body and the brain, influencing the balance of the body and brain chemistry, supressing serotonin and endorphin levels in the brain, which can lead to the illness called depression.
Depression is characterized by an abnormally low mood, which lasts for a long time. When your mind is healthy and you have a low mood because of one or more reasons; for example, you have just had a traumatic life event, or you are tired, hungry or cold, this is quite normal. You still feel life is worth living and normally recover quite quickly.
Depression can last for weeks or months and your mood can be so low at times you just want to die. In severe cases, you may even have thoughts about harming or killing yourself. Some people even attempt it. Occasionally they unfortunately succeed. Luckily most people don’t actually attempt suicide, even if they have a desire to die. Everybody has their own unique type of depression. There are as many types of depression as there are people who are depressed. There are, however, some commonalities, which make it easier for doctors, psychiatrists and therapists to identify, understand and treat the illness. Note, I have used the term ‘illness’ here. This is because it can be considered an illness, just as real as flu. Some therapists don’t subscribe to this label and prefer to call it a ‘state of mind’. Whichever label you apply to it, it is a real problem, but one from which you can make a full recovery.
Very often during an episode of depression, your mood is not low the whole day. There may be phases where you feel quite normal, phases where you can cope with doing things and phases where you can’t face anything. But rest assured, as you slowly start to get better, the ‘good phases’ tend to get longer and more frequent and the ‘bad phases’ tend to get shorter and less frequent.