They’re two separate illnesses – but they often go hand in hand. According to a study by Nicholas C. Jacobson and Michelle G. Newman, previous research suggests that between 16-50% of people with a depressive disorder also have an anxiety disorder. This may be because the two conditions share some of the same symptoms according to the NHS, like having trouble concentrating or feeling worried – although anxiety often manifests in an abundance of energy, while depression often shows as lethargy. But why else? ‘They are flip sides of the same coin,’ therapist Geraldine Joaquim at Quest Hypnotherapy tells metro.co.uk. ‘Effectively we are all pre-programmed to fall back on these two conditions (as well as anger) from way back in our caveman days. They helped keep our ancestors safe.’ Depression was an energy conserver when cavemen/women couldn’t go out to hunt, and anxiety kept hunters aware of predators. Our primitive brain kicks back in with these feelings when we’re having a crisis.
‘The good news is we can control these feelings if we understand them,’ says Geraldine. ‘The first step towards making any change is understanding what we are changing and then putting stepping stones in place to get there, not trying to achieve huge change in one go.’ Most people I know who have depression also have anxiety, so I wanted to ask a few different people about their relationship with the two, to see it from a perspective other than my own. I’ll also be sharing my own story. I’ve never gone into detail about my mental health publicly before, but it’d pretty douche-y of me to expect other people to share without doing the same.
‘I’ve dealt with anxiety since my childhood, which manifested itself as OCD that came to a head in my mid 20s. ‘By that point my days, and especially my free time, were largely structured around checking and counting. I could feel my world getting smaller and smaller with every new check that came into my life, while the reasons to not leave the house by myself were growing all the time. ‘It was, however, relatively easy to hide these symptoms from everyone I knew. ‘I remember having to step out of work to be interviewed by my GP about it, and later opening up to some colleagues about the call – they thought I was making an excuse for having a job interview! ‘When I was later diagnosed with severe anxiety, it actually brought a bit of relief to see it in writing and on paper. ‘My depression, on the other hand, surfaced in a totally different way, during my first winter away from home, when I was living in halls at university. I found this an incredibly hard period to get through, with little support structure in London and my family so far away.
‘My depression took over everything. I did not answer calls from friends, or leave my room, or go anywhere or want to do anything. I lost a lot of weight and basically felt like no one wanted to be around me and nowhere was home. I thought I was just homesick and felt a lot of pressure to get out and enjoy being at university and in a new city, and that certainly made it worse. ‘Over the years, my depression subsided as I was able to make some great friends in London and settle down to a routine – and this is when my OCD came back – a different version of what I had dealt with in my childhood and teens. ‘When I turned 25 I signed up for CBT and was very, very lucky to have a brilliant counselor. ‘Within a year of signing up, I was able to completely cut out my OCD checks and really bring my anxiety down to a manageable amount. ‘It was also one of the toughest things I’ve ever done mentally, and beginning to pick away at my anxiety made me really, deeply depressed. ‘Thankfully I was told to stay in work and keep up with a routine, which was amazing advice and I think it saved me from being far worse. ‘Without the structure my OCD had given me, I found it much harder to organise my anxiety. But over time, I felt myself unfurl from this state of being constantly braced for the worst, and was able to start really seeing the benefit of a life without anxiety being a major player, and thankfully my depression subsided along with it. ‘I now love that the hours I used to spend checking over everything can now be spent on things I actually love doing with my time, like seeing friends and family. I used to make a lot of my decisions based on appeasing my anxiety, whereas now I get to make them for me. ‘I’m 28 now. I do not think of myself as someone who has OCD, but I do think of myself as someone who is susceptible to anxiety and also someone who can be depressed. ‘I use the help I picked up in CBT every day. From never, ever, touching wood again for good luck, to not having a lucky number. It also means when I can see a tough time approaching, I also make sure I give myself a bit of break. I think it’s easy advice to shrug off but being my own best friend is what helped me most.’
Oli, 35 ‘I was diagnosed bipolar in 2012 but I started having symptoms in my early 20s. It was only after a bad suicidal patch that I went to the doctors, so I suffered for 9 years. And just hid it. I blamed it on all sorts of physical illness because I had to have so much time off work. People must have thought I was a massive hypochondriac! ‘I don’t know whether my anxiety is random or connected to my bipolar – it’s not a definitive thing with me. I think my anxiety’s worse when I’m depressed as I overthink more and have constant negative thoughts running through my mind. ‘However, I’ve also had anxiety issues when I’ve not been depressed, and seemed relatively stable – that’s when it really comes out the blue. Massively unpleasant. ‘I’m a tennis coach and my worst ever anxiety attack was when I was coaching on the tennis court. I thought I was having a heart attack as I’d never experienced such severe symptoms of anxiety before. I had to take myself off home and take a couple of days off work. ‘I take lithium and quetiapine for my bipolar and have diazepam to help me sleep. I have it in my bag just in case I have an anxiety attack as it takes the edge off it, but I try not to take it in the day as it makes me woozy and I don’t want to dampen my enthusiasm and my energy for my job as a tennis coach. I need to be energetic and encouraging and that doesn’t go hand in hand with diazepam. ‘I’ve had counselling and CBT which has helped to a certain degree but I find it difficult to implement if I’m very depressed, as I’m not thinking rationally ‘Since my diagnosis, I’ve had manic phases and depressive phases though I’m not sure I’ll ever truly get to grips with knowing if I’m depressed or if I’ve just had a rubbish day. Humans can’t be happy all of the time, you’re going to go through difficult periods in your life where you’re upset and you cry and you’re angry. ‘There are certain coping mechanisms in place and exercise is huge in that. I ran the marathon for Movember this year, and after that I started taking my running more seriously. I’m currently training with a friend of mine four times a week to do the Manchester half marathon and that has helped me hugely keeping it going. ‘I’ve always known that running has helped both my anxiety and depression, but it can be tough to keep up when you feel sh*tty. You’ve just got to make sure you try and keep it up as much as you can because everything seems to subside. ‘I still have the odd bad day – as everybody else does – but that’s just life isn’t it? You have good days and bad days and learn to not panic that anything is wrong – but that’s much easier to get a handle on that when I’m fit, sleeping well, eating well and not drinking very much. Just because you’re doing all these things doesn’t mean that a mental health issue is going to go away, but you give yourself a better chance. ‘My dad took his own life through suicide and I am determined to not let that happen to me.’ Oli is a Movember ambassador – head here for more male mental health info. (Picture: Ella Byworth for Metro.co.uk) Vicky, 36 ‘I’ve suffered on and off with depression since I was a teen, but I think I’d always felt like I was reveling in my angst a bit, as if it was a little bit affected. However, that changed when I had a massive breakdown about 10 years ago and was signed off work with anxiety and depression. ‘I felt like something had snapped completely in my head and I didn’t know how to function. At the time I was in a good job and went to the gym regularly but then things just started to crumble for me. ‘Initially I was signed off work for a week and went back; they were very good and let me do reduced hours, sometimes just 2 hours a day, for a few weeks. But then my manager practically begged me to go to the GP and get signed off because he was so worried about me. ‘I just didn’t know how to get through the day. It was like I was just waiting for the next time marker: waiting for time to go to work, then waiting for time to go to the break room, then waiting for lunch time, then walking around town waiting for it to be time to go back to work, waiting for home time, getting home and waiting for bed time. It was like torture because I didn’t sleep when I went to bed either! ‘I was off work for a month, with weekly sick notes so that I had to check in with both my GP and my manager every Friday, and went back on phased return after that but I just couldn’t cope and they let me take voluntary redundancy with almost immediate garden leave so then I was off work for my entire notice period – about three months I think. ‘I actually never went back to work full time; I worked in a pub for a while and then got a job working four days a week in an office, and then I had my daughter. ‘I’d never suffered with anxiety until I had a breakdown, and then I started having panic attacks,where I had a constant inability to catch my breath. They went away as I began to recover from the breakdown and I’ve been lucky not to have had them much since. ‘When I first started to go a bit wobbly they gave me Prozac and it made me ten times worse; I stopped eating or sleeping. I went back and they switched me over to Zoloft but I had to have a week off medication in the middle and during that week I went properly crazy. I don’t even remember much of it but I was not at all well. I flew to Spain and fully intended to kill myself while I was there. After a while they increased my Zoloft dosage, and I think I was on it for a couple of years. ‘I stopped my medication when I found out I was pregnant with my daughter 6 years ago and my GP was very concerned about it. All through my pregnancy every health professional I spoke to mentioned that after the first 12 weeks I could go back on the medication if I wanted. ‘Once I’d had my daughter I think I must have been flagged as high risk for post-natal depression, because I got a lot of attention while I was in hospital, and the medication was offered to me numerous times up until my daughter was a few months old. ‘I did struggle during that time but (perhaps pig headedly) I was determined to continue breastfeeding my daughter, and not to pass mind-altering chemicals to her in my milk, I never went back onto them. In fact, I think the fact everyone was so worried about me getting post-natal depression made me more determined to take really good care of myself. ‘I increased my supplements and made sure I went out for a 10k walk every single morning, no matter how rubbish I felt. I think that routine dragged me through what was a very difficult time for me as I became a single mother before my daughter was a month old too, and now I’m a parent I really can’t afford to be anywhere near as bad as I was before. ‘I’ve had ups and downs but I’m much more aware of how my mood is and take preventative measures to ensure it doesn’t get too bad. These days I make sure I take a good quality multivitamin every day but more importantly fish oils, which I am sure are the reason I’ve managed to stay sane through a rather stressful time. ‘I never really found the counselling offered by my local community mental health team any good any way, but I do think writing my blog helps, and reaching out on social media when I’m feeling isolated can be useful too. ‘Since my breakdown, I’ve worked really hard on my mental health to ensure it doesn’t happen again. ‘At the time I felt like I’d hit rock bottom and there was no way out; I couldn’t see how I would ever live a normal life again but now I feel like it’s one of the best things that could have happened to me because I appreciate what I have so much more now.’