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What's the difference between anxiety and depression?
One in four people in the UK experience a mental health problem each year. This means there’s a chance you may know somebody affected by either depression or anxiety, two of the most common mental health conditions. You may have heard these terms a lot, possibly used alongside each other. But how well do you understand them? And do you know the key differences between anxiety and depression?
Speaker 1: Abby Stanford
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Welcome to another episode of the Bupa Healthy Me podcast. My name is Abby Stanford and I'm a Specialist Health Editor on Bupa’s Health Content Team. And today, I'm joined by Caroline Harper.
Speaker 2: Caroline Harper
Hi, Abby. I'm Caroline Harper. I'm a Specialist Mental Health Nurse with Bupa.
Abby Stanford:
On this episode, we're going to be talking about two of the most common mental health conditions and that's anxiety and depression. So, Caroline, could you first of all, explain to me what anxiety is?
Caroline Harper:
Yes. So anxiety’s quite typically defined as excessive worry. We all experience worry in our lives, don't we, Day to day, but more so when it’s sort of been described or diagnosed as anxiety is when it becomes worry sort of most days. And it's sort of difficulty controlling them or it's that excessive worry that's really impacting on other activities of your living in and it's taken over your thought processes.
Abby Stanford:
Okay. And and then could you explain to me what depression is?
Caroline Harper:
Yes, depression is sort of defined more so about your mood. So it's can be low mood or it can be a loss of interest or a loss of pleasure in activities that typically has gone on for sort of two weeks or longer, they're like the symptoms of depression. There are some of the symptoms of depression that we can experience as well, such as guilt or feeling helpless and also low confidence as well.
Abby Stanford:
Okay. And so is it possible that anxiety and depression can sometimes feel quite similar to each other?
Caroline Harper:
Yeah, I mean, as with a lot of different mental health problems, really, it can be quite complex. It can be difficult to work out what you're experiencing and if you're experiencing a bit of both, can be a bit confusing for people. So some of the symptoms can be similar. So we know that people often experience poor concentration, difficulty sleeping, sort of feeling very tired all the time.
But then, like I say, not not being able to get to sleep or stay asleep or actually waking up early. So that's something that we see in both anxiety and depression. But then there are more symptoms that have sort of definitely come more into the anxiety umbrella or more into the depression umbrella.
Abby Stanford:
Okay, So what ways might they feel different? How might I be able to tell if I'm feeling anxious as opposed to feeling depressed?
Caroline Harper:
Yeah. So typically with anxiety, say somebody is going to feel sort of very restless, fidgety and unable to relax. It's almost as if they've they've been sped up in some way and that's often a way that doctors used to describe it and quite fidgety. Sometimes they can have palpitations. And I think a lot of people will have heard about panic attacks.
And that's that's typically when our thoughts impact our bodies. And and we sort of it comes to a bit of a head in a bit of a panic attack. And and that's really your body and your mind letting you know that you're really struggling with something, that you're really anxious about something.
Whereas if we think more about depression, it's sort of the other way. It's often people who are slowed down their movements or their thoughts can can be a lot slower than normal. Their energy levels are typically very low. They may experience, some aches and pains, and they're certainly going to be experiencing poor motivation. So things that they previously have enjoyed do when they're just lacking the motivation to get up and do those things.
Abby Stanford:
Okay. That's really helpful. And and I understand that those are kind of different symptoms, but you said sometimes it can be difficult to maybe tell which one of those you're feeling. Maybe you're feeling lots of those things all at once. And is it possible to have anxiety and depression at the same time?
Caroline Harper:
It is. Research shows that actually a high number of people almost up to 85% of people, can have those two conditions side by side. Obviously, not everybody does, but is very common.
It is more common that you will have a mixture of both. So sometimes that's referred to as anxiety and depressive disorder and the way that it sort of makes sense for me to think about it is if somebody feels very anxious most of the time it's only going to be a matter of time before that starts to impact your mood, because obviously that's really not a nice place to be in day to day.
And if we start feeling that level of distress on an ongoing basis, then it's going to start impacted our mood. So we might have times throughout the day or throughout a week, for example, where we feel particularly anxious, but we might have other sort of hours or days where actually we don't feel as anxious and we feel more low, more poorly motivated and also at times might feel a bit of both.And obviously that can be really confusing for people.
Abby Stanford:
Yeah, that makes perfect sense. And like you say, that kind of feeling of being sped up and and like very stressed and worried all of the time, it would make sense and that would make you feel kind of sad and emotional when it wears off or goes away.
And so if somebody thinks that they might have depression or they might have anxiety or that they're feeling a mixture of all of these feelings, maybe they they don't know what's going on, what are some things that they can do? What should they do?
Caroline Harper:
Mm. Personally, I think a good thing I would recommend is perhaps speaking to a close family member or a friend for interest. If it's somebody who's had their own experience of anxiety or low mood, then they would be even better to speak to because it might be that you need to sort of identify it is that that feeling and perhaps maybe which of those you might be feeling.
And so having a chat with somebody who's been through that can be really helpful and they can sometimes point you in the right direction.
But other than that, I would definitely say sort of speak to your GP, whether that sort of face to face over the telephone or virtually they, they will usually do some very small questionnaires with you and that can identify where you're at on that sort of scale of feeling anxious, of feeling low, and sometimes just having that fed back to you and can really sort of identify and validate exactly how you've been feeling.
For some people, that can be a bit of a shock. For other people, it's it's quite reassuring that actually you know, to have a sort of description and a bit of a name to it.
And then what the GP will typically do once they've done those mini questionnaires with you is talk about the next step. So some people will benefit from a lot of sort of self self-help - guided self-help which the GP can give you information about, or you can have a look online at a lot of the sort of big mental health charities and the Bupa web page has lots of info on there.
Depending on the severity of those symptoms they might want to discuss talking therapy with you. So talking therapy can look at any specific triggers you've got for your anxiety or low mood and and look at perhaps changing some of those or learning to manage them in different ways. If you're really quite struggling with your symptoms, you know, day to day. And it's at a point where perhaps it is impacting on your work or your sleep to quite a decent level, then they may look at medication.
So sometimes that can just be sort of short term medication that could help with your sleep and get you back on track. It might be something that might take the edge off your anxiety or, you know, if you're feeling quite bad and quite quiet down there might discuss antidepressants with you. But that will always be alongside talking therapy and support from family and friends as well. That should never just be something that's prescribed alone.
Abby Stanford:
Mm hmm. And I think it's probably helpful for people to know as well - that your GP is used to seeing that it's not you're not going to be the last person that's come to the doctor to speak about that.
Caroline Harper:
Yeah, absolutely. I bet it's it's a very common thing to experience. You know, I don't think many people go through their life and never experience some anxiety or some low mood. You know, at times life can be hard and at times, unfortunately, these illnesses can just impact you from nowhere. So GP's are, you know, well aware of what's available for people and that people need support and particularly, you know, through different periods of our life, we do need that support.
They may also recommend things like exercise and sort of looking at your diet and things like that and also your support network because those things can have a big impact on your mood. And you know, lots of people turn to sort of walking or running, haven't they, to manage their anxiety over the last sort of 18 months when gyms were closed and things like that?
Abby Stanford:
That's really helpful. Caroline, thank you so much for speaking to me today. And and thanks for listening to this episode of The Bupa Helping Me podcast.
What do the terms anxiety and depression mean?
A key difference between anxiety and depression is that one refers to a single illness, and the other to a group of conditions.
- Depression is really one illness. It has lots of different symptoms (see below). And it may feel very different to different people. But the term depression refers to a single condition.
- Anxiety is a term that can have a few different meanings. We all feel anxious sometimes and ‘anxiety’ can be used simply to describe that feeling. But when we use anxiety in a medical sense, it actually describes a group of conditions.
Anxiety includes some less common conditions. These include phobias and panic disorders. But the most common is generalised anxiety disorder (GAD). Generalised anxiety disorder may affect between four and five in every 100 people in the UK. We’ll focus on generalised anxiety in this article.
What do anxiety and depression feel like?
Generalised anxiety disorder and depression can both have emotional and physical symptoms.
Mood and feelings
Depression is defined by having a low mood and/or a loss of interest or enjoyment in most activities, for two weeks or longer. These are seen as ‘core symptoms’ of depression. There are a range of other mood-related symptoms that a person with depression may experience, including:
- guilt
- helplessness
- feelings of worthlessness, low self-esteem or low confidence
- thoughts of death or suicide
Similarly, generalised anxiety disorder centres on two ‘core symptoms’. These are:
- excessive anxiety
- worry on most days for more than six months, and difficulty controlling these feelings of anxiety and worry
And again, there are further symptoms beyond these that someone may experience, such as:
- feeling on edge or restless
- irritability
With generalised anxiety disorder you may feel very worried about a range of everyday things. And there may not be one obvious logical cause for your anxiety.
Physical symptoms
There are quite a few physical symptoms that appear in both generalised anxiety disorder and depression. For example:
- fatigue or tiredness
- poor concentration
- being fidgety or unable to sit still
- difficulty sleeping
But there are also physical symptoms unique to both conditions. In depression, physical symptoms might include:
- weight changes, often caused by changes in appetite
- being slower in your movements
The physical effects of generalised anxiety disorder include:
- muscle tension and aches
- headaches
- sweating
- dizziness
- bowel problems
- a fast heartbeat and shortness of breath
All of the physical symptoms above can potentially be signs of other problems with your physical health.
Can you have anxiety and depression at the same time?
It’s a complex picture. Depression and generalised anxiety disorder have some distinct features, and some that overlap. To complicate things further, it’s actually possible for someone to experience depression and anxiety at the same time.
In fact it’s not just possible; it’s quite common. Around half of people with generalised anxiety disorder will also have depression. When the conditions coexist like this, they can be more severe and long-lasting than usual.
It’s also possible to be diagnosed with one of the conditions, and to have symptoms of the other (but at a level that on their own would not lead to a diagnosis). The way symptoms overlap make it hard to be precise with numbers. But estimates of the number of people with depression who also experience symptoms of anxiety range as high as 85 per cent.
Many experts actually view ‘mixed anxiety and depressive disorder’ (MADD) as a separate category in itself. This is where someone may have symptoms of both conditions, but not severe enough to have a formal diagnosis of either condition. But this combination can still cause considerable distress and affect someone’s daily life.
Similarities in treatments
When it comes to depression and generalised anxiety disorder, one clear similarity is the way they are treated. For both conditions there are two main categories of treatment. These are:
- psychological therapies
- medicines
Psychological therapies involve talking through your thoughts and feelings with a qualified professional. An example is cognitive behavioural therapy (CBT). CBT aims to address the way your thoughts, feelings and behaviours interact.
Medicines called antidepressants are used for both conditions and are effective for many people. The most common ones are called selective serotonin reuptake inhibitors (SSRIs). But there are lots of others the doctor might try.
Treatment will often involve a combination of both psychological therapies and medicines. This will be tailored to the individual and their situation. The doctor may also look to address lifestyle issues as part of the treatment, if they think these may be contributing to the depression or anxiety.
So generalised anxiety disorder and depression are two different conditions. But you can see why they are often mentioned together. They have overlapping symptoms, can happen together and have similar treatments. If you’re struggling with your mood, or some of the symptoms mentioned here are familiar to you, it’s important to seek help. Don’t worry about labelling anything as anxiety or depression. What’s important is to get in touch with your GP so they can find out more and offer you support if you need it.
If you’re feeling particularly distressed and feel the need to talk to someone immediately, you may want to contact The Samaritans.
If you’re worried about your mental health, our direct access service aims to provide you with the advice, support and treatment you need as quickly as possible. You’ll be able to get mental health advice and support usually without the need for a GP referral. Learn more today.
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Sources Sources
- Mental health facts and statistics. Mind. www.mind.org.uk, published June 2020
- Generalized anxiety disorder. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2021
- Anxiety and stress-related disorders. Oxford Handbook of Psychiatry (3rd ed, online). Oxford Medicine Online. oxfordmedicine.com, published June 2019
- Depression. NICE Clinical Evidence Summaries. cks.nice.org.uk, last revised February 2021
- Depression in adults. BMJ Best Practice. bestpractice.bmj.com, last updated March 2021
- Generalised Anxiety Disorder. BMJ Best Practice. bestpractice.bmj.com, last updated March 2021
- Möller HJ, Bandelow B, Volz HP. The relevance of ‘mixed anxiety and depression’ as a diagnostic category in clinical practice. Eur Arch Psychiatry Clin Neurosci. 2016; 266(8): 725–736. doi: 10.1007/s00406-016-0684-7.
- Psychotherapy. Oxford Handbook of Psychiatry (4 ed, online). oxfordmedicine.com, published June 2019
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