10 Things to Know About Major Depression and Generalized Anxiety

Many people who develop major depression also struggle with generalized anxiety, and vice versa. Anxiety and depression are closely associated in general, and one of the strongest correlations in this regard is the relationship between major depressive disorder and generalized anxiety disorder, two clinical conditions that are frequently diagnosed by mental health professionals. While the two conditions have some clear differences, they are connected in many more ways than most people realize.

In some ways, major depression and generalized anxiety seem to come from opposite ends of the spectrum. One is associated with feelings of sadness and persistent low energy, while the other is marked by the strong physical, psychological, and emotional reactions that persistent anxiety can create.

But beneath the surface differences, there are commonalities and connections. By examining these similarities more closely, it is possible to gain a greater understanding of where each condition comes from, what impact each has, and what can be done to get the symptoms of both disorders under control.

Here are 10 important facts about major depression and generalized anxiety you should know:

Major Depression and Generalized Anxiety Have a High Rate of Comorbidity

The latest estimates are that about 60 percent of people with major depression will develop an anxiety disorder at some point in their lives. This association is striking, but the numbers are even more elevated with respect to major depressive disorder (MDD) and generalized anxiety disorder (GAD).

On a lifetime basis, approximately 80 percent of those who are diagnosed with GAD will also be diagnosed with major depression or bipolar disorder (which causes depressed states), either before, during, or after the depression manifests. Among those who experience anxiety disorders and mood disorders simultaneously, MDD and GAD are the most commonly experienced comorbid pair.

Major Depression and Generalized Anxiety Disorder Have Symptomatic Overlap

Depression is known to suppress mood and dampen emotional and psychological responses, while generalized anxiety disorder will persistently elevate them. Nevertheless, these two supposedly disparate conditions actually share four symptoms.

As revealed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), major depressive disorder and generalized anxiety disorder can both cause:

  • Restlessness and agitation, not traceable to any obvious source
  • Chronic fatigue
  • Sleep disturbances, or odd sleeping patterns
  • Difficulty focusing or concentrating for any more than a short period of time

These similarities exist simultaneously with the differences, suggesting there is more overlap between the two conditions than most would suspect.

Major Depression and Generalized Anxiety Share the Same Hereditary Risk Factors

Having a close member of your family who has experienced either major depression or generalized anxiety disorder will put you at increased risk for having both conditions. To clarify, this means that if you had a parent or grandparent who was diagnosed with clinical depression, you’ll have a greater chance of developing either MDD or GAD (or both).

Many mental health experts speculate that this is because major depression and GAD are at least partially caused by shared genetic factors, and indeed research indicates that this association is quite strong. Studies have been carefully structured to eliminate the possibility that environmental causes might mimic genetic effects, which allows scientists to confirm that heredity is a major contributing factor in many observed cases of comorbidity.

The Personality Trait of Neuroticism is Associated with Both Conditions

Neuroticism refers to a tendency to see the world as threatening, hostile, or unfriendly. Those who demonstrate this personality trait are prone to anxiety, often struggle with self-esteem, and have a habit of overreacting (in a negative way) to setbacks both big and small.

Research has revealed that individuals with major depression and/or generalized anxiety are likely to manifest the telltale symptoms of neuroticism. Their emotions can be unstable and unpredictable in even the best of times, and if their neuroticism remains untreated it can lead to more serious mental health issues.

Individuals With Both Depression and Anxiety Often Struggle with Substance Abuse

It is common for individuals with mental health problems to self-medicate for their troubling symptoms. While drugs and alcohol may seem to bring some short-lived relief, that positive result will quickly fade, and if substance use continues addiction will be the likely result.

Studies show that approximately one-third of people with major depression have active substance abuse issues, and the lifetime rate of drug or alcohol dependency is even higher. In research that looked at the substance use habits of men and women diagnosed with GAD, between 30 and 35 percent had developed an alcohol use disorder at some point in their lives, while 25-30 percent had developed a drug use disorder.

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Major Depression and Generalized Anxiety Disorder Cause Chronic Physical Pain

A notable percentage of people who have major depression or generalized anxiety disorder will report a variety of mysterious aches and pains. Especially common are discomfort in the neck, back, and facial areas, and in some instances the pain can become chronic or severe.

Those who experience these pains will often seek out the services of a physician, convinced they’re suffering from some type of physical malady. In reality, these pains are mainly caused by persistent muscle tension, which is a predictable side effect of frequent anxiety or depressed moods. Once the depression and anxiety are treated, the pains will tend to gradually disappear.

Exposure to Trauma and Abuse in Childhood Predicts Major Depression and Generalized Anxiety

Many serious mental health issues have their roots in past trauma. Often the trauma will have occurred in childhood, and will involve exposure to some kind of abuse or extreme neglect. These exposures interfere with normal development, and if left unresolved will almost certainly cause mental, emotional, and behavioral health issues later in life.

In one 2015 study, more than 75 percent of chronically depressed individuals reported exposure to childhood trauma. Research into the link between childhood trauma and GAD has been more limited, but one 2013 research project found that people who’d been traumatized as children experienced developmental changes in areas of the brain known to be overly active in people who have generalized anxiety.

Depression and Generalized Anxiety Respond Well to the Same Types of Medications

Antidepressants take their name from their ability to reduce the intensity of symptoms associated with depressive disorders. What many don’t realize is that these medications are also frequently given to people who have anxiety disorders, and in fact certain classes of antidepressants are the most widely prescribed medications for men and women with generalized anxiety disorder.

Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are the specific classes of medication most often recommended for individuals who are struggling with the symptoms of GAD. No one who develops either major depression or generalized anxiety should rely exclusively on medication to achieve wellness, but should instead use them as supplements to weekly or daily psychotherapy sessions, which may be delivered in either outpatient or inpatient settings.

Neither Major Depression nor Generalized Anxiety Disorder Will Cause the Other to Develop

If major depression occurs before generalized anxiety disorder, or vice versa, it would be tempting to suggest that the condition that developed first somehow played a role in the development of the other.

In fact, this type of cause-and-effect relationship does not exist with co-occurring mental health disorders. Regardless of which condition manifests first, both disorders can be said to emerge independently and organically, from a confluence of risk factors and life experiences.

Both MDD and GAD have their roots in genetic, environmental, and social factors, and often in traumatic experiences that occur within the context of those causal factors. They are each a sign of an underlying vulnerability, and should not be seen as precursors to each other.

Those Who Develop Both Conditions Can Benefit From Inpatient Care

Many people are able to recover from major depression and generalized anxiety disorder with outpatient care. But when these conditions occur together, intensive residential carel that facilitates a full-time focus on wellness is more likely to produce transformative and sustainable results.

Recovery regimens for a dual diagnosis of MDD and GAD will include a full menu of therapeutic services and complementary healing methodologies appropriate for all symptoms that are being experienced. Blended recovery plans can be highly effective for men and women who are determined to heal and recover, and are prepared to tackle all the challenges associated with overcoming multiple mental or behavioral health disorders.

Major depressive disorder and generalized anxiety disorder are a potent combination. But a well-rounded, evidence-based recovery program can provide a powerful and effective antidote to these persistent conditions.