I’m no stranger to depression or anxiety, and have been managing both for the duration of my adult life. Depression, I’ve known since adolescence. I was a tween when my critical inner voice got louder and louder, when I would struggle to get out of bed, and when I would find myself thinking about dying far more than I now know is normal. I may have romanticized it to some degree. I had read about the great artists and writers who also suffered from depression, and I fancied myself a poet and an artist, so at some point I began to really identify with my depression.
When I was first diagnosed with both Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD), I was defiant. Sure, I would often worry about things, ruminating and keeping myself awake when all I needed was sleep. And sure, I would convince myself that friends were mad at me or that I wasn’t going to do well on my next exam, paper, job interview (or whatever), but at the time, I didn’t identify with anxiety in the same way.
I spoke to a friend I had made in college, who knew me well, to tell her about the recent diagnosis and she guffawed. She reminded me how I would spend hours cleaning my apartment in college and how I wouldn’t leave to go out with her, sometimes canceling plans, to mop the floors for yet another take. I had to sit with what it meant to have both depression and anxiety, and to confront the reality of having to manage both (which I had already been doing, poorly, for a long time).
Learning to recognize how these two conditions worked together in my life: how the anxiety would rev my system up while the depression pulled me down, how they fed into each other in ways I couldn’t see until I stepped back, that recognition changed everything. It didn’t make things easy, but it gave me a framework for understanding what was happening and, eventually, what might actually help.
That’s part of why I’m writing this now. In our practice here in Los Angeles, I see so many people arrive with that same confusion I felt, wondering if what they’re experiencing is anxiety, depression, or something more complicated. This article is meant to help you make sense of that.
Starting Where You Are
Anxiety and depression are two of the most common mental health conditions. They are often confused with each other, misdiagnosed, and unfortunately, stigmatized. Throughout the article, we will talk through the differences and overlaps between them, whether you are trying to make sense of your own experiences, support someone you care about, or simply want to learn more.
Before we dive in, it feels important to talk about what is happening around us. The conditions we live under right now are intense, to say the least. Many of us move through our days with the sense of being watched or evaluated: through social media, through work metrics, through cameras and digital trails that track where we go and how we spend our time. Our lives are also saturated with information. Economic instability, climate concerns, and ongoing violence near and far all contribute to a background level of stress. It is understandable if you find yourself wondering how all of this is affecting your mental health, and whether the stress you are feeling is turning into something more like anxiety, depression, or both.
In Los Angeles and across California, almost everyone who reaches out to our practice is holding multiple pressures at once. They are navigating work or school, family responsibilities, social expectations, and more. They may also be living with identities that are targeted or marginalized, which adds another layer of vigilance and emotional weight. With all of this in the mix, it is not surprising that questions about anxiety, depression, and their overlap are so common.
What Do We Mean By Anxiety, And What Do We Mean By Depression, In Plain Language? How Do These Experiences Feel In The Body, Thoughts, Emotions, And Behavior?
Anxiety, in its most basic form, is a normal human response to stress. According to the American Psychiatric Association, it can even be useful in some situations, helping us focus on a test, prepare for a presentation, or stay alert when something important is at stake. It becomes something different when the worry is more intense, more persistent, and harder to turn down, and when it starts to interfere with daily life rather than helping us move through it.
The Diagnostic and Statistical Manual (DSM-5) describes one of the most well-known anxiety conditions, generalized anxiety disorder, as persistent and excessive worry about several areas of life that shows up more days than not for at least six months. The person finds it very hard to control the worry. The anxiety is comprised of a cluster of symptoms such as feeling restless or keyed up, getting tired easily, having trouble concentrating or noticing that the mind goes blank, feeling irritable, carrying tension in the body, and struggling with sleep. To qualify as a disorder, these experiences need to cause meaningful distress or make it harder to function at work, at school, in relationships, or in day-to-day life, and they cannot be better explained by substances, a medical condition, or another mental health condition with a similar picture.
In plain language, people with anxiety experience a mind that is constantly active, replaying past events, imagining future problems, or rehearsing conversations. Even when nothing urgent is happening, they may sense their body is tense and on high alert. Their nervous system focuses on “what if” scenarios, even when they realize their worries may be exaggerated.
Depression is part of a different cluster of conditions, commonly called mood disorders. The DSM-5 groups several diagnoses together under depressive disorders. What they share is a mood that is consistently lower, sadder, more empty, or more irritable than usual, along with changes in the body and in thinking that significantly affect how a person is able to function. During a depressive episode, someone experiences a depressed mood or a loss of interest and pleasure in activities most of the day, nearly every day, for at least two weeks. Other symptoms can include difficulty concentrating, feelings of guilt or low self-worth, hopelessness about the future, thoughts about death or suicide, disrupted sleep, changes in appetite or weight, and feeling very tired or low on energy.
These mood episodes differ from the normal ups and downs of life. They last longer and make it noticeably harder to keep up with what life is asking of them. Depression can interfere with work and school, make relationships feel distant or strained, and change how someone feels about themselves and their future. Episodes can be mild, moderate, or severe. For some people, there is a single episode that eventually resolves. For many others, episodes recur, sometimes with long stretches in between or sometimes in a more chronic way.
Anxiety and depression share a lot of symptoms. Both can change sleep, appetite, energy, and concentration. Both can involve self-criticism, a feeling that something is wrong, and a pull to withdraw. From the outside, cancelling plans because you feel overwhelmed by worry and cancelling because you feel numb or hopeless can look very similar. In research, both anxiety and depressive disorders are placed under a broader “internalizing” umbrella, meaning that the distress is more often turned inward as fear, guilt, or sadness than expressed outward as aggression.
There are still meaningful differences in how they tend to feel. Anxiety leans more toward a body that feels tense and toward future thinking. Depression leans more toward a body that feels slowed or weighed down and a mind that has trouble imagining that things could feel better. Anhedonia, the loss of pleasure and low positive affect, is a symptom that is most closely associated with depression, and physiological hyperarousal and intense fear are most closely associated with anxiety. Many people who search for “anxiety vs depression symptoms” are really trying to understand how these pieces are showing up together in their own lives.
It is also worth noting how common these experiences are. Globally, anxiety disorders are estimated to affect around 4 to 5 percent of adults in a given year, and depressive disorders around 5 to 6 percent. In the United States, about one in three adults will meet criteria for an anxiety disorder at some point in their lives, and roughly one in five will meet criteria for major depressive disorder. In U.S. data, anxiety disorders are the most common diagnosable mental health condition, and depressive disorders are also highly prevalent.
How Often Do Anxiety And Depression Co-Occur, And How Can Someone Start To Recognize Their Own Mix?
It’s normal to wonder, “Can you have anxiety and depression at the same time?” or “Do I have anxiety or depression?” Research shows that it’s possible to experience both conditions together, and that this overlap actually happens quite frequently.
Co-occurrence is not a rare exception. Across large community studies, roughly half of people who meet criteria for major depression also meet criteria for at least one anxiety disorder either at the same time or at another point in their life. Conversely, a similar proportion of people with an anxiety disorder will also experience a depressive episode at some point. When researchers follow people over time, they see that anxiety and depression act as risk factors for one another. Higher anxiety now predicts more depression later, and higher depression now predicts more anxiety later, with almost equal strength.
Anxiety and depression together looks like feeling on edge and worn out at the same time. Sleep may be hard to come by because your mind is racing, and then the next day you have no energy to engage. You might want life to change but feel too overwhelmed and deflated to take steps. You may care deeply about your relationships, your work, or the world, but feel strangely unable to show up the way you want. It is common to worry constantly about letting people down while also feeling detached from the things that used to matter.
Studies that look at quality of life show that people with both anxiety and depression tend to have more limitations in work, school, caregiving, and social life than people with just one of these conditions. The impact shows up in physical health, in roles and responsibilities, and in the basic sense that life feels worth engaging in.
What Is The Real Difference Between Depression And Anxiety?
Part of why people get stuck on questions like “Which is worse, anxiety or depression,” or “What is the real difference between depression and anxiety,” is that they share so many features. Both can change how you sleep and eat, make it harder to concentrate, and leave you with a painful sense that something is off inside and that you cannot quite reach the version of yourself you want to be.
Some people experience mostly anxiety or mostly depression, while others clearly meet criteria for both. And while studies of mental conditions can help us understand how anxiety and depression uniquely present themselves, there is not always a clear way to draw the line between them. What can be helpful to look at is how different parts of your experience tend to move together. One way to start is by paying attention to how these three kinds of symptoms tend to show up: general distress, anxious arousal and apprehension, and anhedonia or low positive affect.
General distress is the kind of emotional pain that tends to show up in both anxiety and depression: sadness, tension, irritability, guilt, and feeling emotionally overloaded. Anxious arousal and apprehension is more typically associated with anxiety and shows up when your body and mind are on alert: a racing heart, tight muscles, restlessness, and racing thoughts about what might go wrong. Anhedonia and low positive affect are more typically associated with depression and are about a loss of joy and energy: feeling emotionally flat, disconnected from things that used to matter, and unable to feel pleasure even if, on paper, things are going well.
If general distress is high and the loudest part of your experience is the body alarm, but you still have some access to enjoyment and motivation, you may be dealing with anxiety that comes with some low mood. If general distress is high and the loss of pleasure and energy feels central, but your body does not feel especially revved up, you may be dealing with depression that includes some worry. When all three aspects are present for a long stretch of time, and your quality of life has dropped in several areas, research suggests you are more likely dealing with a mix of anxiety and depression, rather than one condition that has symptoms of the other.
It can be valuable to pay attention to how your symptoms change over time. Some people notice that anxiety flares up first, followed by a heavier mood as the body and mind recover from being on high alert. Others experience a steady low mood, punctuated by bursts of fear or physical tension when new stressors arise. Symptoms like sleep problems, fatigue, irritability, and constant rumination usually overlap, fueling both anxiety and depression. Studies tracking people’s mood and anxiety day by day show that everyone has their own unique pattern, making self-observation especially helpful. Paying attention to how you feel and function over time can give you information about what might be happening and what kinds of support or tools are most helpful when these experiences show up.
It is important to note that reading about these patterns is not the same as getting a thoughtful evaluation with a mental health professional. Instead, you can use this as an invitation to pay attention to how anxiety and depression might both be showing up for you, so you can more effectively find what helps you feel more grounded and better understand what is going on for you specifically.
What Keeps The Two Conditions Feeding Into Each Other?
If you’ve lived with anxiety and depression at the same time, you might wonder why it feels so intense and so hard to shift. Part of the answer lives in the body. Research on our main stress hormone, cortisol, shows that when anxiety is high on its own, the stress system has a stronger rhythm and the body is on full alert and ready to react. When depression is present, that daily rise and fall becomes flatter, and the system is more tired and slow to respond. When both anxiety and depression are happening together, the rhythm can become disrupted altogether, so it does not swing up and down in a clear way. Researchers see this as a sign that the stress system is being pulled in two directions at once. In daily life, this can feel like never really recovering from stress, being too tired to function but too wired to truly rest, and finding that even small demands feel enormous.
Our habits and life situations matter, too. Studies show that anxiety and depression can make life feel harder, and that a lower quality of life can also make symptoms worse. For many people, life already feels difficult before anxiety or depression fully sets in, because of things like stress, health problems, or ongoing personal challenges. As symptoms worsen, quality of life usually drops too. People may lose jobs, pull back from relationships, or stop doing things they enjoy. Even when symptoms improve, life doesn’t always return to how it was before, especially if anxiety and depression have been present for a long time. This lower quality of life can then make future episodes more likely. One study found that people with a lower quality of life were more likely to develop both anxiety and depression at the same time, not just one or the other.
You can see how this might play out slowly, over time. Someone with long-standing anxiety might avoid social situations, pass up new opportunities, or stick only to places that feel safe. Consequently, their world becomes smaller over time, which can lead to feelings of hopelessness and depression. On the other hand, someone experiencing depression may pull away from relationships and activities because everything feels too heavy or overwhelming. As their lives grow smaller and feel less meaningful, worries about the future, money, relationships, and self-worth can begin to arise.
Research also shows that a sensitive nervous system, early adversity, unhelpful parenting, trauma, and ongoing stress are common risk factors for both anxiety and depression. Many people first show anxiety in childhood or adolescence, then develop depression later, and the reverse path is also seen. Once both are present, studies suggest that they repeatedly increase each other’s likelihood over time.
Given How Complex And Challenging These Diagnoses Can Be, What Are Some Compassionate Ways To Check In And Offer Support Without Adding Pressure Or Trying To Fix Things? What Boundaries Protect Both The Supporter And The Relationship?
If someone you care about is experiencing both anxiety and depression, it can be deeply difficult to witness their struggle and not know how to help. It’s easy to feel powerless, or to find yourself alternating between offering advice and pulling back. Many people search for “how to help someone with anxiety” or “how to support a loved one with depression” and end up with recommendations that don’t always feel tangible or applicable. While research isn’t perfect, it does offer insights that align with what many people already know in their gut.
Support tends to feel most helpful when it shows up as companionship rather than control. Studies on people living with serious mental health conditions suggest that what makes a difference is feeling listened to, taken seriously, and invited into choices, rather than being directed or managed. In day-to-day life, that might mean checking in about how someone has been feeling in their body and in their days, then letting them decide whether they want to talk, have quiet company, or do something small together.
Validation is another core piece. Research and clinical guidance are clear that minimising, cheerleading, or pushing quick fixes increases feelings of shame and loneliness. People tend to feel more supported when someone acknowledges that what they are going through is heavy, and that their exhaustion, fear, or hopelessness makes sense given what they are carrying.
Loved ones play an important role in gently opening the door to care without becoming a crutch. A helpful middle ground is noticing and naming changes you see, framing anxiety and depression as health conditions that deserve support, and offering help with practical steps like finding a provider or getting to an appointment, while still respecting the pace they are comfortable with. The aim is to walk alongside someone as they consider help, not to push them into it.
Boundaries protect both people. Research on “expressed emotion” and “family accommodation” shows that when everything begins to revolve around symptoms, and when support turns into constant monitoring, criticism, or doing every hard thing for the other person, distress and relapse tend to increase for everyone involved. Clear, compassionate limits, like being honest about what you can and cannot offer, helping with some tasks but not all of them, and allowing parts of life that are not organized around the illness, are associated with better long-term outcomes and more sustainable relationships.
Finally, the research on caregivers reminds us that supporters need support too. Psychoeducation and mindfulness-based programs for family members help people feel more grounded and less self-critical in their roles. In practice, this might mean having your own therapist, leaning on trusted friends, or joining a group for relatives.
What Are Some Tools For Helping Out With Anxiety And/Or Depression? How Do You Move Forward?
Tracking Symptoms
One place to begin is by tracking your symptoms. Noticing patterns in sleep, appetite, movement, social contact, and how your mood and anxiety rise and fall through the day can help you see your particular mix more clearly. It could be helpful to keep a journal on your phone or to use an app to track your mood. Over time, you may notice certain situations, times of day, or thought patterns that consistently stir both worry and heaviness.
Strengthening the Basics
From there, it can help to focus on a few basics, like getting a more consistent sleep schedule, making sure you’re tending to your sleep and that you’re eating well, and finding ways to reduce your overall stress load whenever possible. Alongside these foundations, try to gently rebuild or protect small pockets of activity and connection throughout your day, without judging yourself.
For depression, one helpful strategy is called behavioral activation: choosing one or two manageable actions that move you toward something meaningful, even when you do not feel motivated. For anxiety, approaching rather than avoiding certain situations in small, planned steps can help your nervous system learn that you can survive feeling activated without needing to escape every time.
Emotional Regulation Tools
When you’re living with both anxiety and depression, having some go-to strategies for managing intense moments can make a real difference. The tricky part is that what helps with anxiety doesn’t always help with depression, and vice versa. Learning to recognize which tool to reach for depending on what’s loudest in your system takes some practice.
For When You’re Feeling Anxious:
-When your body is revved up, heart racing, muscles tight, and thoughts spinning into worst-case scenarios, the goal is to bring your nervous system down a notch. Breathing techniques work here because they directly communicate safety to your body.
-Try the 4-7-8 breath: breathe in through your nose for a count of four, hold for seven, then exhale slowly through your mouth for eight. The long exhale is key. It activates your parasympathetic nervous system, which is responsible for calming you down. You can do this sitting at your desk, in your car, or lying in bed when sleep won’t come.
-Box breathing is another option: inhale for four counts, hold for four, exhale for four, hold for four, and repeat. Some people find the predictability of the pattern soothing in itself.
-Grounding exercises can also interrupt the spiral. The 5-4-3-2-1 technique asks you to name five things you can see, four you can hear, three you can touch, two you can smell, and one you can taste. It pulls your attention back into the present moment and out of the future scenarios your mind is constructing.
For When You’re Feeling Depressed:
-When depression is the louder voice, and everything feels flat, slowed down, or meaningless, different tools tend to be more helpful. The goal here is less about calming down and more about gently activating or reconnecting.
-Movement, even small movement, can shift things. This doesn’t mean forcing yourself to go to the gym. It might look like standing up and stretching for two minutes, walking to get the mail, or putting on a song and moving your body however it wants to move. Depression tells you that nothing will help and nothing matters, but sometimes the body has information the mind doesn’t have access to yet.
-Sensory experiences that are pleasurable or grounding can also help: a hot shower, wrapping yourself in a soft blanket, lighting a candle, or making yourself a cup of tea. These small acts of care can feel almost radical when depression is telling you that you don’t deserve them or that they won’t make a difference.
When Both Are Present:
-When anxiety and depression are both loud, you might need to experiment. Sometimes you’ll need to calm the anxiety first before you can access any motivation or pleasure. Other times, a small bit of activation through movement or social contact can ease both the heaviness and the worry.
-Journaling can be helpful here. It gives the looping thoughts and worries a place to land so they’re not just cycling in your head. You don’t need to write anything profound. Sometimes it’s just listing what happened that day, what felt hard, or what you’re worried about. Getting it out of your head and onto paper (or a notes app) can create a little bit of distance from it.
-It’s worth paying attention to which tools you already reach for, which ones you’ve let go of, and which ones you’re curious to try. There’s no one-size-fits-all approach, and what works can shift depending on where you are in your experience with anxiety and depression.
Social Support
Anxiety and depression both encourage withdrawal. Making room for a few relationships where you can be honest about how you are doing, and letting others walk alongside you while you seek support or try new tools, can make the path less isolating. Because both anxiety and depression can be recurrent, it can help to think in terms of ongoing care. That might mean returning to basic routines and supports when you notice early warning signs, or staying connected to a therapist or prescriber over time.
Therapy
Cognitive behavioral therapies and related approaches have strong evidence for both anxiety and depression and have been shown to improve quality of life when people are able to stay with them. Antidepressants like SSRIs and SNRIs are commonly used medications for both anxiety and depressive disorders and can lower the intensity of symptoms enough that other tools feel more accessible. For some people with very severe or treatment-resistant depression, more intensive options like ECT or other neuromodulation treatments can be life-saving and are grounded in strong evidence.
When To Reach Out For Professional Support
If you’ve been reading this and recognizing yourself in these descriptions, or if you’ve been trying to manage on your own and finding that it’s not enough, that’s important information. There’s no specific threshold you need to meet before reaching out for help. You don’t need to wait until things are unbearable.
Some signs that it might be time to connect with a therapist: your symptoms are interfering with work, school, relationships, or daily responsibilities in ways that feel unsustainable. You’re noticing patterns that keep repeating despite your best efforts to shift them. The tools you’ve tried on your own aren’t making enough of a difference. You’re having thoughts about harming yourself or ending your life. You’re curious about what therapy might offer, even if you’re not sure you “need” it yet.
Here in Los Angeles and throughout California, we work with people at all stages of recognizing and managing anxiety and depression. Some folks come to us knowing exactly what they’re dealing with and what they need. Others arrive confused, exhausted, and just knowing that something needs to change. Both are completely valid starting points.
Our practice specializes in helping people untangle the complicated relationship between anxiety and depression, whether you’re dealing with one, both, or aren’t quite sure yet. We offer individual therapy, couples counseling, and family therapy options, and we can also connect you with other resources in the Los Angeles area if we’re not the right fit.
If you’re ready to take that step, or even if you’re just curious about what therapy might look like for you, we’d be glad to talk with you. You can reach out through our website to schedule a free consultation call. We’ll take the time to understand what you’re experiencing and help you figure out what kind of support makes sense for where you are right now.
You don’t have to have it all figured out before you reach out. That’s part of what we’re here for.