Ms. Smith is a new patient who came to see me for a diagnostic evaluation and psychopharmacological treatment. Her presenting complaint was “I have always been an anxious person, but recently my anxiety has been out of control!”
Currently this has been the chief complaint I hear in my practice, as pandemic restrictions continue to isolate people and cause increased feelings of depression and anxiety.
To evaluate Ms. Smith’s symptoms, we must first consider her specific circumstances (known as “precipitants”). Has she recently experienced the loss of a family member, friend, pet? Is she currently navigating increased economic problems, moving of a household, marriage or divorce, major change in life circumstances?
Then we need to keep in mind this diagram, which I usually sketch in the air for my patients. Notice the left circle represents symptoms of depressive disorders and the right circle lists those of anxiety disorders.
However, if the circles are conceptualized as a Venn diagram, there is a large overlapping area that contains symptoms common to BOTH depressive and anxiety disorders!
Bottom line: you can be equally anxious with either a depression or an anxiety disorder. It is the sadness, suicidality, anhedonia (loss of interest or pleasure in things), decreased self-esteem, fatigue, and changes in sleep or appetite that identify your illness as depression. Similarly, it is the sweating, palpitations, having a sense of impending doom (“I will either die or go crazy if I don’t get out of here”), shaking, and feelings of powerlessness that identify your illness as one of the anxiety disorders. Restlessness, trouble with thinking and/or concentrating, worrying, somatic (body) complaints, and agitation are symptoms that are common to both depression and the anxiety disorders.
And just to make it more complicated, you may have both depression and an anxiety disorder, which, luckily, are generally treatable by the same anti-depressant!
This was the case for Ms. Smith, who initially reported a primary symptom of anxiety, but upon evaluation, met criteria for depression as well. She has achieved full remission of all depression and anxiety symptoms after treatment with the correct antidepressant.
Even with the pandemic highlighting the importance of mental health, there remains a stigma associated with depressive disorders (often more so than with anxiety). At Psychiatric Associates of Southern CT, our focus is on getting each individual patient back to feeling better. We use a multimodal approach to treat depressive disorders, anxiety disorders, mood disorders and other psychiatric illnesses.
Find out how we treat anxiety and depression at our offices in Westport and Milford Connecticut. Please feel free to contact us if you’d like to learn more about Psychiatric Associates of Southern Connecticut.
If you feel suicidal, please call 911. If you have been exposed to COVID please consult CDC guidelines.