Do I Have a Combination of Anxiety and Depression?
Although in the DSM5, Psychologists and Psychiatrists consider that Anxiety and Depression are 2 very different conditions, in actuality, we find that many people are suffering from a combination of both of these. And even when we notice that there is a combination, there are many variations on the types of combinations.
A US Psychologist, Margaret Wehrenberg, has identified 7 different combinations. If you feel that you are both anxious and depressed at times, perhaps you can see what type of combination might best describe you:
1. Low Energy
This combination is the closest to pure depression.
Here is a checklist of the main characteristics:
o Lethargy. You may continue to work but you complain about fatigue even when you exert yourself very little, and you spend many nonworking hours napping, lying around, watching TV, or not doing very much.
o Oversleeping. Sleep may be excessive and you don’t feel refreshed after it.
o Loss of interest. You tend not to have many hobbies.
o Not much involvement with others (though not necessarily isolation). You may keep up your required family activities or maintain minimal contact with your friends, but you very rarely initiate any contact with them.
o Rarely answer your phone or return messages.
o Overeating. You may be overweight, as eating is one of the few pleasures you have.
o Rumination. You often feel anxious and preoccupied with what will happen, what has gone wrong, what to do, and what cannot be changed.
2. Anxious & Hopeless
You feel sad, negative and worried, and hopeless to be able to change.
Here are the main characteristics:
o Persistent worry. You notice your anxiety more than your depression, because your worry about everyday life situations doesn’t seem to go away, no matter what you do.
o Hopeless attitude and negative expectations. You may hold some small hope that things could improve, but your overall view of life is pessimistic and you don’t expect your efforts to make a difference.
o Sense of duty or heightened responsibility. You meet your work responsibilities and perform with strong sense of duty, but you are rarely enthusiastic or energetic.
o Restrained anger. You tend not to express your anger openly and may be passive aggressive if you are afraid of losing a relationship if you were to speak up.
o External locus of control. You are moody and worried about choices you make, but you perceive that most decisions are made because of other people’s needs.
o Difficulty describing the quality of one’s overall emotional and physical state. You have trouble describing what emotions you feel, other than to know you’re feeling “bad”.
3. Panicky & Depressed
You feel panicky, but may not be aware that you are also depressed.
The following checklist indicates the main characteristics:
o Mild to moderate depression symptoms. You may not be aware that you are depressed.
o Passive personality. This may mask your depression as you are naturally less socially involved and talk less about emotions than the average person.
o Introversion. Even though you may be socially capable, you get exhausted by too much “other people time” and by work meetings.
o Panic attacks are initially triggered in you by unexpected situational stress. The first panic attack usually occurs in the wake of a sudden loss, a difficult situation at work, or an unexpected health problem.
o Panic following overreaction to stress. This leads you to bad decisions about life problems and hasty reactions while panicky.
o Less participation in previously enjoyed activities to avoid panic. You usually initially withdraw from life to avoid panic, so then you have fewer fun and joyful experiences, which leads to you feeling depressed.
o Difficulty accomplishing work or personal goals due to panic. You may have begun to avoid situations that might cause panic, which interferes with your work and personal life.
o Pessimism. You feel negative about how things will turn out, and about being able to overcome your anxiety and stress.
4. Worried & Exhausted
You try to keep up with daily living requirements but are increasingly fearful of failing to perform in the future. You feel stressed and overtaxed.
Here’s the checklist which indicates the main characteristics:
- “Stressed out” emotionally and physically.
- Persistent, ruminative worry about many things.
- Ability to manage real and immediate problems without worry. You actually can manage problems when you put your mind to it.
- Insufficient or nonrestorative sleep.
- Extensive efforts to solve problems: You are highly responsible in general, and will increase your work to solve problems, which often worsens your exhaustion.
- Rigid approaches to problem-solving. You can get stuck in thinking and deciding what actions need to be taken, often feeling like you are the only person who can do the job.
- Poor problem-solving for anxiety and depression, but otherwise a good trouble shooter.
- Blindness to the severity of the situation. You can just soldier on, and not perceive the problem to be as extreme as it actually is.
5. Quiet Avoider
You have been born with a shy and sensitive temperament. Although you might look like a LOW ENERGY person, it is social anxiety that dominates your life.
The following checklist indicates the main characteristics:
o Social anxiety or separation anxiety. These show up early in life and dominate your experiences.
O Low tolerance for sensations of anxiety. Feeling anxious feels very uncomfortable for me.
o Somber, passive temperament. Nothing gives you a “kick out of life” and this makes you feel depressed.
o Persistent depression, periodic anxiety. Your depression feels like it is unremitting, but your anxiety may come and go.
o Avoidance of opportunities to advance or fulfill potential. Your social anxiety deters you from taking the risks involved in to pursue opportunities to reach your full potential.
o Social reluctance in unfamiliar situations. You may have warm relationships with your family and close friends but withdraw from social interaction in unfamiliar situations.
o Dependence on loved ones. You may feel dependent on your parent, partner, or close friend for help in leaving your comfort zone.
o Introversion. Even if you are socially competent, you are introverted.
o Need for “ down time.” You usually need time to recharge after being in high-stimulation environments or engaged with people for long periods of time.
6. High Energy & Depressed
You have a high activity level and often feel anxious, but don’t feel your depression.
Here is the checklist:
o High anxiety when your activity level is interrupted. You attempt at all times to keep yourself busy, and in cases when you can’t, you will start to feel anxious.
o Lifestyle marked by high levels of activity and productivity. You cope with your stress by being always on the go and getting things done. It is very difficult to stop and relax.
o History of trauma. You may have suffered one or more past traumas.
o Tension-related physical problems. Your anxiety may manifest as headache, muscle pain, stomach or digestive problems, or insomnia.
o Perfectionism. You have a strong fear of making mistakes or not doing things exceedingly well, and this drives most of your anxiety.
o Rumination. There is a strong ruminative quality to your anxiety.
o Underlying negative emotional states. You often don’t really notice these while you are keeping yourself very busy.
o Underlying depression. This is masked by your energy and shows up mostly in pessimism about life.
7. High Anxiety
Your high anxiety is unremitting, significantly impairing the quality of your life. The longer it persists, the more likely it is to create a state of depression.
The following checklist shows you the main characteristics:
o Dread felt in the gut. You physically feel a persistent state of anxiety in your gut.
o “Serial” worrying. You actively looks for external “causes” of your anxiety and attempt to eliminate them, only to find that the anxiety returns.
o Worsening anxiety. Good days without anxiety become less frequent over time.
o Absence of pleasure and joy in life. This is not because you are not capable of feeling pleasure or joy, but rather because your high anxiety interferes with experiencing these feelings.
o Depression resulting from anxiety. Your anxiety eventually leads to depression.
o High-level functioning. You typically continue to perform work functions well.
o Tendency to be controlling and critical of others. You may try to allay your anxiety by pushing your ideas about how to behave or do work onto other people.
o Tendency to be excessively apologetic. In addition to (or instead of) being controlling and critical, you may be excessively apologetic as you frets over whether things are being done correctly.
o Feelings of “absence.” Because of the anxiety, you may be unable to feel engaged in the present.
o Increased anxiety during significant life transitions. It is harder for you to adjust to new life circumstances that the average person.
o Irritability, impatience, and strained relationships. You find yourself becoming easily irritable and impatient with things and other people.
If you find that any of these combinations feels like you, we at Hart Psychologists can help. We have Psychologists Australia wide, so one is near you. Please ring our friendly receptionists and we'll help you find the best Psychologist for you. Phone 1300830552.