This sad, hopeless feeling just can't go on. It's affecting your job, your
life. It seems like depression. But could it be
Many people with depression also experience some degree of anxiety - anxiety that goes
beyond the typical tension we experience when we face life's challenges. For
people with an anxiety disorder, the overwhelming worry and fear is constant -
with obsessive thoughts, feelings of panic, trouble sleeping, heart
palpitations, cold or sweaty hands.
A person with obsessive-compulsive disorder (or OCD) may experience:
Concern about contamination or serious illness
Too much concern with keeping everything arranged in an exact way
Intrusive thoughts or horrible mental images
Sexual or religious thoughts felt to be unacceptable
Excessive fear of your house burning or flooding, of causing a car wreck, of spreading an illness, of losing something, of being responsible for another person getting hurt
Fear of harming another person...
"Very often, we find that people have more than one condition -- both
depression and anxiety disorder," says Charles Goodstein, MD a professor of
psychiatry at New York University School of Medicine, with a clinical practice
in Tenafly, N.J. "As a matter of fact, it's very hard to find patients who are
depressed who don't also have anxiety. It's equally hard to find people with
anxiety who don't have some depression."
Mood Disorders Similar to Depression
Indeed, sadness, depression, and anxiety are often triggered by life events
- and the symptoms are not easily separated
out, says Andrea Fagiolini, MD, a psychiatrist and medical director of the Bipolar Center at the University
of Pittsburgh School of Medicine.
"We see this very frequently," he tells WebMD. "Financial, relationship, and
family problems - all these can trigger anxiety and sadness, so we consider
these feelings to be normal. They are not normal when the feelings are
extremely intense, when they impair everyday functioning, affect quality of
life. When all that is happening, it becomes difficult to solve the very
problems that started the depression."
In addition to anxiety and depression, there might be something else going
on -- bipolar disorder. This is a condition that involves shifts in a person's
mood from severe depression to manic phases - with soaring highs, restlessness,
difficulty concentrating, racing thoughts, impulsive decisions, reckless
behavior, and poor judgment. In many cases there is normal mood in between the
Antidepressant Not Always Best
Because of the difficulty in diagnosing these mood disorders, it's important
to talk to your doctor candidly about what you've been feeling. It's also
crucial that your doctor take time to ask enough questions, Goodstein adds.
"Many people go to a general practitioner first. They've been feeling depressed
and think they may need an antidepressant. But if that
doctor is very busy, he or she can't do much evaluation."
Under those circumstances, an antidepressant is often prescribed - yet that
may or may not be the right choice. "Antidepressants are used to treat both
anxiety disorders and depression. However, someone with bipolar disorder needs
a different set of drugs -- a mood stabilizer and
antimanic medication," Fagiolini tells WebMD. There are several types of
mood-stabilizing drugs, which include medications like lithium and
anticonvulsive drugs such as Depakote or Lamictal.
The danger: "Giving an antidepressant to someone with bipolar disorder could
trigger a manic episode," he explains. "Manic episodes can be dangerous,
because you have very poor judgment, tend to use more drugs, drive recklessly,
spend a lot of money, have much more sex - and have it completely unprotected.
There's a higher risk of high-risk behaviors because there is poor