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Depression: Coping With Anxiety Symptoms

Depression and anxiety often go together.
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Treating Depression and Anxiety

Different experts take different approaches to treating depression with anxiety. Some try to work out which condition is causing the major problems -- the primary condition -- and try to resolve that first. Others try to deal with both at the same time. Fortunately, many treatments are good for either individual condition. They just might be used in different ways.

Here’s a rundown of five ways to treat depression and anxiety.

  1. Antidepressants. Despite the name, these drugs aren’t just for depression anymore. “We’ve learned that a lot of the medications originally approved as antidepressants also relieve anxiety symptoms,” says David I. Sommers, PhD, Scientific Review Officer at the National Institute of Mental Health in Bethesda, Md. However, it’s key that you get the right medication. Some antidepressants have a reputation for being activating, which could worsen anxiety symptoms.
    For depression and anxiety, many doctors first turn to an SSRI antidepressant -- like Lexapro, Paxil, and Zoloft. “I think they’re some of the safest and easiest to use,” MacKinnon says. Cymbalta and Effexor -- newer antidepressants known as SNRIs -- are other first-line anxiety and depression treatments. If those medications don’t work, your doctor may try other antidepressants like the older tricyclic medications.
  2. Therapy. Although many types of talk therapy may help, the approach with the best evidence for depression and anxiety is cognitive behavioral therapy (CBT.) What is cognitive behavioral therapy? CBT is a technique that helps people identify and then change the thought and behavior patterns that add to their distress. “When you’re anxious and depressed, you’ve come to believe that the world is a much more negative and frightening place than it is,” MacKinnon says. “CBT helps expose those ways of thinking and teaches you ways to develop new ones.”
  3. Anti-anxiety medicines. Although some antidepressants can help both depression and anxiety, they take some time to work. Other drugs like benzodiazepines -- Ativan or Xanax, for example -- can quickly control the symptoms of anxiety. However, many doctors are reluctant to prescribe them in the long term because of a potential risk of abuse or addiction.
  4. Other medications. Depending on how a person responds to treatment, other medications might help. MacKinnon says that some people with depression and anxiety benefit from mood stabilizers like lithium, antipsychotic drugs, and antiepileptic drugs on top of their antidepressants. Medications that help with sleep – like the antidepressant trazodone – may allow people with anxiety to get the rest they need.
  5. Lifestyle changes. Experts stress that you can do a lot to support your treatment for depression and anxiety. Try to eat well and get enough sleep. Don’t rely on alcohol or illicit drugs. Physical activity is key, as there’s good evidence that it can help with mood and may help people bounce back from depression. Breathing exercises, muscle relaxation, and disciplines like yoga can help too.
    “Most people already know this stuff,” Sommers says. “Telling people that eating well or exercising is a good idea is often just preaching to the choir.” The key, he says, is to figure out ways of integrating better habits into your life. That’s something else that you can work on with your therapist.
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Are You Treating Your Depression?
Cymbalta
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Cymbalta is approved for the treatment of depression.

Important Safety Information About Cymbalta

Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is aknown risk of depression and some other psychiatric disorders. Call your doctor right away if you have new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.

What should I talk about with my healthcare provider?

Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.

Who should NOT take Cymbalta?

You should not take Cymbalta if:

  • You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
  • You have uncontrolled narrow-angle glaucoma (increased eye pressure)
  • You are taking Mellaril® (thioridazine)

What other important information should I discuss with my healthcare provider?

Before starting Cymbalta, talk with your healthcare provider:

  • about all of your medical conditions, including kidney or liver problems, glaucoma, diabetes, seizures, or if you have bipolar disorder. Cymbalta may worsen a type of glaucoma or the control of blood sugar in some patients with diabetes
  • about your alcohol use
  • if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life-threatening condition
  • if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
  • if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant

While taking Cymbalta, talk with your healthcare provider:

  • if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
  • if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
  • before stopping Cymbalta or changing your dose
  • if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose.
  • about your blood pressure. Cymbalta can increase your blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
  • if you experience headache, weakness, confusion, problems concentrating, memory problems, or feel unsteady while taking Cymbalta which may be signs of low sodium levels
  • if you develop problems with urine flow

If you have any questions, talk to your healthcare provider before taking Cymbalta.

What are the possible side effects of Cymbalta?

In clinical studies of depression, the most common side effect of Cymbalta was nausea. Other common side effects included dry mouth, constipation, decreased appetite, fatigue, sleepiness, and increased sweating. This is not a complete list of side effects.

Other safety information about Cymbalta:

Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you should not drive a car or operate hazardous machinery.

See Prescribing Information for additional Important Safety Information, including Boxed Warning.

Safety Information and Boxed Warning | Prescribing Information | Medication Guide
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