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Coping with Anxiety and Phobi... Health Article

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Links to depression

Two-thirds of people with anxiety disorders also suffer from depression at some point in their lives, and 58% of people with depression also have an anxiety disorder. The anxiety/depression combination is so common that many mental health experts now consider it a distinct disorder, known as mixed anxiety-depressive disorder (MADD) or cothymia. The presence of depression in patients with anxiety disorders increases the severity of both illnesses, the likelihood of alcohol or substance abuse, and the risk of suicide, and it also reduces the chances that treatment will succeed.

In other cases, people may have one of these disorders first, recover from it, and then develop the other. Anxiety can also be a symptom of depressive disorders, and depression can be a symptom of anxiety disorders.

Anxiety and depression are much more closely linked than was once thought. Many scientists now believe that anxiety and depression are different expressions of a single, shared underlying biological problem. They point out, for example, that the same kinds of abnormalities in neurotransmitters (brain chemicals) that promote depression can also trigger anxiety. The brain structures that react to perceived threats are hypersensitive in some people with depression, as well as in some with anxiety disorders. Women are more likely than men to be diagnosed with MADD. Other risk factors include difficulties at school, early separation from a parent, having a parent with a history of mental illness, and financial problems. Given the similarity of the two conditions, it's no surprise that most of the medications used to treat anxiety are antidepressants.

What if you are just plain worried?

Not everyone who suffers from frequent worry has an anxiety disorder. Perhaps you are one of the many "worried well." If you don't have an anxiety disorder but think you worry too much, the following advice may help you lighten up.

Practice relaxation techniques. Listen to music or to relaxation recordings to take your mind off whatever is worrying you. Progressive muscle relaxation, a technique in which you relax one set of muscles at a time, can also relieve tension.

Exercise regularly. Studies have found that exercise improves mood and modestly decreases anxiety symptoms. The type of exercise is less important than its frequency. Exercise regularly; aim for at least 30 minutes of moderate activity on all or most days (see "Exercise").

Consider biofeedback. If the techniques mentioned above don't do the trick, biofeedback may help. Biofeedback helps you become more aware of your body's responses to stress and teaches you to control them using relaxation and cognitive techniques. A clinician who is experienced in biofeedback can help you do this by measuring specific body functions, such as heartbeat, and feeding them back to you in the form of sound or light (see "Biofeedback").

What causes anxiety?

Many people assume that anxiety arises from a traumatic event or overwhelming stress. It's true that experiences such as the death of a parent during childhood or another early trauma can play a significant role, but these kinds of events aren't always at the root of the problem. Not everyone who has lived through a tragedy or terrifying occurrence develops an anxiety disorder, and not everyone who develops an anxiety disorder has endured such an ordeal. Research suggests that anxiety is partly genetic. Certain genetic variations may cause imbalances in brain chemistry that can predispose someone to anxiety. The biological tendency toward anxiety may be latent for years until an exceptionally stressful event triggers its expression. Personality factors may also play a role.