How do we tell the difference between Anxiety and Depression?

I found this intriguing question raised on a Google alert, wondering what the answer would be I decided to take a look. The answers came from an article on referring to a recent book by Doctor Michael A Tompkins, a psychologist at the San Francisco Bay area Centre for Cognitive Therapy, entitled "Anxiety and Avoidance."


 Also quoted in the article is Beverley B Flaxington author of “Self Talk for a Calmer You.”


 I thought that I would look at the four areas mentioned from my own understanding of anxiety and my knowledge of depression. Before we do it is worth noting that the development of both disorders is not fully understood, there are potential links with genetic background and predisposition to the conditions; environment is also thought to have major influence.

It is also quite common for anxiety to lead to depresssion and for the two conditions to exist simultaniously.




 Focusing on the past versus fearing the future.


Depressed people tend to have an inward focus that is negative and can have a tendency to mull over past problems and encounters. Anxiety is caused by setting the “fight flight” response in action when considering future possibilities, for instance an up and coming social occasion may well cause a lot of consideration and worry about others judgements.


 Active versus passive


 Anxious people are very active mentally, constantly going through the "what if" process; worrying about what will happen. In this state people have great difficulty calming the mind as the whole system is aroused. The body is alert and will react excessively to sudden noise and other shocks.  On the other hand depression is a low state of mind, arousal is down and the focus is internal but passive. The body expresses the internal feelings by looking burdened with slow movements.


  Withdrawal versus avoidance


 A depressed person has negative feelings about themselves and the world around them. He/she may well feel worthless, tired and have trouble focusing on tasks due to lack of motivation. Consequent withdrawal from the social world and self-harm is not uncommon. Those troubled by anxiousness, what was called "nerves," find themselves avoiding situations which are potentially threatening. These will include places and situations that could cause discomfort such as the fear of being judged or even places similar to where panic attacks have taken place.


  Physical symptoms


 As the person who fears the world is often in a state of arousal there is tension in the body often with tingling sensations in the skin. Sometimes there are chest pains, which can lead to false fears of heart problems. Other pains without physical cause are also a focus of worry. Small lesions on the hands and feet that also have no apparent physical cause are not uncommon. Tension in the neck and shoulders often produce headaches. Irritable bowel syndrome often accompanies anxieties as can hyperactivity.


 Depressed people have little energy and drive plus they show little interest in things previously enjoyed. Consequently it's easy to recognise these people by their slow physical and mental states. Sleepiness during the day is also prevalent.


Both conditions can have disrupted sleep patterns, the anxious often through repeated thoughts whilst those in low states are troubled by various disturbances.


  My Conclusion


 My own answer to the question at the start of this brief article is that it is possible to separate the symptoms of the two conditions when they exist on their own. Both conditions simultaneously (comorbidity) are obviously less clear, precise questioning from the practitioner should establish the two components of the clients concern.




Ian Bracegirdle






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