The Overlap Between Anxiety & Depression: Why It’s Not Always One or the Other

Introduction

Anxiety and depression are two familiar terms in mental health, but in real life they often intertwine. Many individuals find themselves both persistently worried and profoundly sad, a combination that can be confusing and distressing. You might wake up with a heavy sense of hopelessness (a classic sign of depression) yet also feel constantly on edge with racing thoughts (hallmarks of anxiety). As a result, people often wonder: am I anxious, depressed, or both? In clinical experience, the answer is frequently both. Anxiety and depression commonly overlap, and it is not always easy to disentangle one from the other.

This blog clarifies the differences between these conditions, explores their common ground, and discusses how co-occurring anxiety-depression is assessed and managed. The aim is to inform and reassure readers that with the right support, even complex mental health challenges can be understood and effectively treated.

Anxiety vs. Depression: Understanding the Difference

Anxiety and depression are distinct diagnoses, each with its own features. Anxiety is not just worry, it is a cluster of disorders such as Generalised Anxiety Disorder, panic disorder, and social anxiety, marked by excessive fear and physical tension. People with anxiety often experience constant apprehension about potential threats or “what-ifs” beyond their control. Common symptoms include restlessness, a racing heart, muscle tension, shortness of breath, and feelings of dread or panic. The body’s fight-or-flight system is in overdrive, even in everyday situations.

Depression, on the other hand, is primarily a mood disorder. It goes far beyond normal sadness. Depression is characterised by a persistent low mood, loss of interest or pleasure in activities, and a range of emotional and physical changes. Someone with depression might feel hopeless, withdraw from social interactions, struggle with low energy, and even experience physical symptoms such as changes in sleep, appetite, and physical aches. It is not simply feeling down for a day – depression can last weeks, months, or longer if untreated and significantly impair daily functioning.

While anxiety revolves around fear of future or uncontrollable events, depression often involves pain about the present or past, manifesting as guilt, worthlessness, or a sense of emptiness. In summary, anxiety tends to be about high arousal – the mind and body racing with worry, whereas depression tends to be about low mood and slowed vitality. However, these two conditions are not mutually exclusive and frequently coexist in the same person.

Shared Symptoms and Why They Overlap

It is common for symptoms of anxiety and depression to overlap and feed into each other. Research shows that a large proportion of people do not experience just one or the other. Roughly 60% of people diagnosed with an anxiety disorder also show signs of depression, and the same is true vice versa. Anxiety and depression are among the most common mental health issues, and often they are tangled together in what patients feel.

The two disorders share common symptoms that can appear similar in daily life.

Overlapping symptoms include:

●       Sleep disturbances: insomnia, restless sleep, or oversleeping

●       Fatigue and low energy

●       Difficulty concentrating or experiencing “brain fog”

●       Irritability or restlessness

●       Physical symptoms such as headaches, muscle tension, or stomach problems

These shared symptoms can blur the line between the two diagnoses. If someone is constantly tired, unfocused, and not sleeping, it may be due to anxiety or depression – or both. One condition can also lead into the other. A person with long-term anxiety might start feeling hopeless or burned out, developing secondary depression. Conversely, someone with major depression might become anxious about their health, work, or sense of identity. In some cases, anxiety and depression form a cycle. Anxiety leads to feeling defeated and depressed, and that sense of hopelessness worsens the anxiety.

The Challenge of Co-Occurring Anxiety and Depression

When anxiety and depression occur together, it can complicate both diagnosis and treatment. Overlapping symptoms can make it difficult to identify where one condition ends and the other begins. A person might initially be treated for depression but still experience unresolved anxious panic, or be treated for anxiety while symptoms of hopelessness remain unaddressed.

Missing one part of the presentation can lead to incomplete care. Treating depression alone might not fully help someone who has underlying anxiety fueling their insomnia and tension. Likewise, focusing solely on anxiety without addressing a coexisting depressive disorder may leave the person feeling emotionally numb and unmotivated.

Having both conditions can also increase the severity of impact on one’s life. The combination of low mood and high emotional tension can be exhausting. People with both anxiety and depression often experience more significant impairment in daily functioning than those with only one diagnosis. Such presentations may require more nuanced or long-term treatment approaches.

However, these challenges can be managed with a thoughtful, individualised plan. Treating both conditions together often involves combining therapeutic approaches. For example, using cognitive behavioural strategies to manage anxious thoughts while also working on behavioural activation to support someone with depression. Certain medications may also address both sets of symptoms. The most important step is an accurate and thorough assessment to guide this process.

A Consultant-Led Approach to Assessment and Treatment

A comprehensive psychiatric assessment is key to properly identifying mixed anxiety and depression. This involves taking time to understand the individual’s symptom history, emotional patterns, physical health, and personal context. Rather than assigning a quick label, the focus is on developing a full picture.

Because anxiety and depression often co-occur, a careful evaluation is used to screen for both. For example, someone presenting with panic attacks and chronic worry would also be asked about sleep, energy, and enjoyment levels. Someone who is low in mood might be asked about physical tension or persistent fears. Any additional issues such as trauma, ADHD traits, or substance use are also explored if relevant.

Once a diagnosis is established, treatment is tailored to the individual. This may include psychiatric medication, psychological therapies, or both. Antidepressant medication can help regulate mood and anxiety. Cognitive Behavioural Therapy (CBT) or similar approaches may be used to address negative thought cycles and avoidance behaviours. Breathing techniques, behavioural activation, and lifestyle adjustments may also be incorporated depending on the person’s presentation.

Importantly, care is provided directly by senior clinicians in a private, discreet setting. Consistency of care and close follow-up make a significant difference, particularly for complex or overlapping conditions. This approach ensures clarity, reduces the risk of misdiagnosis, and improves overall outcomes.

Your Next Step: Seeking Support

If you have been experiencing symptoms of anxiety, depression, or a combination of both, it may be time to consider seeking help. A thorough psychiatric assessment at the Psyche Clinic can provide clarity, support, and direction. Recovery is possible with the right plan in place.

Appointments can be arranged either face-to-face or via secure online consultation, depending on your needs. With appropriate guidance, even longstanding or complicated symptoms can be effectively managed.

You do not have to face this alone. Support is available, and a personalised treatment plan can help restore balance and wellbeing.