Learn about the symptoms and causes of anxiety and depression and explore treatment options such as anxiety and depression medications.
Anxiety and depression are two of the most commonly occurring mental health disorders. Depression is not just having a bad day; it is a constant feeling of sadness for an extended period of time that interferes with normal everyday functions. Approximately one in six American adults will have depression in their lifetime.1
Nearly half of people who are diagnosed with depression also have an anxiety disorder or vice versa. Anxiety is a highly treatable disorder that can result from a combination of a wide variety of factors, such as genetics, age, past trauma, and other medical conditions. Approximately 19.1% of the adult population in the US struggles with some type of anxiety disorder.2
While there are many types of anxiety disorders, they are typically characterized by symptoms of excessive anxiety and persistent dread. These feelings do not go away on their own and can cause other symptoms such as panic attacks, fatigue, and feeling wound up.
Similarly, depression can produce symptoms such as fatigue and loss of interest. Together, symptoms of co-occurring depression and anxiety can include anger, irritability, restlessness, loss of interest, chronic fatigue, appetite changes, gastrointestinal issues, and suicidal thoughts. These will be detailed further below.
Similar to anger, many individuals may experience irritability as a symptom of depression and anxiety. You may notice that you have a “shorter fuse” and are annoyed more easily. Irritability can manifest as being overly critical or aggressive toward those around you. Additionally, irritability can manifest as a defeated and hopeless outlook.
Struggling to sit still? Restlessness is another symptom of anxiety and depression. Feeling a need to be in motion or constantly doing something can be an indicator of depression and anxiety.
A major indicator of both anxiety disorders and major depressive disorder is a loss of interest. Individuals may experience a loss of interest and pleasure in their usual activities and hobbies.
Both depression and anxiety can lead to chronic fatigue issues. Individuals who struggle with both depression and anxiety may suffer from changes in sleeping patterns. This may present as insomnia or, conversely, as oversleeping. Individuals who struggle with both may also report feeling generally tired and low.
Individuals, especially children, may experience gastrointestinal problems. These issues may appear to come out of nowhere and have no clear cause. Nausea, abdominal pain, and cramping can all be signs of depression and anxiety.
Both anxiety and depression can cause suicidal thoughts. Feelings of guilt and hopelessness can result in low self-worth and can increase suicidal thoughts. Warning signs of this symptom include an increased focus on death, withdrawing from loved ones, making plans, and reckless behavior.
While episodes of depression and anxiety can be triggered by a major life event, the causes of long-term anxiety and depression vary. Risk factors include family history, childhood trauma, brain structure, other medical conditions, and the use of medication.
Family history and genetics play a role in the development of both anxiety and depression. Both depression and anxiety have a hereditary component. Individuals who have a family history of these disorders are more likely to develop them than those who do not. Individuals whose parents have an anxiety disorder are seven times more likely to develop an anxiety disorder themselves.6
Anxiety and depression can also be side effects of medication use. Certain cardiovascular drugs, such as captopril, enalapril, digoxin, reserpine, and hydralazine, can cause anxiety-like symptoms. Certain anticholinergics, anticonvulsants, antihistamines, steroids, and NSAIDs are also linked to anxiety.
Stimulants such as amphetamines, caffeine, cocaine, and ephedrine can all cause anxiety. Additionally, depression and anxiety are common symptoms of withdrawal from alcohol, anxiolytics, barbiturates, narcotic agonists, and sedative-hypnotics.
Medication is a popular treatment choice for anxiety and depression. Medication is often used in combination with therapy, but it can also be used alone. It is important to work with a healthcare provider to determine what type of treatment for anxiety and depression will work best for you. Severe anxiety and depression can require complex treatment.
There are six different classes of drugs for depression and anxiety. These medications include selective serotonin reuptake inhibitors (SSRIs), selective serotonin & norepinephrine inhibitors (SNRIs), tetracyclic antidepressants, benzodiazepines, N-methyl-D-aspartate (NMDA) receptor antagonists, and monoamine oxidase inhibitors (MAOIs).10
Selective serotonin reuptake inhibitors (SSRIs) are a type of depression medication that also has applications in the treatment of anxiety. For individuals who suffer from both depression and anxiety, SSRIs can be a powerful treatment option. Many doctors consider SSRIs to be the best medication for anxiety and depression. SSRIs work by stopping the brain from reabsorbing serotonin, which is involved in mood regulation. Over time, SSRIs increase the amount of serotonin available in the brain. The effects of the medication can usually be seen in two to six weeks, with treatment lasting around six months to a year.
Common antidepressants in the SSRI class include:
Selective serotonin and norepinephrine inhibitors (SNRIs) work similarly to SSRIs, but they also affect the brain’s capabilities to reabsorb norepinephrine. Much like serotonin, norepinephrine is important in emotional regulation. SNRIs work to increase the amount of freely available serotonin and norepinephrine in the brain.
Commonly prescribed SNRIs include:
Tetracyclic antidepressants are older anti-depression medications that are useful in treating both depression and anxiety. However, because of their side effects, many doctors will choose to prescribe newer SSRIs or SNRIs before prescribing tetracyclic antidepressant drugs.
Examples of tetracyclic antidepressants include:
Benzodiazepines are a type of sedative drug used as an anxiety medication due to their relaxing effects. Because they tend to be habit-forming, benzodiazepines are often only prescribed in the short term, typically less than six months. Benzodiazepines tend to be a fast-acting anxiety medication, reaching peak levels in the blood within one to two hours of taking the medication.
Commonly prescribed benzodiazepines include:
N-methyl-D-aspartate (NMDA) receptor antagonists are medications that were initially developed for anesthesia but show promising effects in rapidly treating resistant depression and anxiety. While the use of NMDA receptor antagonists as depression and anxiety medication is fairly new, it is effective in eliminating depression symptoms due to its antidepressant effects. NMDA receptor antagonist treatment is usually done in a supervised clinical setting, over the course of a few hours.
Common names for N-methyl-D-aspartate (NMDA) Receptor Antagonists include:11
Monoamine oxidase inhibitors (MAOIs) are some of the oldest anti-anxiety and anti-depression medications. Because they often have many side effects, doctors will opt to prescribe newer SSRIs or SNRIs instead of MAOIs. Additionally, MAOIs have several food and drug interactions, making them a less desirable treatment option.
Popular MAOIs include:
Only about one-third of individuals taking medication for anxiety and depression see an improvement within the first two months of beginning treatment with medication. Medication can be a powerful tool, but it tends to be more effective in treatment when combined with therapy. Additionally, for those who do not want to take medication at all, there are some natural remedies available.
Many individuals struggling with anxiety and depression benefit from therapy in combination with medication or by itself. There are a number of therapy-based treatments for anxiety and depression including:12
Many individuals may choose to treat their anxiety and depression naturally rather than taking antidepressant drugs. Pills for anxiety and depression can have a wide variety of side effects, making them an unattractive choice for some people. For individuals with less severe anxiety and depression, natural remedies can prove to be effective treatments.
Some examples of natural remedies include:13