What to Do When Depression and Anxiety Mix

You've noticed some changes lately. Maybe you feel sad, hopeless, or don’t get any joy out of activities that used to be fun. Sounds like depression, right?

Maybe that's not all. Sometimes you're worried, afraid, and just plain uneasy. Isn't that a sign of anxiety?

Not so fast. It’s normal to have ups and downs or to have things you’re concerned about. You might be going through a difficult time. Your doctor can help you figure out if it’s actually a condition and what would help.

Depression and anxiety are like flip sides of the same coin, says therapist Nancy B. Irwin, PsyD. "Being depressed often makes us anxious, and anxiety often makes us depressed."

If you have both conditions, there are lots of ways to get help.

Talk Therapy (Counseling)

A professional therapist can develop a plan to treat your anxiety and depression at the same time.

Some types of therapy that can help are:

• Cognitive behavioral therapy. It teaches you to adjust your thoughts and actions.
• Interpersonal therapy. It shows you how to communicate better.
• Problem- solving therapy. It gives you skills to manage your symptoms.

You can find a therapist who specializes in these through the Anxiety Disorders Association of America. Or ask your doctor for a referral.

Medication

Your doctor may prescribe an antidepressant drug that treats both depression and anxiety symptoms, such as an SSRI (selective serotonin reuptake inhibitor), an SNRI (serotonin-norepinephrine reuptake inhibitor), or others such as bupropion and mirtazapine.

Some examples of SSRIs are:

• Citalopram (Celexa)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac, Sarafem, Symbyax)
• Fluvoxamine (Luvox)
• Paroxetine (Paxil)
• Sertraline (Zoloft)
• Vilazodone (Viibryd)

Some examples of SNRIs are:

• Desvenlafaxine (Khedezla, Pristiq)
• Duloxetine (Cymbalta)
• Levomilnacipran (Fetzima)
• Venlafaxine (Effexor)

Examples of bupropion include:

• Aplenzin
• Wellbutrin
• Wellbutrin SR
• Wellbutrin XL

Tell your doctor about all your symptoms so they can decide which is best. Also mention any supplements you take, even if they are natural, in case they could affect your treatment.

It may take a few weeks or months for your medicine to work. You may have to try a few different kinds before you find one that's best for you.

Exercise

It’s a proven mood-booster that’s good for your body and mind. Exercise also raises your self-esteem and confidence and can improve your relationships. And it’s considered to be a treatment for mild to moderate depression.

"Even a brisk walk can jump-start the endorphins," which are chemicals in your brain that help you feel good, Irwin says.

High-energy and frequent exercise is best. Aim to do it at least 3-5 times a week. If you need motivation, go with friends or join a group, suggests psychiatrist Ken Braslow, MD.

Relaxation Techniques

Give yoga, meditation, and breathing exercises a try.

Meditating for just 2-5 minutes during the day can ease your anxiety and lighten your mood, says psychiatrist Sheenie Ambardar, MD. She suggests trying any of these simple strategies:

• Focus on your breath.
• Make a picture in your mind of a beautiful image.
• Repeat a simple word or mantra, like "love" or "happiness."

Check Your Diet

Don’t let comfort food put your eating habits out of balance. Anxiety and depression often trigger cravings for carbs, Braslow says.

Choose lean protein with a little bit of healthy fats to feel more satisfied and calmer. And fill half your plate with fruits and veggies. Limit or avoid sugar, caffeine, and alcohol.

Get Support

Strong relationships help you feel better. Reach out to family and friends and let them know what you’re going through so that they encourage you.

You can also join a support group, where you'll meet people who are going through some of the same things you are.

Take Some Steps on Your Own

Get organized. "Less clutter in your physical surroundings, email inbox, and to- do bucket will help your mind be more at ease," Braslow says. You don’t have to tackle it all at once. Make a plan to work on one area at a time.

Make new goals. Is there something you’ve always wanted to do, or a place you want to go? Create a step-by-step, realistic plan to make it happen.

Do something meaningful. Get involved in an activity that feels important to you. It may be athletic, political, spiritual, or a social cause where you can volunteer. Look for something that gives you a sense of purpose.

Be creative. Direct your focus into something constructive. Rediscover your strengths. If you have a long-lost talent or interest, dive back into it. Braslow suggests trying poetry, music, photography, or design.

Read a good book. It's a great way to relax. There’s even research that shows that reading books on spirituality or psychology may boost your mood.

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