Anxiety vs. Depression: how the two are different

WHAT IS DEPRESSION? Depression is diagnosed when a person feels persistent sadness, low energy, feelings of hopelessness and an inability to experience pleasure. These symptoms frequently

combine with changes in appetite and sleep. They also combine with overall malaise, or a general sense of being unwell, often accompanied by fatigue and diffuse pain. Occasionally,

depression can also present with agitation. Depression is not a passing thing. We all go through low times, but depression sticks around for at least two weeks and interferes with daily

activities. In cases of suicidal thoughts or decreased ability to enjoy things, it is important to seek mental health care or call 988, the Suicide & Crisis Lifeline. For both anxiety

and depression, the key is to ask yourself whether your reactions are temporary and proportional to the situation. Mourning the loss of a loved one, for instance, often involves deep sadness

and grief. But when the depression lingers to become a permanent problem in your daily life, it’s probably time to talk with a health care professional. While anxiety and depression can

develop at the same time, one can come on before the other. It is more common for anxiety to show up first, often in childhood, says psychiatrist Mary E. (Beth) Salcedo, M.D., medical

director of the Ross Center, a mental health clinic in Washington, D.C. In people with a long history of anxiety, there is often a “wear-and-tear effect,” Sawchuk says. It can get to a

point where people become more disconnected from social supports, then “they become more vulnerable to depression.” A person with long-term depression may be more prone to anxiety in later

years, especially as their circumstances change. For instance, the uncertainty of a move is more likely to trigger anxiety in someone with depression, who is already sensitive to stressful

life events. HOW ARE BOTH CONDITIONS DIAGNOSED? Depression and anxiety are the most common mood disorders, yet few health care providers screen their older patients for either disorder. In

June 2023, the U.S. Preventive Services Task Force recommended that adults of all ages be routinely screened for depression. For anxiety, the group called for screening of people under 65

every year. The task force said there wasn’t enough evidence that there should be similar screens for people 65 and older, though others disagreed, calling anxiety disorders “pervasive and

pernicious” in older adults, who “should not be denied the opportunity to benefit” from available treatments. If you want to be screened, talk to your health care provider.  Screening,

usually via a short questionnaire, asks about common symptoms, thought patterns and behaviors. It can help uncover the physical symptoms that often accompany anxiety and depression —

inadequate, unrestful sleep, foggy memory and chronic aches and pain — that are sometimes dismissed as a normal part of aging, even by medical staff. Some of the more commonly used

questionnaires are the Geriatric Depression Scale, Patient Health Questionnaire-9  and Generalized Anxiety Disorder-7.  To help confirm whether or not you have a mood disorder, your health

care provider might recommend a physical exam and lab tests to rule out medical issues, such as low iron and thyroid problems. Medication use is also reviewed, as some medications may cause

anxiety and depression. TREATMENT OPTIONS FOR ANXIETY AND DEPRESSION The good news is that remedies exist for depression and anxiety in older adults. “If we do diagnose depression, it’s a

highly treatable condition,” says psychiatrist Mani Santhana Krishnan, chair of the Faculty of Old Age Psychiatry at the Royal College of Psychiatrists in London. After treatment, older

adults “can lead a very normal life.”