Identifying signs of anxiety and depression

What is stress, and what happens when you can't cope well with it?

Stress can present itself after being fired from a job, going through a divorce or losing a loved one. Even getting married, transitioning to a new job or having a baby can cause stress. Everyone experiences stress at one time or another.

Many people define stress as either good or bad when it's neither. Stress is an event you view as out of your control, and it typically occurs outside your daily routines. How you react shapes your ability to cope with these and other similar events in the future.

When people struggle to cope with stressful situations, depression and anxiety become more noticeable.

Anxiety and depressive disorders are common. These illnesses affect more than 40 million adults in the U.S., or about 18% of the population, every year. The World Health Organization has estimated that the COVID-19 pandemic led to a 27.6% increase in depression and 25.6% increase in anxiety disorders worldwide in 2020.

The most common anxiety disorders include:

• Specific phobias
  Phobias could be related to animals, like spiders, cats or dogs; the natural environment, such as heights, storms or being in water; blood injection injury, which is a fear of needles or invasive medical procedures; or locations, like airplanes, elevators or enclosed places.
• Social anxiety disorder
  This is a fear of being around other people or in social situations.
• Generalized anxiety disorder
  This is an overall worry about many different things.
• Separation anxiety
  This is an excessive fear of, or anxiety concerning, separation from attachment figures or items.
• Panic disorder
  This is an abrupt surge of intense fear or discomfort.

The most common depressive disorders include:

• Major depressive disorder
  This is a depressed mood that lasts for a two-week period. This could occur as a single or recurrent episode.
• Persistent depressive disorder
  This is a depressed mood that occurs almost every day for at least two years

It's common for those struggling with anxiety disorders to also struggle with depression or vice versa. Close to 10% of the world's population suffers from anxiety and depression. However, while anxiety and depressive disorders are highly treatable, only a small percentage of affected people receive treatment.

How are stress, anxiety and depression connected?

Anxiety and depression can be caused by several things, including:

• Genetics
• Environmental exposure
• Personality
• Life events

Early signs of anxiety and depression

An early warning sign for anxiety or depression occurs when someone begins avoiding things once enjoyed.

Other warning signs for anxiety include:

• Shakiness
• Increased heart rate
• Tightness in the chest
• Rapid breathing
• Racing thoughts

Meanwhile, warning signs for depression include:

• Isolating oneself
• Frequently thinking negative thoughts
• Recurring feelings of sadness
• Advanced signs of anxiety and depression

Advanced signs of generalized anxiety disorder include:

• Excessive worry occurring more days than not for at least six months
• Feeling restless
• Fatigue or frequently feeling tired
• Difficulty concentrating
• Irritability
• Muscle tension
• Sleep disturbances, like difficulty falling or staying asleep
• Distress or impairment in social, occupational or other important areas of functioning

Advanced signs of a major depressive disorder include:

• Feeling down or depressed most of the day, nearly every day
• Diminished interest in activities you once enjoyed
• Significant changes in your weight (increase or decrease)
• Difficulty with sleep, like difficulty falling, staying asleep or sleeping too much
• Fatigue or frequently feeling tired
• Difficulty concentrating
• Recurrent thoughts of death
• Distress or impairment in social, occupational or other important areas of functioning

To cope with anxiety and depression, try these tips:

Try diaphragmatic and square breathing techniques.

Diaphragmatic breathing involves taking a deep breath from your diaphragm. Your stomach should expand as you breathe in. Square breathing techniques involve taking a deep breath in for five counts, holding this deep breath for five counts, exhaling for five counts and finally holding for five counts before repeating. The entire time should be spent focusing on your breath versus the stressful event.

Challenge your thoughts.

This involves not judging situations — good or bad — and focusing on what you're feeling and identifying what's in your control. Your primary areas of control are acknowledgement of your emotions, feelings and your reaction to stressful situations. It is also important to focus on the facts of the situation. Sometimes your anxious and depressive thoughts are not always based in facts. Facts are 100% absolute — not assumptions.

Ask yourself:

• What am I feeling?
• What are these emotions?
• How would I like the situation to turn out?
• What are the facts?

Then identify small, specific goals to get to your desired outcome. If you fail to acknowledge your emotions and feelings and attach a negative thought to a situation, the outcome of that situation will result in avoidance and increased anxiety and depression.

Focus on the facts.

Challenge yourself to find the facts in a situation and acknowledge whatever emotions and feelings the situation reveals. Doing so increases the likelihood you'll be able to cope effectively with a stressful situation.

When to seek professional help

It's best to talk to a health care professional when:

• You find it difficult to function in your daily life.
• You no longer participate in activities you once enjoyed.
• You find it difficult to get out of bed.

Treatment for anxiety and depression

Medications and psychotherapy are effective for most people with depression and anxiety. Your primary care provider or psychiatrist can prescribe medications to relieve symptoms. Many people benefit from outpatient psychotherapy, like cognitive behavioral therapy or dialectical behavioral therapy.

Additional treatment can include changing your exercise or eating habits, using social supports, getting enough sleep, changing your responses to stress, avoiding alcohol and recreational drugs, and joining a support group.

If you have severe depression or anxiety, you may need to use crisis resources, like contacting a crisis hotline, going to the nearest emergency department for a mental health evaluation or participating in an inpatient or outpatient treatment program until your symptoms improve.

Why it's important to address your mental health

It's important for people to address their mental health to live lives that are fulfilling. Acknowledging and treating your mental health helps create resilience. It also teaches you to better cope. Then when a similar situation occurs, you are equipped to handle it.

Stressful situations are going to happen. How you react can determine how these situations will affect you. Many resources are available regarding anxiety, depression and stress. Talk to your health care team if you have concerns about your mental health.

These resources also are available:

• Crisis text line: Text "HOME" to 741741
• National Suicide Prevention Lifeline: 1-800-273-8255

Jolene Hanson is a social worker in Psychiatry & Psychology in Mankato, Minnesota.