Disturbing Duo: Depression and Anxiety

Depression is a common problem, affecting about one in six adults in their lifetime. But what if you also feel excessively anxious? If so, you may be one of the many people who experience an anxiety disorder at the same time as depression.

A study from Harvard found that among people with depression, nearly two-thirds also had generalized anxiety disorder. The rates of co-occurring related anxiety disorders -- social phobia, post-traumatic stress disorder, panic disorder, specific phobias and obsessive-compulsive disorder -- in depressed people were also all greater than 40 percent.

Treating with antidepressants. Having an anxiety disorder at the same time as depression can make it harder to find a treatment that works, according to guidelines from the American Psychiatric Association, but not impossible.

Antidepressants are often effective for symptoms of both depression and anxiety. You should be aware, however, that selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), and tricyclics, which include the drug nortriptyline (Pamelor), can make anxiety worse before making it better. For this reason, your doctor will probably start you at a low dose and slowly increase the amount you need to take.

SSRIs seem to be an especially good choice for people with social phobias or post-traumatic stress disorder. Both SSRIs and the tricyclic clomipramine (Anafranil) have been shown to help people with depression and obsessive-compulsive disorder. SSRIs are the treatment of choice for both depression and panic disorder.

Additional treatments. If an antidepressant is helping with your depression but not your anxiety, your doctor may add a benzodiazepine such as clonazepam (Klonopin) or lorazepam (Ativan) -- but be aware that it's easy to become dependent on these drugs.

Also keep in mind that medication isn't the only way to treat depression and anxiety. Many people opt for psychotherapy, which can be effective for both conditions. Many studies show the greatest benefit from a combination of drugs and psychotherapy. Although it's normal to feel sad or anxious from time to time, see your doctor if your symptoms are severe and interfere with daily functioning.

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