Depression and Anxiety: Causes, Treatments, New Research
Cindi Griffin is a family nurse practitioner who sees patients at our Highland and Montfort clinics. She has been part of Upland Hills Health since 2016.
Depression (major depressive disorder or clinical depression) is a very common and serious mood disorder. It may cause symptoms that can affect how you feel, think, and deal with daily activities, including sleeping, eating, or working.
There are different types of depression: postpartum depression, psychotic depression, seasonal affective disorder (SAD), bipolar disorder (formerly called manic depressive disorder), situational depression, persistent depressive disorder (also called dysthymia) and major depressive disorder.
Depression is more than just a period of the blues, it isn’t a weakness and people simply can’t just “snap out” of it. Depression is treatable and usually requires a long-term treatment plan. Most people with depression will feel better with either medication, psychotherapy or both.
Symptoms of depression can include:
- Feelings of sadness, tearfulness, emptiness or hopelessness
- Angry outbursts, irritability or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
- Sleep disturbances, including insomnia or sleeping too much
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
- Anxiety, agitation or restlessness
- Slowed thinking, speaking or body movements
- Feelings of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
- Unexplained physical problems, such as back pain or headaches
Anxiety disorders are also very common, causing symptoms such as excessive and persistent worry with repeated episodes of sudden feelings of uncontrollable anxiety. These feelings may interfere with your daily activities. People with anxiety may avoid places or situations that they fear may trigger these feelings. Symptoms may start during childhood, teenage years or adulthood.
Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. It is possible to have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.
Common anxiety signs and symptoms include:
- Feeling nervous, restless or tense
- Having a sense of impending danger, panic or doom
- Having an increased heart rate
- Breathing rapidly (hyperventilation)
- Feeling weak or tired
- Trouble concentrating or thinking about anything other than the present worry
- Having trouble sleeping
- Experiencing gastrointestinal (GI) problems
- Having difficulty controlling worry
- Having the urge to avoid things that trigger anxiety
According to the Center for Disease Control (CDC), anxiety has been diagnosed in 7.1% of children of the ages of 3-17 years old and depression in 3.2% of children 3-17 years old. Generalized anxiety disorder (GAD) affects approximately 6.8 million adults in the U.S. Panic disorder affects 6 million adults in the US, there are 19 million adults in the US that have specific phobias, 7.7 million adults have PTSD symptoms. Women are twice as likely to develop all of the above symptoms then men. Many believe that the higher prevalence in women may be caused by hormonal issues and sexual assault.
The CDC also estimates that 80% of older adults that have at least one chronic health condition and that 50% who have two or more chronic health issues have depression. Depression is more prevalent in older people who have other illnesses such as heart disease or cancer, and/or those whose function is limited.
Depression and anxiety are very treatable conditions. Medication along with therapy can be very beneficial in treating both anxiety and depression. Your family medicine provider is a great place to start if you feel that you may be experiencing anxiety and/or depression. They will discuss options with you and help you decide the best treatment plan that fits you.
Because these conditions are so common, there is a lot of research being done to understand and treat them better. Here are a few interesting research areas.
- Researchers have identified that depression and anxiety symptoms likely result from an interference with the balance of impulses from the brain. MRIs have shown that in posttraumatic stress disorder (PTSD), social phobia, and other specific phobias, there is significant hyperactivity in the amygdala and insula (the part of the brain that processes emotional issues).
- People who experience both depression and anxiety have been found to have decreased levels of omega-3 polyunsaturated fatty acids compared to those that do not experience these symptoms. (https://www.uptodate.com/contents/comorbid-anxiety-and-depression-in-adults-epidemiology-clinical-manifestations-and-diagnosis)
- Research is mixed on whether depression can be inherited. There are people who have depression and also have a first degree relative with depression and some research has shown that these people may have a two to three time higher risk of developing the condition than others. Researchers have also reported that the condition may be because of both/all of the family members being exposed to the same environments/stressors/traumas and not because of familial inheritance. There are also many people with depression that have no family history of the condition. (https://ghr.nlm.nih.gov/condition/depression#inheritance)
- Recent research suggests that the gut microbiota may have an influence on depression/mood. Poor diet was identified as a risk factor for depressive symptoms, suggesting that a healthy diet may prevent or lessen the severity of depression. Regulation of the gut microbiota using diet, probiotics and even fecal microbiota transplant could have significant benefits. (https://dx.doi.org/10.9758%2Fcpn.2015.13.3.239)
- Clinical Psychopharmacoly Neuroscience 2015 Dec; 13(3): 239–244.
Published online 2015 Dec 31. https://dx.doi.org/10.9758%2Fcpn.2015.13.3.239