Anxiety/Depression Link

[Mermaid16]

Call me naive, but in the 20 something years I have suffered from anxiety, I never realised it is so close depression. I have been suffering from early morning waking and anxiety on waking. When I was talking to the psych about it, she said early morning waking is a hallmark sign of depression. To which my response was, "I am not depressed though, I'm anxious". Her reply to that was that "some people show depression through feel sad, you show it through anxiety". I had never really linked the two before. I guess I learn something new everyday about this illness.

[Dreamer49]

I am the same, waking early, usually with a panic attack. I am not getting enough sleep so that makes things worse. I am better in the summer when it gets light early - I can get back to sleep then cos I know the day is coming. I always thought panic attacks and anxiety were different to depression - suppose they are both expressions of the same thing.

[MyNameIsTerry]

Yeah, early waking or disturbed sleep is a depression symptom but I don't see why it can't be an anxiety symptom too. I was definitely not depressed when I had my breakdown, it was a classic too much daily work stress issue that culminated in an anxiety attack at work. I only felt depressed when I started Citalopram, and this was a side effect and the depression never came back.

Leading up to my relapse though, I was feeling periods of depression and certainly afterwards courtesy of the latest med.

My sleep problems were more about getting to sleep and staying asleep the first time around. In the relapse it was about waking early.

There are mixed anxiety & depression disorders where one can't be determined to be prominent than the other. And they can determine a dual diagnosis if they wish.

It's where it all gets confusing when getting a diagnosis. How can depression be a diagnosis based on just waking early yet every other symptom is blatantly screaming anxiety? Do they mean we have anxiety but experience periods of low mood, or even depression, but the primary diagnosis is still anxiety?

I find it sometimes gets confusing because they may be softening their language to be easier for us to understand it can be confusing for those of us more clued up on our disorders whereas someone new to it would just accept what they say and think no more of it.

[Bill]

If you didn't suffer from anxiety, would you get depressed?

This is the way I've always understood it although it could be wrong -

Anxiety and depression are closely linked because if you're constantly feeling stressed and anxious, it's bound to get you down so you're likely to suffer from a depressed state.

However, in what they call clinical depression, the person may suffer from anxiety but more commonly I believe suffer from depression alone but that doesn't necessarily mean they feel low or sad.

Anxiety is caused by worry, fear and stress but clinical depression normally occurs for no obvious reason. The person doesn't normally suffer worry, fear, stress etc. In anxiety, we can become frustrated etc and that can lead to a depressed state but once the frustrations are sorted, we feel better.

In the old days they used to prescribe sedatives such as diazepam for anxiety but because they are so addictive, they now use the alternative modern drugs such as prozac, sertraline etc which are non-addictive, although they can feel addictive because anxiety sufferers may fear stopping them.

These modern drugs are called ant-depressants and as the title suggests, they ward off depression so they're very effective against clinical depression. However, my personal feeling is that they don't work so well for anxiety because the underlying causes of anxiety are worry, fear etc and these drugs can't stop people worrying. What they can do though is lift the mood so they ease anxiety symptoms by making people feel happier but the underlying causes still need to be treated.

To give you an example, when I went through my really bad spell, I was prescribed a variety of anti-depressants as well as valium (diazepam). The valium worked best because it is a sedative so it lowered my stress levels but they didn't warn me how addictive it was so I got hooked on them. It took me 6 months to stop them by reducing them very slowly otherwise my anxiety shot through the roof. They are really most effective when taken as one offs but the trouble with general anxiety is people feel ill daily so they'll want to take them daily.

On the other hand, I found anti-depressants less effective because although they worked in the beginning, their effects wore off so each time the dose was increased until I reached a point that they had to try another type. I must admit I had the same problem with diazepam because although I found them most effective because of the sedative effect, my body got so used to them as I was taking them daily so the dose was increased to the maximum at which point I ended up feeling worse.

When they found that neither ad's or valium were working, they then gave me ECT thinking that I had clinical depression. What they never seemed to realise was that my depressed state was being caused by too much stress at home and at work and that was the real reason I was feeling so depressed. Once I helped myself to ease my stresses, I was able to cope and I managed to come off all the meds completely. I still get depressed at times and I still get anxious but I now know the reasons why because they are feelings connected to my life and the situation I'm in rather than for purely biological reasons.

To sum up - I feel ad's work well for clinical depression (depression caused for no obvious outside reasons) but they only ease the depressed state in anxiety sufferers because worry, fear, stress etc are the causes of the depressed state which once treated lift the depressed state.

Those are just my thoughts based on my experiences but I honestly wouldn't like to say they are totally correct. I just feel that if someone suffers from bouts of severe depression, they really need ad's to stay well whereas anxiety sufferers can learn to cope without them because the underlying causes can be treated by the sufferer themselves by making changes in their thinking and lifestyle or through the help of therapy.

[Mermaid16]

Thanks for your reply. I have to say, that when ECT was suggested while I was in hospital, I immediately said "but I'm not depressed". In any case I do think it helped some. I just don't feel down or sad, I feel wired up and anxious. I saw the psych today, she suggested upping the Olanzapine to 5mg, which I firmly said no too. I've already packed on heaps of weight and am willing to put up with the early waking at the moment. I did ask to have my cholesterol, be tested for diabetes, hormone test and Nortriptyline level test. I know last time my nort levels were tested they were at the lower end of the range. I am more happy to increase the nort and see if it makes a change than increasing anything else. Hopefully I stabalise again and can look at reducing to Olanzapine and then the Mirtazapine. Sorry for getting off track, but yeah I tend to agree that the early waking is more to do with anxiety than depression in my case. I might try some deep meditation before bed tonight and see if that makes a difference. It probably won't, but it will be beneficial in other ways.

---------- Post added at 16:26 ---------- Previous post was at 16:17 ----------

Hi Bill! Thank you for your reply. It really made sense to me. I am on Clonazepam and am hoping to reduce my dose at some point. I am on 1mg twice daily. I have been on Valium from July to December and then Clonazepam from December to now. Do you have any tips on how best to reduce when the time comes? I have done a CBT course and an ACT course and they have both helped. I am better able to deal with anxiety now. I had been pretty stable until these last couple of days with the waking early with anxiety. It's good to get other people's opinions though rather than just believing what a doctor tells you. Thanks again.

[Bill]

Hello Mermaid,
I'm sure you know this but just to be sure to others, NEVER attempt to reduce or come off meds without consulting the doctor or psychiatrist first. That's Extremely Important to remember.

If they agree that a patient can attempt to come off a drug like valium that's addictive, remember percentages. For instance, if you're taking 30mg daily and reduce to 15mg, it's a 50% drop which could mean your body will react so it must be done in small steps according to what mg's the tablets can be split into. You may also find that you have to be just as careful or even more so when you reach the point where you reduce the lower doses. For instance, if you get down to 2mg and cut to 1mg, it's still a 50% drop. At these small doses where you can't split the tablets I'd take the dose 7 days a week then miss one day a week and take for 6 days a week for a couple of weeks, then 5 days a week for a couple of weeks and so on. This is why it took me 6 months because it had to be done gradually to avoid effects.

When I came off them, I made a chart. I can't remember exactly but it went something along the lines of 30mg for 2 weeks, then 25mg for 2 weeks, then 20mg for two weeks and so on until I got to the small doses and missed a day in the week. If I had a reaction, I just went back up on the dose for a week then reduced at a smaller amount.

If I reduced them too quickly or at too bigger a dose, I just found I got very shaky and my anxiety went through the roof but it settled once I increased the dose back up temporarily.

You mustn't try to rush it and it is trial and error according to how you react to the reductions but remember percentages and frequency in reductions.

I think I took valium for about 3 years but I'm not sure how long it takes before you become addicted or if it's easier to come off them when you've not taken them that long.

Above all though, you MUST ask your doctor/psychiatrist First to make sure they agree to it or you could end up feeling much worse if it's too soon. They will also advise how they think it should be done.

Hope that helps.

[braindead]

Anxiety breeds depression they follow each other like sheep .