Anxiety vs Depression: What's the Difference?

Stigmatization of individuals with mental disorders is one of the main reasons that people suffer in silence. Unlike ailments such as cancer where everybody in the society is merciful and willing to show their support for cancer patients, mentally ill individuals face prejudice and disapproval. These conditions makes people suffering from acute mental disorders to ignore their symptoms and try to adjust to the social norms. Little to their knowledge their symptoms escalates and result in chronic ailment that diminishes their living standards, result in job loss, attempted or successful suicides. According to DSM-V revised edition, mental disorders are many different ailments affecting the brain and psychology of the individual (APA 2013). These diseases result in both physical and psychological harm to the patient and if left untreated, they develop into chronic conditions that are difficult to treat.

Brief History

The extensive range of disorders under either depression or anxiety makes it difficult to determine the total effects of the ailments. Chronic stress is the main cause of depression thus making it evident that everybody is likely to suffer from depression. It is evident that humans are stressed in their daily lives but the ability to deal with such daily stressing emotions is the difference of developing depression (Khan & Khan, 2017). Misdiagnosis and the continued failure to seek medication for either depression or anxiety makes it difficult to determine the correct effects of these mental disorders. The studies demonstrate that depression is one of the leading causes of economic challenges and affects the patients and their dependents more than any other ailment. The studies base their arguments on the direct and indirect costs associated with mental disorders. The costs range from the diminished productivity of workers due to their low concentration, increased absenteeism, mood swings, conflict, and other adverse interpersonal interactions both at work and at home. Failure to treat the early symptoms leads to the intensification of the conditions making it difficult to access medication and attain the level of productivity accustomed to them before the depression (Fekadu, Shibeshi & Engidawork, 2017). Job loss attempted and successful suicidal thoughts during these incidents are irreversible hence the need to enhance awareness and support for mental disorder treatments.

According to Jiller (2013), the comorbid anxiety and depression disorders occur in over 25% of the general patients. The study depicted that 85% and 90% of patients with depression and anxiety disorders respectively have the other disorder due to their similarities in symptoms, which includes anxiety in the two types of disorders. The study argues that scholars concur that over 40% of people with mental disorders do not seek medication and over 50% of those who seek medication do not acquire beneficial or quality medication for their illnesses thus making them venerable for chronic or severe accelerations of their conditions (Jiller, 2013). According to Fekadu, Shibeshi, and Engidawork (2017), depression costs over 450 million in the world with its costs more prevalent in sub-Saharan Africa than in other regions. The study argues that depression costs are higher than those of HIV/AIDs are in most parts of the region.

MDD prevalence is between 10 and 25% in women and 5 and 12% in men (Fekadu, Shibeshi, & Engidawork, 2017). The DSM-V enhanced the manner of diagnosing mental disorders by the reclassification of the ailments that have similar symptoms and including disorders such as PTSD in a different category to eliminate the misdiagnosis. According to Locke, Kirst, & Shultz (2015), generalized anxiety disorders (GAD) prevalence in the U.S. for one year of adults of age 18 to 64 years is 2.9 and 3.1% respectively. However, the lifetime prevalence is 7.7% and 4.6% in women and men respectively whereas panic disorders are 7.0% and 3.3% in women and men respectively (Locke, Kirst, & Shultz, 2015). The statistics depict that women are more likely to suffer from anxiety disorders compared to men due to the social norms and the venerability of women in a patriarchal society.

Definition of terms

The revised edition of DSM-V by the American Psychiatric Association (APA) has the best definition and diagnosis procedure for mental disorders. DSM-V uses a generalized definition of depression by using the definition of major depressive disorders (MDD) although there are many different types of depression. Therefore, it defines depression as the occurrence of depressed mood (dysphoria) and anhedonia, the increasing loss of interest in activities that were pleasurable in the past, for a period of at least two weeks (APA 2013). At least four symptoms such as sleep loss, altered psychomotor, changes in appetite or weight, guilt, feeling of worthlessness, recurrent thoughts of death or suicidal ideation, difficulty in concentration and decision-making must accompany the earlier discussed feelings. The heterogeneous aspects of depression make it difficult to diagnose as a single mental disorder with the ailment having symptoms similar to other mental disorders such as anxiety and PTSD (APA 2013). Depression is either mild or severe with conditions such as psychotic depression resulting in hallucinations and delusions.

Anxiety disorders, on the other hand, originates from the normal and regular occurrence of emotions that is evident in all humans and various animal species. However, the failure to control these emotions may escalate to irregular and prolonged anxiety or fear thus resulting in anxiety disorders such as panic, phobia, generalized anxiety, and social phobia. The revised DSM-V reclassified the ailments that seem to have the same characteristics and eliminated PTSD and Obsessive Compulsive disorders due to their differences with other disorders in the group. Therefore, anxiety disorders comprise a heterogeneous group that shares anxiety as the primary symptom.

Anxiety Disorders

According to Wiedemann (2015), the DSM-V disturbances with different etiology, psychological characteristics, and outcomes classified as anxiety disorders are panic, phobias, and generalized anxiety disorders. Panic disorders involve recurrent paroxysmal anxiety that surmounts the fear of death in acute myocardial infarction. The attacks regularly combine with bodily sensations such as shaking, sweating, dizziness, abdominal distress, trembling, tachycardia, and suffocation. The panic episodes range from a few minutes to about an hour and can be irregular and often thus making it uncontrollable for the individuals (Wiedemann, 2015). Affiliation of such events results in the avoidance, which leads to agoraphobia, as the events are longer and more rapid than earlier.

Phobias are categorized into three distinct types namely agoraphobia, social phobia, and simple phobias. As earlier stated panic causes agoraphobia if it is untreated with the longer episodes creating a fear within the individual of being in a situation he or she cannot escape. Symptoms such as depersonalization, cardiac symptoms, derealization, and dizziness are evident in agoraphobia patients (Wiedemann, 2015). Social phobia is fear of exposure to scrutiny by others that result in the individuals avoiding social integration. Alienation, avoidance, and bodily alternations are the core symptoms of this type of phobia. Lastly, simple phobias characterize fears of defined objects or situations. For instance, fear of chameleons and fear of height, which hinders the exploration and daily routines of the patients due to the need to avoid such objects and situations. Generalized Anxiety Disorders (GAD) is the extensive worry for unspecific, the uncertainty of the future, and unrealistic events. The fear creates psychological arousal such as hyperactivity, restlessness, muscle tension, and sleep disturbances that the patient is unable to control.

Literature Review

According to Wiedemann (2015), anxiety has a complex origin that involves the interplay of biological, social, genetic, and psychological events. The study depicts that generic and biological factors, combined with the development and environmental impacts on an individual determine the ability to deal with acute stressors thus enabling or inhibiting their abilities to adapt to change. The study quoted Schumacher and colleagues study of 2011 arguing that the early and late onset of cases of development or lack of developing the physical expectations of either male or female resulted in anxiety (Wiedemann, 2015). It was evident that these characteristics are based on animal breeding that yielded different innate anxiety behaviors in mice from different lines whereas rats from the same line depicted similar stress reactions. The genes’ argument is suitable in explaining panic disorder.

Social aspects such as maltreatment of children, family conflicts, and abandonment of children resulted in personality traits associated with low self-esteem and indecisions. These children grow with the inadequate confidence in facing challenges thus when stressed or face a panic attack they are unable to adapt to the change. Therefore, childhood events influence their future ability to deal with anxiety. Children enduring harassment or have a social phobia when young are more likely to suffer from separation anxiety than their mates in stable families are. The childhood maltreatment is also associated with other mental conditions such as substance abuse, PTSD and depression (Wiedemann, 2015). Wiedemann argues that life events affect the amygdala and the prefrontal cortex structural plasticity thus leading to an imbalance of neural circuitries that decreases expressions. These changes make the fearful and anxiety adaptive in the short-term but as continued events result in failure for the behaviors to changes after an incident. The amygdala fails to differentiate the social and environmental stimuli thus making the relapse of the attacks and activating the hypothalamus, which activates the sympathetic system and locus coeruleus (Wiedemann, 2015). These activations increase the noradrenaline release that in turn raises blood pressure, heart rate, and behavioral fear responses. However, panic attacks associated with anxiety disorders tamper with the normal response behavior of fear leading to misinterpretation of the cognitions.

Locke, Kirst, & Shultz (2015), argue that treatment following diagnosis should combine medicines and therapies for at least one year to limit relapse of the conditions. The study depicts that medications such as benzodiazepines reduce anxiety at a faster speed compared to other medications but they do not improve the long-term conditions of the patients. Drug abuse and increased mortality tend to be the main concern for the medicine hence the need to combine it with either cognitive behavior therapy or mindfulness-based stress reduction (Locke, Kirst, & Shultz, 2015). The flexibility of the therapies enables the psychiatrist to address the unique aspects of the disease for each patient thus increasing long-term improvements.

Depression Disorders

Depression is one of the most challenging disorders to diagnose due to the co-occurrence of various mental conditions but subtypes such as MDD, dysthymic disorders, melancholic, seasonal affective disorder (SAD), post-partum depression (PPD), and psychotic depression can enhance the understanding of depression disorder. As earlier defined MDD, symptoms include dysphoric mood and anhedonia combined with physical changes such as weight gain or loss, fatigue, appetite increase or decrease, and sleep pattern alterations. This condition is dangerous due to the preoccupied suicidal thoughts (Khan, & Khan, 2017). Dysthymic disorder is a persistent depressive disorder that results in sadness for long durations. SAD unlike most of the other mental disorders is seasonal for instance, irritability during summer or winter and is associated with cravings of food. PPD is a condition of chronic depression in pregnant women that lead to mood swings. It also affects the conditions of the baby. Lastly, psychotic depression is severe as it causes delusions and hallucinations. It is also the most challenging of all depression disorders to treat.

Literature Review

According to Fekadu, Shibeshi, and Engidawork (2017), even with extensive search and determination to determine the exact cause of depression, the answer remains elusive to scientists. However, the essence that social events and situations continue to cause depression, pharmacologists and scientists focus on brain monoamine neurotransmitters to develop anti-depressants. The pathogenesis employed by these experts can help in gaining insight into the causes of depression. Based on different studies reviewed by the study it is evident that genes, social interactions, biological and hormonal factors influence the probability of suffering from depression.

The antidepressants target the brain to enhance receptors and neurons on the hypothalamus thus enabling reactions to the stressing incidents and thoughts. The hormonal imbalances caused by depression affects emissions of thyroid and estrogen involvement thus impairing the hippocampal neurogenesis to decrease serotonergic neurotransmission thus diminishing the abilities of the individual to deal with stress (Fekadu, Shibeshi, & Engidawork, 2017). Similarly, to anxiety, the upbringing of a child influence their capacity to adapt to changes and creates response behaviors that diminish the secretion of false signals. Therefore, maltreatment reduces confidence, which in turn result in indecisions and the inability to shred the stressing thoughts leading to desperation.

Discussion

The studies analyzed the varying aspects of both anxiety and depression disorders. It was evident that the similarities in diseases make it difficult to focus on one disorder without referring to the other. However, the studies demonstrated that it is essential to classify the disorders differently due to their characteristics and effects on the patients.

Anxiety Response 

The literature provided key aspects of anxiety such as the separation of fear and anxiety from anxiety disorders. It was evident that the fear and anxiety are normal and regularly occurring behaviors for humans and some specific animal species. Whereas anxiety disorder was the lack of control of the fear and anxiety for the prolonged period. The tension of enduring such feelings and inability to control the impulse increases the rates of hypertension and high blood pressure thus increasing the risks of cardiovascular diseases. The reviews also depicted that GAD and panic disorders affected the patients more than other types of anxiety disorders. The essence that panic or fear attacks the amygdala limiting the panic response behaviors shows treatment of the ailment must focus on both medication and therapies. Lastly, it was clear that anxiety is different from depression disorder.

Depression Response 

Most of the studies focusing on depression disorder focused on MDD whereas the most dangerous illness is psychotic depression. The severity of this disorder shows that more research is needed to understand the disorder. MDD may affect more people than other depressive disorders but the failure to focus on other types of disorders hinders extensive understanding of the disorder. The reviewed journals lacked vital information on the causes of depression thus constrained creation of awareness and ways to mitigate the continued rise of depression.

Conclusion

The goal of this essay was to compare and contrast anxiety and depression disorders. It is clear that the two mental conditions are distinct even if they share some of the major characteristics. Anxiety, unlike depression, is based on fear and reaction whereas depression is passive uncontrolled thinking. Anxiety increases adrenaline whereas depression does not hence the desperation exhibited among MDD patients. However, recent studies on the two ailments lacked suitable and informative analysis that would differentiate the diseases. For instance, studies focusing on both studies resulted in confusion rather than enlightenment. Therefore, future scholars should focus on providing conclusive studies or quantitative studies differentiating the two mental conditions. Focus on one condition limited the ability to understand whether all conditions in any group were similar thus limiting quality analysis.

References

American Psychiatric Association, (2013). Diagnostic and Statistical Manual of Mental Diseases, fifth ed. American Psychiatric Association, Washington, DC.

Fekadu N, Shibeshi W, & Engidawork E (2017) Major Depressive Disorder: Pathophysiology and Clinical Management. J Depress Anxiety 6: 255.

Locke, A., Kirst, N., & Shultz, C., (2015, May 1). Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. American Family Physicians. Retrieved October 13, 2018, from http://www.aafp.org/afp/2015/0501/p617-s1.html

Khan S., & Khan R., (2017). Chronic Stress Leads to Anxiety and Depression. Ann Psychiatry Ment Health 5(1): 1091.

Tiller, J., (2013). Depression and Anxiety. Medical Journal of Australia, 4: 28-32.

Wiedemann, K., (2015). Anxiety and Anxiety Disorders. International Encyclopedia of the Social & Behavioral Sciences, 2nd edition , 1: 804-809.