Anxiety and depression are a serious problem for millions of Americans, and the majority of my clients experience one or both. According to the National Institute of Mental Health (NIMH), approximately 25 percent of U.S. adults struggle with depression, anxiety or some combination of both. In fact, anxiety is the most common mental illness in the U.S., with almost one out of every five people suffering from an anxiety disorder. Fortunately, both depression and anxiety can be treated and managed with therapy.

Anxiety and depression are not the same, but they often occur together. It is not uncommon for people with depression to experience anxiety and people with anxiety to become depressed. Depression and anxiety also share an essential psychological component – namely, pushing people away from living in the present moment. Individuals with anxiety are continuously worried about the future, while people with depression are often focused on what has happened in the past. Further, anxiety and depression share an avoidant coping style. Sufferers avoid what they fear instead of developing the skills to handle the kinds of situations that make them uncomfortable.


Everyone feels anxious and under stress from time to time. Situations such as meeting tight deadlines, important social obligations or driving in heavy traffic, often bring about anxious feelings. Such mild anxiety may help make you alert and focused on facing threatening or challenging circumstances. On the other hand, anxiety disorders cause severe distress over a period of time and disrupt the lives of individuals suffering from them. The frequency and intensity of anxiety involved in these disorders is often debilitating. Symptoms of anxiety are often physical, as well as cognitive and behavioral, and can include:

  • Physical: panic attacks, hot and cold flushes, racing heart, tightening of the chest, quick breathing, restlessness, or feeling tense, wound up and edgy
  • Cognitive: excessive fear, worry, catastrophizing, or obsessive thinking
  • Behavioral: avoidance of situations that make you feel anxious or remind you of a traumatic experience

Many people who suffer from an untreated anxiety disorder are prone to other psychological disorders, such as depression, and they have a greater tendency to abuse alcohol and other drugs. Their relationships with family members, friends and coworkers may become very strained. And their job performance may falter.


Depression is more than feeling sad or upset. It can be confused with healthy and natural feelings associated with unhappiness or grief over specific events or circumstances, such as the end of a relationship or failure to achieve a goal. But when sadness lingers more than two weeks, interfering with daily life and relationships, it could be a sign of depression.

Aside from feelings of sadness, some of the most common signs of depression include:

  • Feelings of helplessness or hopelessness
  • Feeling overwhelmed
  • Chronic fatigue
  • Unwillingness to socialize
  • Loss of appetite
  • Insomnia
  • Significant changes in weight
  • Difficulty focusing or making decisions
  • Thoughts of death or suicide

Among the most effective treatments for depression and anxiety disorders are interpersonal psychotherapy and cognitive-behavioral therapy. Interpersonal therapy strives to help the patient cope with stressful relationships and situations that may trigger depressive episodes. Cognitive-behavioral therapy teaches more constructive thought patterns to replace thinking habits that magnify feelings of worthlessness and hopelessness.