Co-Occuring Anxiety / Depression
ANXIETY AND DEPRESSION
Anxiety is a mood condition that can often occur without an obvious cause. Anxiety is related to circumstances perceived as uncontrollable or unavoidable. Individuals who experience anxiety many times express it as dread or panic. It is not unusual for these conditions to present ancillary to addictive issues.
Clinical depression and major depression is characterized by hopelessness, listlessness and loss of interest or pleasure in normally enjoyable activities. The diagnosis of a depressive disorder is based on an assessment, which includes the client’s own experiences and at times the observations of relatives or friends.
There is no laboratory test for major depression, although it is very helpful to test for physical conditions that may cause similar symptoms. If depressive disorder is not detected in the early stages it may result in a slower recovery and may affect a person’s physical health. The most common time of onset is between the ages of 20 to 40.
- Mental and physical evaluations by contracted health providers to try to uncover the causes of the anxiety or depression.
- Providing access to assessment services to help gauge the severity of the anxiety or depression.
- Recommending courses of action that may include medical or psychiatric care, psychotherapy, wellness activities, nutrition, exercise and proper amounts of sleep.
- Providing resources to help individuals suffering from anxiety or depression to stop using drugs or alcohol.
- Educating our clients and their loved ones on the signs and symptoms of anxiety and depression.
- Assisting our clients with medication management and encouraging medication compliance.
The nature and causes of depression has evolved over time, proposed causes include psychological, psycho-social, hereditary, evolutionary and biological factors. Certain types of long-term drug use can both cause and worsen depressive symptoms.
Physical effects of anxiety may include heart palpitations, muscle weakness and tension, fatigue, nausea, chest pain, shortness of breath, stomach aches, or headaches. External signs of anxiety may include pale skin, sweating, trembling, and pupillary dilation.
A panic attack is a cluster of symptoms that signify anxiety. Panic attacks are not at all uncommon for addicts and alcoholics, and can cause a person to get caught in a vicious cycle of self medicating the panic attacks with the very thing that brought the panic attack on.
A panic attack can include some or all of the following symptoms: sudden onset of extreme fear (panic), shortness of breath, dizziness, feeling hot/cold, a choking sensation, numbness or tingling in the fingers and/or toes, sweating, nausea and/or vomiting, and palpitations or a sensation of heart pounding. Panic attacks typically last for a few minutes, reach peak intensity, and then resolve with time.
Frequently Asked Questions:
Dr. Tim Fong MD, Head of Addiction Medicine, UCLA: Psychiatric disorders have a wide variety of ways of presenting themselves. So when you think about heart attacks, how does that present itself: Chest pain, shortness of breath, chest pressure, trouble breathing. There are a lot of different signs that could be the sign for a heart attack. The same is true for all psychiatric disorders. Even with depression, classically we think of it as sadness suicidal thoughts, feeling guilty or having a negative mood all day. But it could also be things such as being irritable, changes in sleep or appetite. These are symptoms that people don’t normally think of. We think of anxiety disorders the same way. As though it is just people with excessive worry. It can also be things like nausea and vomiting, not sleeping, or having difficulty concentrating. So the way I think about psychiatric conditions is that any time someone is experiencing an emotion or a loss of functioning in an area they can normally do, that may be a sign of a psychiatric disorder. For instance if you are working a 40 hour job and you find yourself not being all that productive and showing up for 20 hours of it or you are there but you are not really getting much done, it may be a sign that you are having depression or anxiety or drugs that are interfering with your functioning. This is the same with home life. If you are at home and not really finding yourself engaging with your family and struggling with sleep or not enjoying life, these are all possible signs of depression. One of our screening questions for depression is, ‘Can you imagine yourself doing something enjoyable over the next 2 weeks’ oftentimes patients who are depressed say ‘no because there is simply no joy in life’. Most of us can think of looking forward to something in the next couple of weeks, which would reflect we are not depressed right now.