Catawba Valley Healthcare is an independent, comprehensive, non-profit healthcare organization that offers a wide range of whole-person healthcare and services that integrate physical and mental health.

Depression & Anxiety

Depression & Anxiety

Depression and anxiety are different conditions, but they commonly occur together, and they often have similar treatments. Both are two of the main classes of mental health illnesses in the United States, and both are very common in our modern-day society. 

Feeling down or having a bout of the blues now and then is normal. And everyone feels anxious from time to time as anxiety is a normal response to stressful situations. But severe or ongoing feelings of depression and anxiety can be a sign of an underlying problem that needs attention.

Seeking the proper medical care and therapies when you are suffering from depression or anxiety, or any brain illness, is as important as seeing the doctor when you have a broken bone.

    depression and anxiety


    Depression is a medical condition that affects your mood and ability to function day to day. Depressive symptoms include feeling sad, hopeless, or anxious. It can cause difficulty with thinking, focusing, memory, sleeping, and eating. A diagnosis of major depressive disorder (clinical depression) is given when an individual has felt sad, low, or worthless most days for at least two weeks while also having symptoms such as sleep problems, change in appetite, and loss of interest in activities.

    Without medical treatment, depression can get worse and last longer. In very severe cases, depression can lead to self-harm. Fortunately, treatments can be very effective in improving symptoms of depression.

    Depression is Very Common

    Depression is common all over the world, and in the United States, healthcare providers estimate that nearly 7% of American adults experience depression every year. More than 16% of U.S. adults (1 in 6) will have some form of depression in their lifetime.

    Types of Depression

    Depression is categorized according to symptoms and causes.
    Types include: 

    • Major depressive disorder (MDD): Major depression (clinical depression) has overwhelming or intense symptoms lasting longer than two weeks. These symptoms include sadness, hopelessness, and lack of interest in everyday activities, among others. These symptoms interfere with everyday life.
    • Bipolar depression: Individuals with bipolar disorder have alternating periods of low mood and extremely high-energy (manic) periods. 
    • Perinatal and postpartum depression: Perinatal depression can occur during pregnancy and up to one year after having a baby. Symptoms go beyond just minor sadness, worry, or stress.
    • Persistent depressive disorder (PDD): PDD is also known as dysthymia. Symptoms of PDD are less severe than major depression, but people experience PDD symptoms for two years or longer.
    • Premenstrual dysphoric disorder (PMDD): this disorder is a severe form of premenstrual disorder (PMS). It affects women in the days or weeks leading up to their menstrual period.
    • Psychotic depression: Individuals with psychotic depression have severe depressive symptoms and delusions or hallucinations. 
    • Seasonal affective disorder (SAD): Seasonal depression, or seasonal affective disorder, usually starts in late fall and early winter when days are shorter. It usually goes away during the spring and summer months.

        Causes of Depression

        Various factors can cause depression, including: 

        • Brain chemistry: Abnormalities in brain chemical levels may lead to depression.
        • Medical conditions: Ongoing physical pain or illnesses can cause depression. People often have depression along with conditions like cancer, diabetes, and Parkinson’s disease.
        • Life Events: The death of a loved one, stress, trauma, isolation, and lack of support can cause depressio.
        • Genetics: Depression can run in families.
        • Medication: Some medications have depression as a side effect, and recreational drugs and alcohol can cause depression or make it worse.
        • Personality: Individuals who are easily overwhelmed or have trouble coping with problems may be more prone to depression.

        Symptoms of Depression

        Depression can affect your emotions, mind, and body with some of the following symptoms:

        • Feeling very sad, hopeless, or worried
        • Not enjoying things that used to bring you joy
        • Eating too little or too much
        • Having a hard time concentrating or remembering things
        • Being easily irritated or frustrated
        • Feeling physical problems such as headaches, stomachaches, or sexual dysfunction
        • Thinking about hurting yourself or thinking about suicide

        Treatments for Depression

        Treatments for depression include: 

        • Counseling: Psychotherapy or counseling is talking with a mental health professional who can address your problems and develop coping skills. 
        • Medication: Prescription medicines called antidepressants can help change brain chemistry that causes depression. Antidepressants can take a few weeks to take effect.
        • Self-help: Exercise, getting enough sleep, and spending time with people you care about can improve symptoms of depression.
        • Brain stimulation therapy: This form of treatment can help individuals with severe depression or depression with psychosis. Types of brain stimulation include electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and vagus nerve stimulation (VNS).
        • Therapies and complementary medicine: People with mild depression can often improve their symptoms with massage, acupuncture, and biofeedback.

        Take action if you have symptoms of depression. See your healthcare provider for an accurate diagnosis and treatment plan.

        Anxiety and Depression Can be Symptoms of Each Other

        Anxiety may occur as a symptom of clinical (major) depression. It is also common to fall into depression triggered by an anxiety disorder, such as generalized anxiety disorder, separation anxiety, or panic disorder. It is not uncommon for people to have a diagnosis of both clinical depression and an anxiety disorder at the same time.



        Anxiety disorders are a mental health condition that includes feelings of nervousness, panic, and fear and can include sweating and a rapid heartbeat. Anxiety is characterized by the anticipation of future misfortune or danger, accompanied by excessive worrying. Anxious individuals often avoid situations that cause anxiety. 

        It is normal to have some anxiety when at work, taking a test, making an important decision, or interviewing. Anxiety can be helpful when it helps us notice dangerous situations or focus our attention.
        But an anxiety disorder takes normal anxiety to another level and occurs when:

        • Anxiety interferes with your ability to function
        • You overreact when something upsets your emotions because you feel fear or anxiety
        • You cannot control your responses to situations
        • You find it difficult to get through the day

        Types of Anxiety Disorders

        There are several types of anxiety disorders, including: 

        • Generalized anxiety disorder (GAD):  GAD is a condition of feeling extreme and unrealistic worry even when nothing is truly wrong. Various topics of worry might include health, work, school, and relationships. The worry often gravitates from one thing to another.
        • Panic disorder: Panic disorder describes a condition among those who experience panic attacks. With this disorder, individuals become persistently worried about having more panic attacks, obsessed with losing control during a panic attack, and may change their behaviors to avoid situations that could trigger a panic attack. A panic attack can feel like a heart attack. It is a sudden feeling of fear with a strong physical reaction such as difficulty breathing, sweating, and a racing heart in response to a nonthreatening situation.
        • Phobias: Phobias are an intense fear of certain situations or objects, and while some fears make sense (like fear of tick bites), the fear doesn’t match the situation. Common phobias include fear of blood, flying, heights, injections, and animals.
        • Social anxiety disorder: This disorder results in an overwhelming worry and self-consciousness with everyday daily social situations that can lead to avoiding social contact entirely.
        • Agoraphobia: Agoraphobia is an intense fear of being unable to get help or feeling overwhelmed, usually in one or more of these environments: enclosed spaces, lines or crowds, open spaces, places outside your house, or public transportation. In extreme cases of agoraphobia, individuals may not leave their houses.
        • Separation Anxiety: This condition occurs most often with children or teens who have excessive worry about being away from their parents for fear that they may not be able to return to them.

        There are other health conditions that share features with anxiety disorders, including post-traumatic stress disorder and obsessive-compulsive disorder.

        Anxiety Disorders are Common

        Anxiety disorders are the most common mental health condition in the U.S., affecting about 40 million Americans and happening to nearly 30% of adults at some point. Anxiety orders most often begin in childhood, adolescence, or early adulthood.

        Causes of Anxiety Disorders

        Just like other forms of mental illness, anxiety disorders do not stem from personal weakness or character flaws.
        Researchers suspect a combination of variables plays a role, including:

        • Chemical imbalance: Severe stress can change the chemical balance that controls your mood, and experiencing stress over a long period of time might lead to an anxiety disorder.
        • Environmental factors: Experiencing trauma can trigger an anxiety disorder, particularly in an individual who has inherited a higher risk to start.
        • Heredity: Anxiety disorders tend to run in families.  

            Symptoms of Anxiety Disorder

            Symptoms of Anxiety disorder vary depending on the type, but general symptoms include: 

            • Feeling panic, fear, or unease
            • Trouble sleeping, nightmares
            • Repeated thoughts or flashbacks of traumatic experiences
            • Uncontrollable, obsessive thoughts
            • Cold or sweaty hands, muscle tension, heart palpitations, 
            • Numbness or tingling in hands or feet, nausea, dry mouth
            • Inability to be still and calm, ritualistic behaviors like washing hands

            Treatments for Anxiety Disorders

            Treatments for anxiety disorders include medications and cognitive behavioral therapy. While medications do not cure brain illnesses, they can often improve symptoms significantly. They can also help make other treatments, such as talk therapy, more effective. The best medications will depend on your unique situation and how your body and brain respond to particular medications. Medications include:

            • Anti-anxiety medications, such as benzodiazepines, can decrease anxiety, panic, and worry quickly. The challenge is that your body can build up a tolerance to them, making them less effective over time. So, your provider might prescribe an anti-anxiety medication for the short-term, then taper you off while adding an antidepressant to the mix.
            • Antidepressants can also help with anxiety disorders but take a little time to work. 
            • Beta-blockers are usually used for high blood pressure, but they can help reduce some of the physical symptoms of anxiety disorders such as rapid heartbeat, shaking, and trembling.

            Counseling Helps Anxiety Disorders

            Psychotherapy can help you deal with your emotional responses to your anxiety disorder by talking through strategies to help you better understand and manage your condition, including: 

            Cognitive-behavioral therapy (CBT) teaches you to recognize thought patterns and behaviors that lead to problematic and troublesome thoughts and how to change them.

            Exposure therapy focuses on the fears behind the anxiety disorder and slowly but surely exposes you to those situations that bring on fear with relaxation exercise and imagery.

            Working Closely with Professionals is Very Important

            Talk to your providers about your medication preferences and concerns. When you start taking medication, follow your provider’s instructions carefully and keep notes on your feelings. Your provider may need to make adjustments early on or as the weeks go by. Medications often take time to take effect, so be patient. 

            Keep your psychotherapist appointments, follow self-help practices, and be patient with yourself as you work through your depression and anxiety.

            Call us at Catawba Valley Primary Care if you are experiencing feelings of depression and anxiety. We can help. Call us at (828) 695-5900.