"If you're facing terror every day, it's gonna bring Hannibal to his knees"
Jim Ballenger, a leading expert on anxiety

ALTHOUGH depression is often considered to be a 'low energy' state, the opposite is usually true.

Inside, the depressed person often experiences a lot of anxiety. This can lead to them having panic attacks.

Of course, having panic attacks can itself be a depressing thing. Any lack of control within our lives can contribute to depression.

The Link Between Depression and Anxiety

Depression and anxiety disorders are not the same though, although at first glance they seem very similar. Depression generates emotions such as hopelessness, despair and anger. Energy levels are usually very low, and depressed people often feel overwhelmed by the day-to-day tasks and personal relationships so essential to life.

A person with anxiety disorder, however, experiences fear, panic or anxiety in situations where most people would not feel anxious or threatened. The sufferer may experience sudden panic or anxiety attacks without any recognized trigger, and often lives with a constant nagging worry or anxiousness. Without treatment, such disorders can restrict a person's ability to work, maintain relationships, or even leave the house.

Both anxiety and depression are frequently treated in much the same manner, which may explain why the two disorders are so often confused. Antidepressant medication is often used for anxiety, while behavioral therapy frequently helps people overcome both conditions.

Why Are Depression and Anxiety Linked?

Although no one knows exactly why, a great number of depressions are also accompanied by anxiety. In one study, 85 percent of those with major depression were also diagnosed with generalized anxiety disorder while 35 percent had symptoms of a panic disorder. Other anxiety disorders include obsessive-compulsive disorder and post-traumatic stress disorder (PTSD). Because they so often go hand in hand, anxiety and depression are considered the fraternal twins of mood disorders.

Believed to be caused in part by a malfunction of brain chemistry, generalized anxiety is not the normal apprehension that one feels before taking a test or awaiting the outcome of a biopsy. A person with an anxiety disorder suffers from what President Franklin Roosevelt called "fear itself." For a reason that is only partially known, the brain's fight-or-flight mechanism becomes activated, even when no real threat exists. Being chronically anxious is like being stalked by an imaginary tiger. The feeling of being in danger never goes away.

"Even more than the depression, it was my anxiety and agitation that became the defining symptoms of my illness. Like epileptic seizures, a series of frenzied anxiety attacks would descend upon me without warning. My body was possessed by a chaotic, demonic force which led to my shaking, pacing and violently hitting myself across the chest or in the head. This self-flagellation seemed to provide a physical outlet for my invisible torment, as if I were letting steam out of a pressure cooker." Douglas Bloch, M.A., author of "Healing From Depression"

Being both anxious and depressed is a tremendous challenge. Clinicians have observed that when anxiety occurs "comorbidly" with depression, the symptoms of both the depression and anxiety are more severe compared to when those disorders occur independently. Moreover, the symptoms of the depression take longer to resolve, making the illness more chronic and more resistant to treatment. Finally, depression exacerbated by anxiety has a much higher suicide rate than depression alone. (In one study, 92 percent of depressed patients who had attempted suicide were also plagued by severe anxiety.*) Like alcohol and barbiturates, depression and anxiety are a deadly combination when taken together.

Unfortunately, over 60 percent of major depressions are accompanied by varying levels of anxious feelings and behavior. (During his illness, Douglas Bloch says extreme anxiety interfered with his recovery and increased the risk of suicide.)