By Candace Schoner
Anxiety and depression are serious mental health conditions that affect the lives of millions of Americans. While they are uniquely different conditions, they can occur together.
The main symptom of depression is generally a lingering low, sad, or hopeless feeling. On the other hand, anxiety mainly involves an overwhelming sense of worry, nervousness, and fear.
Feeling down or having the blues on occasion is normal, however so is feeling anxious in a stressful situation. When the feelings become severe or chronic they can indicate an underlying mental health disorder.
Many people who have anxiety and depression know their worrying is irrational, but they still cannot stop the self-doubt and negative thoughts.
Signs of depression and anxiety frequently show up differently from person to person making it difficult to diagnose the problem. Some of the overlapping symptoms, including, but are not limited to:
Other signs that a person may suffer from both anxiety disorder and depression include:
“It’s a cycle,” says Sally R. Connolly, LCSW and therapist. “When you get anxious, you tend to have this pervasive thinking about some worry or some problem. You feel bad about it. Then you feel like you’ve failed. You move to depression.” (heart grove hospital.com)
According to the National Alliance on Mental Illness (NAMI), some experts estimate that 60 percent of people with anxiety will also have symptoms of depression.
Since anxiety and depression tend to worsen when existing together, mental health professionals recommend treating both conditions at the same time.
The first step in treating any mental health issue is a diagnosis. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5),” the diagnosis for:
Depression is experiencing at least 5 of the 9 main symptoms of depression most days, for at least 2 weeks.
Anxiety is experiencing excessive, uncontrollable worry, along with 3 additional anxiety symptoms most days, for at least 6 months.
Therapy for Anxiety and Depression
In many cases, psychotherapy can be tailored to treat the symptoms of both anxiety and depression, including:
It is important to remember that what works for one person may not work for another.
If a person is not sure about which type of therapy is best for their individual situation, they should consult with their doctor or healthcare provider.
Medications for Anxiety and Depression
There is no single medication to treat anxiety or depression, usually there are multiple medications working in conjunction with each other to address all of the symptoms. In most cases a medication regimen is usually started at a low dose, to minimize side-effects, and slowly increased until the ideal dose is found. The ideal dose is one that provides the greatest benefit with minimum side-effects.
Some of the most commonly prescription drugs used to treat depression include:
Selective serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa), escitalopram oxalate (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine HRI (Paxil), and sertraline (Zoloft). Selective serotonin & norepinephrine inhibitors (SNRIs), such as desvenlafaxine (Khedezla), desvenlafaxine succinate (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor).
When treating anxiety disorders, antidepressants, particularly the SSRIs and some SNRIs (serotonin-norepinephrine reuptake inhibitors), have been shown to be effective.
Other anti-anxiety drugs include benzodiazepines, such as alprazolam (Xanax), diazepam (Valium), buspirone (Buspar), and lorazepam (Ativan). These drugs do carry a risk of addiction or tolerance. Other possible side effects include drowsiness, poor concentration, and irritability. (Source: webmd.com)
Always consult your physician prior to e adding any medication (prescription or over the counter) As there could be a negative reaction mixed with existing medications or diets.
Children of alcoholic parents often share a number of characteristics in adulthood due to chronic stress and the endured unpredictable environment. A parent’s alcohol dependency can have a gradual or cumulative impact on a child’s development. While each family’s situation is unique, experts agree that there are certain patterns and beliefs common among individuals who grew up with one or both parents with alcohol abuse.
According to the National Association for Children of Alcoholics, around 30 million children are born to an alcoholic parent. (mentalhealth.net)
Adult children of alcoholics often feel responsible for their parents' drinking. Therefore, as a result, in order to stop it, most children in this environment will put their parental needs before their own. Therapists refer to this as survival mode or the good child syndrome.
Additionally, individuals raised in a household with an alcoholic parent tend to have difficulty expressing emotions as they are taught not to talk about feelings, concerns, or problems at home.
According to researchers, children of alcoholics commonly fall into stereotypical roles within an alcoholic family—including becoming a scapegoat, a rescuer, a hero, or a caregiver.
Some studies have shown that the chronic stress of growing up in an unpredictable environment due to alcoholism can cause individuals to experience generalized anxiety disorder, panic attacks, trauma, persistent depression, and distrust.
Children raised in households with alcohol addiction may mature faster taking on the role of “surrogate spouse” or parent’s caregiver. This might include accepting more responsibilities such as cooking, cleaning, and taking care of younger siblings. While this can be a lot of pressure on a young child, some positive character traits can develop such as resilience, empathy, responsibility, and determination. (addictioncenter.com)
It is not uncommon for a child of an alcoholic parent to live in denial about the extent of a parent’s problem or blame themselves for it. It is important to let children know their parents' addiction is not their fault. It is not possible to create alcoholism in another person.
Is Alcoholism Genetic?
Alcoholism has long been reported to run in families, and children of alcoholics are four times more likely than other children to become alcoholics themselves. However, experts agree that genetics is only one factor along with environmental and social influences that affect risk. There is no “gene for alcoholism.”
How To Help Children of Alcoholics?
Children raised by alcoholics have little or no choice but to adapt to their environment.
The best way to help them is to create daily routines to add some stability to their life. Whenever possible, let them know that they can talk to you. Children get anxious when they are not able to express their fears and while it’s forbidden to talk about family problems, they learn not to trust their own perceptions. When discussing the alcoholic’s behavior and impact on the family, be truthful while using age appropriate language. Children don’t need to know all the details. They just need to be reassured that every effort is being made to improve the situation.
Click here to read my personal story growing up with an alcoholic parent.
Candace Schoner is a former journalist, TV producer and freelance writer. She has been diagnosed with ADHD, anxiety and visual dyslexia.
“Repurposing is the process by which an object with one use value is transformed or redeployed as an object with an alternative use value” - Wikipedia
My history with therapy began some 25 years ago when I was first diagnosed with major depressive disorder. Through those previous decades of therapy, I blindly went through the process. That is not to say I didn’t put in the work. I did. I simply didn’t pay close attention to the type of therapy.
The pandemic was life altering for me, as it was for everyone. During a global worst case scenario, I was afforded the opportunity of time. I was able to pursue a new form of therapy that worked for me and landed in the type of therapy I was missing all along. In February 2020, I began my journey with a trauma therapist.
To say I immediately took to the format would be disingenuous. Not only did I find her personality a bit “over the top” and jarring to my quiet exterior, it was nearly impossible to accept that the word “trauma” applied to my life. I never had it that bad. It took about six months to accept the notion of “little t” trauma. Death by a thousand little cuts. That understanding was a game changer.
Traumatic experiences alter neural landscapes. They do even more damage when not afforded the space for healthy processing. Many of my traumas distill down to not receiving the type of nurturing I needed as a sensitive soul. After a thousand little cuts that I could make no sense of, I concluded that my essence was wrong. In an attempt to visually convey how my inner child had created defense mechanisms against all emotions, I sent my therapist a meme captioned “Me Holding it Together” above a telephone pole strapped upright by a vast amount of duct tape.
Over the past few weeks, I have experienced a series of depression triggering events. Outside of therapy, I have been incorporating mindfulness meditation, which provided a body awareness in how often I experience depression as exhaustion. I noticed it deeply on a day where I was meant to be going to book club after work. By 3:00 pm that day, I knew I didn’t have it in me to go. Prior to trauma therapy, I would have followed my old pattern and gone anyway. I dislike canceling at the last minute so, regardless of my needs, I put others first. That day, I chose to email my friend to tell her I needed to cancel and why. I trusted she knew my character well enough to understand that I as not making the decision to cancel lightly. She understood and I went home to take a two hour nap.
In talking to my therapist about the decision, I had an epiphany. I had repurposed my duct tape. It was still there in my mental health tool kit, but instead of slapping on five entire rolls so as to not experience emotions, I used it to create a boundary. Boundary success!
We all create methods to survive childhood circumstances we could not understand. They were our protection; our inner child often wants to use them still. Go ahead. Use them. Just don’t use them the same way. Old patterns of survival are not necessarily effective now. Repurposing our defenses to better reflect our adult self’s needs honors our inner child while encouraging growth. It is a glorious moment of transformation, pride, and power.
Written by Lisa Wessner an asexual-spectrum she/they lesbian and molecular biologist working on her retirement career as a mental health advocate