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Depression blog

With Mayo Clinic psychiatrist Gabrielle J. Melin, M.D.

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July 3, 2008

Managing depression by understanding anxiety

36 comments posted

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By Gabrielle J. Melin, M.D.

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Depression can be a challenge to manage. Anxiety and depression may occur together but certainly not always. Be assured that if anxiety accompanies depression, it can be treated.

Anxiety may manifest itself in a multitude of ways including fear, helplessness, a feeling of panic, feeling that something bad may happen, as well as possible physical symptoms. We wouldn't be human if we didn't experience anxiety.

Anxiety is a general term. Anxiety disorders include a number of different specific disorders that includes panic disorder (panic attacks plus other symptoms), generalized anxiety disorder, post-traumatic stress disorder (PTSD), phobias (for example, heights, flying, needles), to name a few.

The diagnosis of panic disorder is made when a person has recurring panic attacks accompanied by other specific symptoms and criteria. Therefore, a panic attack is a cluster of symptoms that signify anxiety. 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 a peak intensity, and then resolve with time. If you do have panic attacks, here are a couple of basic self-management tools:

Although you may feel completely powerless, anxiety is nothing more than an exaggeration of normal body reactions to stress.
Tell yourself in a positive tone of voice that this will pass and it is not dangerous.
Refrain from escalating your panic with frightening thoughts about what is happening and where it will lead ("what if").
Don't fight the feeling of panic, accept it. Get as comfortable as possible without fleeing. You could sit or lean on something.

Many medical illnesses can cause anxiety symptoms, so seeing a professional is important for the right diagnosis.

Finally, we want you to know that we do read through all of the comments you send, but cannot answer all of them. Our goal is to provide accurate information and stimulate conversations amongst visitors. Thanks for visiting our blog and have a great week.

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36 comments posted

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October 28, 2008 11:22 a.m.

I have panic disorder and have researched the web site. The U of Iowa is developing a genetic blood test for this disorder which I believe means there must be a biological cause...if this were strictly a behavioral problem it would not show up on a genetic blood test. Also the National Institue of Health is doing alot of research and has already discovered that the serotonin levels in the brains of people who suffer from this are one-third lower in three key areas of the brain. I have provided this information to my mayo psychologist and now because I don't want to believe that this is strictly a behavioral disorder...that there is definitely a biological trigger point for this disease.,,my doctor wants me to see someone else. At this point I feel my doctor has totally given up on me...that I have made my doctor upset because of the information that I researched. I know that the doctors are very educated and have studied this for many years but I have lived with this illness for years. This disease is not just being a little stressed or anxious...I feel like I am short circuiting...like the wires in my brain just are not connecting properly...and to describe this feeling to doctors is almost impossible. All I really want to say is if doctors really want to learn about this disease listen to your patients. We can teach you more about panic disorder than any textbook.

- No name given

October 27, 2008 12:53 p.m.

MJ, We would recommend you talk to your provider. I am very sorry to hear about your daughter. Anxiety can be normal during stress but you should be evaluated to assess both your anxiety and depression. We cannot predict if you will have another episode, so following closely and monitoring your active symptomsis important. Our thoughts and prayers are with you! Lilly, We would recommend that you discuss all of the risks, benefits and alternatives with your care team. If ECT is their number one recommendation, that doesn't mean that you have to. Ask what their reasoning is for not trying the other medication first. Have all of your questions answered and then you'll be better equipped to make a decision with your loved ones. Best wishes and we hope you feel better soon. MC.Com Staff

- MC.Com Staff

October 25, 2008 3:26 p.m.

I have had GAD for about 15 years now with three major depression episodes sprinkled in just for fun! Five years ago I watched my mother die a very slow death from leukemia. We were best friends. Now my other best friend, my 28 daughter has been diagnosed with an inoperable brain tumor. While she may live a long life, just recently when she visited, I experienced the same anxious feelings being with her as I did being with my mom the last year of her life. It took the joy out of our visit. Is this normal or do I need to worry about heading for another depressive episode?

- MJ

October 21, 2008 9:06 p.m.

Has anyone been treated for anxiety/depression by ECT in less than 2months? The Hospital we are at is pushing ECT before trying an old drug that worked in the family. Should we try medicine first before jumping into ECT treatment?

- Lilly B.

October 17, 2008 6:02 p.m.

I wanted to thank you Val for your post. I feel the same way about the hardest thing being that I'm watching myself act in ways that are not the real me. No one understands that - its destroyed my relationship with my husband and he has the "your tougher than that, its a choice so make it" attitude. It felt so good to know that I'm not alone. Thank you.

- Kel

October 15, 2008 10:11 p.m.

I HAVE HAD IT CAN SOME ONE GIVE ME SOME ADVICE ON WHAT MEDS ARE THE BEST AFTER 15 LONG YEARS IM AT THE END OF MY ROPE IM GOING ON MEDS

- mike

October 13, 2008 10:25 a.m.

Please do not put in personal information such as full name, e-mail address or phone number. We do encourage you to help each other but have found that providing specific personal information is not a good idea. Thank you.

- Mayo Clinic.com Staff

October 12, 2008 3:06 a.m.

i have had anxiety all my life i am 27 now and i have trowed all my medication away and have learned to deal with it i am a severe hyperconderiac and i still worry constanly about my health but i do not have a problem with anxiety anymore but i know how you all feel i was there going on no sleep i still sleep with the light on thinking if i shut it off i will have some kind of symptoms that i will not be able to see in the dark and i used to run the ER everytime i thought i was dyeing but no more and i cannot tell you how i did because i dont know how i did it but i have all the same problems all of you are haveing if my chest starded hurting i whould run to the ER thinking i was haveing a heart attack and i have so bad of panic attacks that it felt like i had a electric shock in my tounge i passed out everytime i have a panic attack but i decided one day i am tired of the doctors useing me as a guiney pig i throwed all my meds away and delt with it i am telling you that you have to that meds might work for you but they did not work for me

- chris

October 9, 2008 9:18 p.m.

i have had anxity,panic,depression for over 15 years at one time i did not leave the house for 3 years im at the end of my rope do i go on med's. on the net all you here is horror stories i no you say you read all of these post but i would like a answer please if you can help it would be a blessing i no god will work through this post so i can get back to liveing life.

- mike

October 2, 2008 1:14 p.m.

I have been taking an SSRI for depression and anxiety for a month now and the depressive moods are gone. But I still have anxiety. Also, the medication appears to have increased my insomina. I have been depending on a sleep aid to sleep but I still feel sleep deprived and stressed. I cannot even take an afternoon nap. I feel fatigue and tired all the time. From my readings, it appears that all SSRIs have insomnia as a side effect. How can i get around this chronic insomnia? I eat right and exercise already.

- Maria Goretti