Sometimes it is not necessary to distinguish between the two.
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Editor’s note: The current mainstream method for diagnosing mental problems in the medical community is to use a checklist system that clinicians compare to the patient’s reported experience to determine which disease. However, there are many similarities between the symptoms of depression and anxiety, making it difficult for patients, both professional and professional, to distinguish between the two diseases. However, considering the similarities in the treatment of these two diseases, it is not very different to distinguish the two from the treatment effect. Even so, scientists are currently actively exploring the field in an attempt to segment the disease classification to provide tailor-made treatments for patients. This article is translated from Medium, author Erman Misirlisoy, PhD, originally titled “Is It Depression, or Is It Anxiety?”, I hope to inspire you.
How does anxiety and depression begin and how does it end?
In 2017, the World Health Organization estimates that 4.4% (more than 300 million people) worldwide suffer from depression and 3.6% (more than 250 million people) suffer from anxiety. But there is a fact that complicates the situation: many people with depressive symptoms also have anxiety symptoms, and many people with anxiety symptoms also have depressive symptoms. This makes it difficult to reliably diagnose and distinguish between the two diseases.
The current mainstream method for diagnosing mental problems is the use of checklist systems, such as the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The clinician compares the list of symptoms to the experience reported by the patient. If a person continues to have symptoms such as depression and worthlessness, he or she may be diagnosed with major depression. If a person usually experiences constant anxiety and irritability, they may be cut off into generalized anxiety disorder. But looking at these criteria for each disease, it is not difficult to find that there are many commonalities. For example, depression and anxiety can interfere with life activities, hinder sleep, and consume energy.
The main difference between the two diseases is the basic state of one’s emotions: extreme sadness can be defined as depression, and extreme fear or worry can be defined as anxiety. But we can easily see the connection between the two. When people feel sad about their lives and past experiencesThey will also feel anxious about their future life. When they are anxious about the future, they also feel sad about their current life.
Laura Hack, Psychiatry Researcher, Stanford University Some signs that help distinguish between depression and anxiety are presented. People with depression are usually slow to talk, and they will shed tears, while anxious people speak quickly and show signs of tension, such as sweating and trembling. But Huck explained that in actual situations, she would not pay too much attention to these signs, because depression is often accompanied by irritability, and anxiety is often accompanied by crying and fatigue. Similarly, people with both diseases tend to quit from daily activities and activities of interest, although their causes are often different: depression destroys the motivation to drive life and enjoyment, while anxiety makes people afraid to escape opportunity.
Because of the considerable overlap in symptoms of anxiety and depression, and because patients can exhibit the same symptoms for different reasons, clinicians should consider the overall situation when making diagnostic decisions. Huck said: “DSM diagnosis of depression or anxiety (or both) must take into account the entire clinical situation, rather than any specific symptoms or signs.”
Most of the people diagnosed with anxiety or depression also seem to have symptoms of other diseases. As Rother said: “Common disease is the norm.”
(Note: Comorbidity of comorbidity is also translated as the same disease, combined disease, meaning that the two diseases coexist. For example, anxiety and depression comorbidity refers to both anxiety and depressive symptoms, such as the two groups of symptoms Considering that they all meet their respective diagnostic criteria.)
Does one feel anxious and depressed at the same time?
Clinical anxiety and clinical depression are common at the same time, which scientists call comorbidity. However, it is unclear how many people have both symptoms at the same time. Jonathan Roiser, a professor of neuroscience and mental health at University College London, said: “The current number of people suffering from depression and anxiety is estimated to be quite different.It depends on the definition of the population and use of the test.
Rother found that the most convincing estimate came from a 2007 study that tracked about 1,000 people born in New Zealand between 1972 and 1973 and tracked them to 32 years old. Of those who were diagnosed with generalized anxiety disorder in 2007, 72% also experienced major depression. Of those diagnosed with major depression, 48% also experienced generalized anxiety disorder. Most people diagnosed with anxiety or depression also seem to have symptoms of other diseases. As Rother said: “Common disease is the norm.”
The key to understanding the relationship between anxiety and depression is how they behave in the brain. “There are many similarities between the brain networks of patients with anxiety and depression,” said Rother. But considering that patients have similar symptoms, we are not surprised by the similarity of the brain network.
In another study in 2007, researchers tried to scan two groups of patients The brain is used to distinguish between depression and anxiety, while patients with and without coexisting symptoms are studied separately. Compared to healthy people, the anterior cingulate cortex has a smaller brain volume in all patient groups. The anterior cingulate cortex is the area in which the brain processes emotional and motivational information. But when observing patients without symptoms, they also found some differences between depression and anxiety. They explained that the similarity of brain activity reflects the common symptoms of both mental disorders, and the differences in brain activity suggest that depression and anxiety are independent obstacles with unique symptoms.
The genetic overlap between depression and anxiety. We recognize a potential, deeper link between the two. Some studies on twins have compared the performance of identical twins and fraternal twins in different settings, and found that generalized anxiety disorder and major depression have a common genetic root. Huck explained that the abnormalities found by researchers in “the structure and function of the neural circuits leading to these two diseases” may be related to these shared genetic roots.
Although there are complications in the diagnosis of depression and anxiety, they do not affect treatment. This is because, as the anterior cingulate cortex and Huck said, the first-line medical response of a psychiatrist to each disease is usually the same: a drug that increases the availability of serotonin, a neurotransmitter in the brain. Cognitive-behavioral therapy is also a common choice for both diseases, so the error is made”Therapeutic prescriptions are not a big problem.
This is not to say that treatment is foolproof. Drugs have side effects that make some symptoms worse, and in some people, all common treatments don’t have a good effect: this phenomenon is called refractory anxiety or depression, which can cause long-term chronic symptoms. Even life-threatening consequences.
If these two disease labels disappear?
The diagnosis of “depression” or “anxiety” depends on the basic report of the symptoms. In the future, these labels may be replaced by more detailed classifications of mental illnesses based on genetic data from genetics and neuroscience.
Huck is currently developing a more detailed category of diseases that are provided by neuroscience. She refers to these categories as “biological types,” which are not necessarily consistent with traditional classifications of depression and anxiety. She is beginning to use these “biological types” to test new ways to treat the most serious anxiety and depression – these types of diseases are resistant to common drugs. Huck believes that by integrating data from genetics, neuroscience, and behavioral science to diagnose patients, she will “be better able to guide patients with emotional and anxiety disorders for tailor-made treatment.”
Obviously, it is still very difficult for clinicians to distinguish between depression and anxiety. Researchers are now developing a tool to separate the two diseases, and in the process they may completely change the entire mental health field.
Translator: Jane
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