Can Anxiety and Depression Occur Together?
Anxiety can make you feel like your mind won't slow down.
Depression can make you feel like you don't have the energy to do anything.
So how can you experience both at the same time?
It's actually possible to experience symptoms of anxiety and depression together.
You might spend hours worrying about everything you need to accomplish while simultaneously feeling unable to get started.
You may desperately want to connect with other people but feel too exhausted or overwhelmed to make plans.
You might lie awake at night because your mind won't stop racing—and then struggle to get out of bed the next morning.
Anxiety and depression can feel contradictory.
But when they occur together, they can also reinforce each other.
Understanding how these experiences overlap can help you recognize what may be happening and, more importantly, understand that treatment doesn't necessarily have to focus on one while ignoring the other.
What Is Anxiety?
Anxiety is part of the body's natural response to perceived threats, uncertainty, and stress.
Everyone experiences anxiety sometimes.
You may feel anxious before an important meeting, during a major life transition, while waiting for medical test results, or when dealing with financial uncertainty.
Temporary anxiety isn't necessarily a problem.
But when anxiety becomes persistent, excessive, difficult to control, or begins interfering with everyday life, it may be worth paying closer attention.
Anxiety may involve:
Excessive worry
Racing thoughts
Overthinking
Difficulty relaxing
Restlessness
Irritability
Muscle tension
Difficulty concentrating
Sleep problems
Avoiding certain situations
Seeking frequent reassurance
Feeling constantly "on edge"
Physical sensations such as a racing heart, sweating, shaking, nausea, or shortness of breath
For some people, anxiety feels primarily mental.
For others, it can be intensely physical.
What Is Depression?
Depression can affect your mood, thoughts, energy, motivation, sleep, appetite, relationships, and ability to function in everyday life.
And depression doesn't always mean feeling intensely sad.
It may look more like:
Feeling emotionally numb
Losing interest in things you normally enjoy
Persistent fatigue
Low motivation
Difficulty concentrating
Changes in sleep
Changes in appetite
Irritability
Social withdrawal
Feelings of guilt or worthlessness
Difficulty completing everyday tasks
Feeling hopeless about the future
Someone experiencing depression may continue working, taking care of family responsibilities, socializing, and appearing relatively "normal" to everyone around them.
That doesn't necessarily mean they're doing well internally.
Can You Really Have Anxiety and Depression at the Same Time?
Yes.
Experiencing symptoms of one condition doesn't prevent you from experiencing symptoms of the other.
In fact, anxiety and depression can overlap in ways that sometimes make it difficult to determine where one ends and the other begins.
For example, imagine you're struggling at work.
Anxiety may tell you:
"I'm falling behind."
"What if I make a mistake?"
"What if my boss thinks I'm incompetent?"
"I need to get everything done immediately."
Meanwhile, depression may tell you:
"I don't have the energy to do this."
"I'm failing anyway."
"Nothing I do is going to make a difference."
"What's the point?"
The result can feel like being simultaneously overwhelmed and unable to act.
Your mind may be telling you that everything is urgent while your energy and motivation are telling you that you can't handle any of it.
That can be an exhausting place to be.
What Does Anxiety and Depression Together Feel Like?
The combination can look different for different people.
You may experience:
"I'm Exhausted, but I Can't Relax"
Depression may leave you feeling physically and emotionally exhausted.
But anxiety may make it difficult to actually rest.
You lie down because you're tired, but your mind immediately starts reviewing:
Everything you forgot to do
Conversations from earlier in the day
Things that might go wrong tomorrow
Whether someone is upset with you
Bills you need to pay
Work you haven't finished
You're exhausted—but your nervous system doesn't seem to get the message that it's time to slow down.
"I Have So Much to Do, but I Can't Get Started"
This can be an especially frustrating combination.
Anxiety may create an intense awareness of everything that needs to be done.
Depression may reduce the motivation and energy required to actually begin.
You might sit on the couch thinking about:
The laundry.
The dishes.
The emails.
The appointment you need to schedule.
The work project you're behind on.
The person you need to call back.
You're thinking about all of it.
But instead of motivating you, the growing list becomes overwhelming.
So you avoid it.
Then anxiety increases because you're falling further behind.
"I Want to See People, but I Keep Canceling Plans"
Anxiety and depression can both contribute to social withdrawal, although sometimes for different reasons.
Anxiety may make you worry:
"What if I don't know what to say?"
"What if everyone notices I'm not myself?"
"What if something awkward happens?"
Depression may add:
"I don't have the energy."
"I don't feel like talking."
"I won't enjoy it anyway."
Canceling the plans may provide immediate relief.
But afterward, you may feel lonely, guilty, or disappointed in yourself.
That can reinforce both anxiety and depression.
"I'm Constantly Thinking, but Nothing Feels Productive"
Anxiety can create a tremendous amount of mental activity.
You may replay conversations, predict future problems, analyze decisions, and repeatedly ask yourself "what if?"
But all that thinking doesn't necessarily lead to solutions.
Instead, you may become mentally exhausted.
Depression can then make concentration and decision-making even more difficult.
The result may be hours of thinking without feeling like you've actually accomplished anything.
"I Worry About Everything, but I Also Feel Hopeless"
Anxiety tends to focus on what might happen.
Depression may influence how you view what will happen.
Anxiety might say:
"What if something goes wrong?"
Depression might respond:
"It probably will, and I won't be able to handle it."
That combination can make uncertainty especially difficult.
You may become increasingly worried about the future while simultaneously feeling less confident in your ability to cope with it.
How Anxiety and Depression Can Reinforce Each Other
One of the reasons anxiety and depression can become so challenging together is that they may create self-reinforcing cycles.
Consider this example:
You're anxious about work.
Because you're anxious, you have trouble sleeping.
Because you aren't sleeping well, you're exhausted.
Because you're exhausted, you have difficulty concentrating.
Because you're having trouble concentrating, you fall behind.
Because you're falling behind, you become even more anxious.
Eventually, you start feeling defeated.
You stop doing things you enjoy because you're too tired.
You withdraw from people.
Your mood declines.
Now depression may be part of the cycle too.
Another cycle might look like this:
Anxiety → Avoidance → Temporary relief → More anxiety → Reduced activity → Isolation → Lower mood → Less motivation → More avoidance
Understanding these patterns can be important because treatment may focus on interrupting the cycle rather than trying to determine which symptom came first.
Symptoms Anxiety and Depression Can Share
Anxiety and depression are different, but some symptoms can occur with either.
These may include:
Difficulty concentrating
Sleep problems
Fatigue
Irritability
Changes in appetite
Social withdrawal
Feeling overwhelmed
Difficulty making decisions
Reduced productivity
Physical symptoms
Difficulty managing everyday responsibilities
This overlap is another reason self-diagnosis can be difficult.
A mental health professional can look at the broader pattern of symptoms, how long they've been occurring, what may be contributing to them, and how they're affecting your life.
Can Anxiety Cause Depression?
It's usually more complicated than saying one condition directly "causes" the other.
However, living with persistent anxiety can be exhausting.
Imagine spending months or years:
Constantly worrying
Avoiding situations
Struggling to sleep
Feeling physically tense
Overthinking decisions
Seeking reassurance
Feeling unable to relax
Over time, you may become discouraged.
You might stop participating in activities because anxiety makes them uncomfortable.
Your world may gradually become smaller.
You may feel frustrated that anxiety continues controlling your decisions.
Those experiences can contribute to lower mood and depressive symptoms.
Can Depression Cause Anxiety?
Depression can also create circumstances that increase anxiety.
If depression makes it difficult to concentrate or complete everyday responsibilities, you may begin worrying about the consequences.
For example:
You fall behind at work.
Now you're anxious about your job.
You stop responding to friends.
Now you're worried that they're upset with you.
Bills pile up because managing paperwork feels overwhelming.
Now you're anxious about money.
You aren't sleeping well.
Now you're worried about how exhausted you'll feel tomorrow.
In this way, depression-related difficulties can create new sources of anxiety.
How Avoidance Can Keep Both Anxiety and Depression Going
Avoidance is an understandable response to discomfort.
If something makes you anxious, avoiding it can provide immediate relief.
If you're depressed and exhausted, avoiding something can feel like conserving desperately needed energy.
But avoidance can sometimes create longer-term problems.
Imagine you're anxious about attending a social event.
You cancel.
Immediately, you feel relieved.
But now you've missed an opportunity for connection.
You spend the evening alone.
You feel disappointed and isolated.
Your mood drops.
The next invitation feels even harder to accept.
Avoidance isn't a character flaw.
It's often an attempt to reduce discomfort.
Therapy can help you understand when avoidance is helping you protect yourself and when it may unintentionally be keeping anxiety or depression going.
Why Sleep Can Become Especially Difficult
Anxiety and depression can both affect sleep.
Anxiety may make it difficult to fall asleep because your mind won't stop thinking.
Depression may contribute to insomnia, early waking, sleeping significantly more than usual, or feeling exhausted regardless of how much you sleep.
When anxiety and depression occur together, sleep can become particularly challenging.
Poor sleep may then worsen:
Mood
Concentration
Emotional regulation
Stress tolerance
Energy
Anxiety
That can create another reinforcing cycle.
Healthy sleep habits may help, but persistent sleep problems alongside symptoms of anxiety or depression are worth discussing with an appropriate healthcare professional.
Why Everyday Tasks Can Feel So Difficult
When anxiety and depression overlap, ordinary tasks can sometimes feel surprisingly difficult.
Anxiety may turn a simple task into a series of questions:
"What's the best way to do this?"
"What if I do it wrong?"
"What should I do first?"
Depression may make starting the task feel exhausting.
So something as simple as answering an email can become:
Read the email.
Overthink the response.
Write something.
Delete it.
Rewrite it.
Decide to answer later.
Feel guilty for not answering.
Worry about what the person thinks.
Continue avoiding it.
This is one reason telling someone to "just do it" may not be particularly helpful.
The task itself isn't always the real problem.
How Therapy Can Help With Anxiety and Depression
When anxiety and depression occur together, therapy doesn't necessarily have to choose one condition to address first.
Treatment can explore the patterns connecting them.
Depending on your experiences and goals, therapy may help you:
Identify anxious thought patterns
Recognize depressive thinking
Reduce avoidance
Gradually reconnect with meaningful activities
Develop healthier coping strategies
Improve emotional regulation
Address self-critical thoughts
Build greater tolerance for uncertainty
Improve communication
Explore difficult experiences
Reconnect with your personal values
Develop more realistic expectations for yourself
Different therapeutic approaches may be used depending on your individual needs.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) explores the relationships between thoughts, emotions, and behaviors.
Consider this thought:
"I'm going to mess this up."
That thought may create anxiety.
The anxiety may lead you to avoid the situation.
Avoidance may provide temporary relief.
But avoiding the situation may reinforce the belief that you couldn't handle it.
Over time, repeated avoidance may reduce confidence, limit activities, and contribute to depression.
CBT can help identify patterns like these and develop alternative ways of responding.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) focuses on developing psychological flexibility.
Instead of trying to eliminate every anxious or depressive thought before moving forward, ACT can help you change your relationship with difficult internal experiences.
You may learn to notice:
"My mind is telling me I'm going to fail."
without automatically treating that thought as a prediction of what will happen.
ACT also emphasizes identifying your values and taking meaningful actions that align with those values.
Mindfulness-Based Cognitive Therapy (MBCT)
Mindfulness-Based Cognitive Therapy (MBCT) combines elements of cognitive therapy with mindfulness practices.
Anxiety can pull your attention toward possible future problems.
Depression can pull your attention toward negative thoughts about yourself, your circumstances, or the past.
Mindfulness can help you become more aware of these patterns without automatically becoming consumed by them.
Behavioral Changes Can Matter Too
Therapy isn't always about changing thoughts.
Behavior matters.
Depression may encourage you to withdraw.
Anxiety may encourage you to avoid.
Both can gradually reduce the number of rewarding, meaningful, or connecting experiences in your life.
Treatment may involve taking small, manageable steps toward activities that support your well-being.
That could mean:
Taking a short walk
Responding to one message
Meeting a friend for coffee
Completing one manageable task
Returning to a hobby
Spending time outside
Establishing a simple routine
The goal isn't to pretend you feel great.
It's to begin changing patterns that may be keeping you stuck.
Can Medication Help With Anxiety and Depression?
Medication may be helpful for some people experiencing anxiety, depression, or both.
Whether medication is appropriate depends on your symptoms, their severity, medical history, preferences, previous treatment experiences, and other individual factors.
Some people benefit from therapy alone.
Others benefit from medication.
And some people find that combining psychotherapy and medication works well for them.
There isn't one correct treatment path for everyone.
At Authentically You Counseling, Medication Management is available for adults age 18 and older through Alicia Pride, APRN.
A qualified healthcare professional can discuss your symptoms, treatment options, potential benefits, risks, side effects, and alternatives with you.
Lifestyle Habits Can Support Mental Health Too
Lifestyle changes aren't a replacement for professional treatment when treatment is needed.
However, everyday habits can play a supportive role in managing anxiety and depression.
Helpful areas to consider may include:
Regular physical activity
Consistent sleep and wake times
Eating regularly
Spending time outdoors
Maintaining social connection
Reducing excessive alcohol use
Taking breaks from constant information and social media
Practicing mindfulness or slow breathing
Creating manageable routines
Making time for meaningful activities
When you're struggling with both anxiety and depression, however, even healthy habits can feel overwhelming.
Starting small matters.
A ten-minute walk is still movement.
One supportive conversation is still connection.
One completed task is still progress.
When Should You Consider Getting Help?
You don't need to determine whether you're experiencing anxiety, depression, or both before contacting a mental health professional.
Consider reaching out if:
Worry is becoming difficult to control
You've lost interest in things you normally enjoy
You're increasingly avoiding situations
You're withdrawing from other people
Your sleep has changed significantly
You're constantly exhausted
Everyday responsibilities feel overwhelming
You're becoming increasingly self-critical
You're feeling hopeless
Symptoms are interfering with work or relationships
You're relying on alcohol or other substances to cope
You simply don't feel like yourself
You don't need a perfect explanation for what you're experiencing.
Figuring that out can be part of therapy.
A Note About Suicidal Thoughts
Depression can sometimes involve thoughts about death, self-harm, or suicide.
These thoughts should always be taken seriously.
If you are in immediate danger or believe you may act on thoughts of suicide or self-harm, call 911 or go to the nearest emergency department.
In the United States, you can also call or text 988 to reach the Suicide & Crisis Lifeline for immediate crisis support.
You do not need to wait until suicidal thoughts become more severe before reaching out for help.
Frequently Asked Questions About Anxiety and Depression
Can you have anxiety and depression at the same time?
Yes. People can experience symptoms of anxiety and depression at the same time. Symptoms may overlap and sometimes reinforce one another.
How do I know if I have anxiety, depression, or both?
Anxiety often involves excessive worry, fear, tension, overthinking, or avoidance. Depression may involve persistent low mood, emotional numbness, loss of interest, low motivation, fatigue, or hopelessness. Because symptoms can overlap, a mental health professional can help you better understand what you're experiencing.
Which comes first, anxiety or depression?
There isn't one pattern that applies to everyone. Some people experience anxiety before developing depressive symptoms, some experience depression first, and others experience symptoms of both around the same time.
Can anxiety make depression worse?
Persistent anxiety can contribute to exhaustion, avoidance, sleep difficulties, isolation, and discouragement, all of which may interact with depressive symptoms.
Can depression make anxiety worse?
Yes. Difficulties associated with depression—such as falling behind on responsibilities, withdrawing socially, or struggling to concentrate—can sometimes create additional sources of worry and anxiety.
Is it harder to treat anxiety and depression when they happen together?
Having symptoms of both doesn't mean treatment won't work. Therapy can address overlapping patterns and develop a treatment plan based on the individual's symptoms, experiences, needs, and goals.
What type of therapy is used for anxiety and depression?
Several approaches may be used, including Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and other evidence-based therapies. The appropriate approach depends on the individual.
Do I need medication if I have both anxiety and depression?
Not necessarily. Some people benefit from psychotherapy alone, while others may benefit from medication or a combination of therapy and medication. Treatment decisions should be individualized with an appropriate healthcare professional.
Anxiety and Depression Therapy at Authentically You Counseling
At Authentically You Counseling, we provide compassionate, individualized mental health care for people experiencing anxiety, depression, or a combination of both.
We understand that mental health symptoms don't always fit neatly into one category.
You may feel anxious and exhausted.
Overwhelmed and unmotivated.
Restless and numb.
You may not even have the words to explain exactly what you're experiencing yet.
That's okay.
Part of therapy can be understanding the patterns you're experiencing and identifying approaches that may help.
Our clinicians use evidence-based therapeutic approaches while recognizing that every person's experiences, strengths, challenges, and goals are different.
In-person counseling is available through our Concord and Portsmouth, New Hampshire offices, with telehealth options available for eligible clients.
Take the Next Step
You don't need to decide whether what you're experiencing is "mostly anxiety" or "mostly depression" before asking for support.
If worry, exhaustion, low motivation, avoidance, hopelessness, sleep problems, or other symptoms are beginning to affect your relationships, work, responsibilities, or quality of life, talking with a mental health professional can be an important next step.
Contact Authentically You Counseling to learn more about Anxiety Therapy, Depression Therapy, our clinicians, current availability, and treatment options.
Related Services
Continue Reading
Explore more from our Anxiety and Depression educational resources:
Why Depression Can Make Everyday Tasks Feel Difficult
How Therapy Can Help Treat Depression
Is Medication Right for Depression?
The Role of Exercise and Lifestyle in Managing Depression
Supporting a Loved One With Depression
What Recovery From Depression Really Looks Like
You can also explore our Anxiety Education Series for more information about anxiety symptoms, treatment, sleep, overthinking, and everyday strategies for managing anxiety.
