Anxiety, Depression, or Both?

Anxiety and depression are both challenging disorders—to make matters worse, they occur together up to 50% of the time.

Ellen Hendriksen, PhD
6-minute read
Episode #84

Shared solution #1: Do things you used to like, even if you don’t feel like it. Sometimes depression and anxiety don’t allow you to do anything at all. But if depression lets you get out of bed and anxiety lets you leave the house, try to do whatever it was you used to like before you got sick. It will seem pointless and stupid, but try.  You’ll likely feel better than if you hadn’t.  And while taking your dog for a walk or working in your garden may seem like a drop in the bucket, keep going—fill that bucket drop by drop. Doing what you love (or used to love) is what will save you.

Shared solution #2: Get hardcore about sleep. Folks with depression and anxiety often become semi-nocturnal, waking up in the middle of the night or way before the alarm. A good portion of the sleep challenges are part of the disorders, but you can minimize the damage with good sleep hygiene: go to bed only when you’re sleepy, wake up at the same time every day (yes, even on weekends) and get out of bed if you can’t sleep to avoid associating your bed with wakefulness, even if it’s 2 am. See also: I Can’t Sleep: 5 Myths About Insomnia, Busted and How To Sleep Now: Quick Fixes for Insomnia.

An important note: don’t feel guilty if you need sleep medication to get through a tough time. Sleep is sleep, drugged or not, and you need sleep to fight whatever you’re facing, especially life changes that trigger anxiety or depression, like a seriously ill spouse or losing your job.  Sleep medication isn’t a long term solution, but it’s designed to get you through a rough patch.

Shared solution #3: Exercise. I know, exercise is the last thing you want to do when you’re depressed. And it’s probably not at the top of your list if you’re anxious either (unless exercising lets you avoid whatever you’re anxious about).

But study after study shows that aerobic exercise reduces depression—one found 30 minutes a day, four times a week for six weeks did the trick, while another showed 30 minutes a day for 10 consecutive days led to significant reduction in symptoms. And a 2014 review of eight different studies found exercise to be helpful for anxiety as well, though it also found that medication is still more effective.

Shared solution #4: Dig down. Think back on your last few days and pick out a particularly bad moment—a time you felt really demoralized or anxious. The next step is hard, but try to zero in on what you were thinking at the time. What was going through your head? Maybe it was something like, “I can’t do this,” “I’ll never feel better,” or “What if I get in trouble?”

Whatever your thought, here’s the next step: ask, “What does that mean about me?”

Ask this question again with each successive answer, cycling through a few times until you hit upon a simple negative statement about yourself. Using our example of “I can’t do this” asking, “What does that mean about me?” might yield, “I can’t even do my job.” The next few rounds of, “And what does THAT mean about me?” might yield, successively, “I’m so stupid to mess this up,” and finally, “I’m a total failure.”

And boom, you’ve got it. This simple statement is called a core belief, and it is the heart (and source) of most other depressive or anxious thoughts. In my experience, depressive core beliefs are generally simple, even stark: I’m a failure, I’m stupid, I’m worthless, I’m helpless, or I’m broken—though there are many more. 

Anxious core beliefs tend to be predictive, like I’ll be ruined, it’ll be all my fault, no one will love me, I won’t be able to handle it, or I’ll be judged.

Once you have your core belief, challenge it. Is this really true? I guarantee it’s not, even if it feels like it is. If it’s really deep-seated, take it to a skilled therapist you like and trust. He or she will help you shrink it and grow a new, more healthy belief: I’m OK, I’m enough, I can handle this, I’m learning and improving.  

To wrap up, anxiety and depression are difficult enough on their own; the double whammy of both is a big challenge, but with so many overlapping symptoms, the good news is that working on one often magically improves the other.  Hang in there, get help, and watch your life come back to, well, life.

Never miss your weekly Savvy! Get every Savvy Psychologist episode delivered straight to your inbox by signing up for the newsletter or get them in your feed on Facebook. And listen to more Savvy Psychologist on iTunesStitcher, or Spotify.



Craft, L.L. & Perna, F.M. (2004).  The benefits of exercise for the clinically depressed.  Primary Care Companion Journal of Clinical Psychiatry, 6, 104-111.

Jayakody, K., Gunadasa, S., Hosker, C. (2014).  Exercise for anxiety disorders: Systematic review. British Journal of Sports Medicine, 48, 187-196.


And FYI: I'm thrilled to be celebrating the release of Furiously Happy: A Funny Book About Horrible Things by Jenny Lawson, who you might know as The Bloggess or as bestselling author of Let’s Pretend This Never Happened. For Jenny, the horrible things in her new memoir are exactly what we're covering on Savvy Psychologist today: anxiety, depression, and a grab-bag of other disorders—all of which she handles with humor and grit.

Listen to a free excerpt from the Furiously Happy audiobook below. It’s moving, sad, pee-in-your-pants funny, totally not PC, and, because we’ve all wondered, it also details what it’s like to regain consciousness while shirtless and surrounded by sympathetic dogs—all because you’re afraid of coats. Give it a listen and you’ll understand … maybe.

If you'd like to read that funny book about horrible things, you can purchase Jenny Lawson's Furiously Happy on AmazonBarnes & NobleIndieBoundBooks-a-Million, or Apple. Or if you prefer listening, yon can buy the audiobook on AmazonBarnes & NobleBooks-a-Million, or Apple.

Image courtesy of Shutterstock.



Medical Disclaimer
All content here is for informational purposes only. This content does not replace the professional judgment of your own mental health provider. Please consult a licensed mental health professional for all individual questions and issues.

About the Author

Ellen Hendriksen, PhD

Dr. Ellen Hendriksen is a clinical psychologist at Boston University's Center for Anxiety and Related Disorders (CARD). She earned her Ph.D. at UCLA and completed her training at Harvard Medical School. Her scientifically-based, zero-judgment approach is regularly featured in Psychology Today, Scientific American, The Huffington Post, and many other media outlets.