Can anxiety cause depression
Pro Research Analysisby 
Searched over 200M research papers
Can Anxiety Cause Depression?
Introduction to Anxiety and Depression
Anxiety and depression are two of the most common psychiatric disorders, often occurring together. They are both considered internalizing disorders, sharing many symptoms and risk factors 4. Understanding the relationship between these conditions is crucial for effective diagnosis and treatment.
Comorbidity of Anxiety and Depression
High Comorbidity Rates
Research indicates a significant overlap between anxiety and depression. For instance, a worldwide survey found that 45.7% of individuals with major depressive disorder also had a lifetime history of one or more anxiety disorders 4. Similarly, the STAR*D study revealed that 53% of patients with major depression had significant anxiety, classifying them as having anxious depression 4.
Bidirectional Relationship
Anxiety and depression are not only comorbid but also bidirectional risk factors for each other. A meta-analysis of longitudinal studies found that anxiety symptoms predict later depressive symptoms and vice versa, with similar degrees of strength 8. This suggests that experiencing anxiety can increase the risk of developing depression and that depressive symptoms can also lead to anxiety 8.
Pathophysiological Mechanisms
Neurobiological Overlap
Both anxiety and depression share common neurobiological pathways. Alterations in prefrontal-limbic circuits, which mediate emotion regulation, are common to both disorders 4. These shared neural circuits contribute to the high comorbidity and bidirectional relationship between anxiety and depression.
Stress and Neurotransmitter Systems
Sustained stress can lead to changes in the 5-HT (serotonin) and stress hormone systems, which are also observed in depression 3. This indicates that stress-induced changes in these systems can contribute to the development of depression, particularly in individuals with anxiety 3.
Clinical Implications
Anxious Depression
Anxious depression is a distinct subtype of major depressive disorder characterized by the presence of significant anxiety symptoms within a depressive episode 19. This subtype has specific neurobiological, prognostic, and therapeutic characteristics, making it essential to identify for effective treatment 19.
Treatment Approaches
The treatment of anxious depression often involves a combination of psychotherapeutic, sociotherapeutic, and pharmacological interventions. Selective serotonin reuptake inhibitors (SSRIs) are commonly used as the first line of treatment 1. Addressing both anxiety and depressive symptoms is crucial for improving patient outcomes.
Conclusion
In summary, anxiety can indeed cause depression, and the relationship between these two disorders is complex and bidirectional. High comorbidity rates, shared neurobiological pathways, and the impact of stress all contribute to this intricate relationship. Identifying and treating anxious depression as a distinct clinical entity is essential for effective management and improved patient outcomes.
Sources and full results
Most relevant research papers on this topic
Anxiety in depression
Anxious depression has specific neurobiological, prognostic, and therapeutic characteristics, requiring psychotherapeutic, sociotherapeutic, and antidepressant treatment.
Systematic Review
Rigorous JournalThe Relationship of Anxiety and Depression: A Review of the Literature
Anxiety and depression differ quantitatively and qualitatively, and combined anxiety and depression syndromes (anxious depressions) differ both quantitatively and qualitatively from either pure anxiety or pure depression.
Literature Review
Highly CitedCan stress cause depression?
Stress can cause depression, with anxiety/aggression-driven depression being particularly stress-inducible, and reducing stress and stress sensitiveness through biological and psychological means is crucial for prevention and treatment.
Highly CitedThe Critical Relationship Between Anxiety and Depression.
Anxiety and depressive disorders are highly comorbid, with shared genetic risk and common nongenetic factors, and are highly influenced by life experiences and parenting styles.
Highly CitedA Review Article on the Relation between Anxiety and Depression
Anxiety and depression are closely linked, with physical exercise reducing symptoms of mild anxiety and depression.
Literature ReviewRelationship of anxiety and depression
Depression and anxiety share a spectrum of symptoms, with some overlap and some predisposition to the other, and the mixed anxiety/depressive disorder proposed by ICD-10 should be considered for inclusion in DSM-IV.
Rigorous JournalAnxiety and Depression as Bidirectional Risk Factors for One Another: A Meta-Analysis of Longitudinal Studies
Anxiety and depression are bidirectional risk factors for one another, with depressive disorders potentially being prodromes for social and specific phobias.
Meta-AnalysisHighly CitedAnxiety and depressive disorders
Anxious depression is a complex and growing issue in modern psychiatry, affecting individuals' deepest aspects of existence due to stress overload and negative social trends.
NEUROBIOLOGY OF ANXIOUS DEPRESSION: A REVIEW
Anxious depression has distinct neurobiological findings from nonanxious depression, including structural neuroimaging, EEG, genetics, and neuropsychiatric studies.
Systematic ReviewHighly Cited