The difference between anxiety disorders and depression is mainly in the difference in symptom presentation. However, because they usually come together, there is an overlap of symptoms that is not easily distinguished. In clinical practice, doctors mainly identify symptoms based on the order of their appearance and their priority. Due to the different psychological states, the physical reactions may also be slightly different, and the clinical treatment methods may also be different.
I. Psychological state
1, anxiety disorder: worry, fear, uneasiness, and trepidation are typical symptoms of anxiety disorder, always worrying about the imminent danger in the next second, and feeling inexplicable fear of things that they cannot specify. In addition, for some specific scenes will deliberately avoid, such as crowded squares, confined rooms, etc..
2, depression: depressed mood, inexplicable sadness, helplessness and disappointment are the norm for depressed patients, and this negative emotion will invade their lives, making them seem to lose the ability to be happy all of a sudden, but they cannot find the cause of the low mood. So they begin to constantly blame themselves, hate themselves, even loathe themselves, and then slowly lose interest in all things, places, and things, and their favorite foods they used to love to eat, and the movies they love to watch become tasteless …… Compared to the avoidance of anxiety patients, depressed patients appear to be more indifferent and oblivious. They are more calm about what is happening outside than normal and are more focused on their own inner world.
Second, somatic reactions
1, anxiety disorder: anxiety patients will be overly worried, fear, so that the whole person is in a state of high alert, thus showing the inability to sit still, rubbing hands and feet, pacing back and forth, increased small movements and other physical reactions, and even in speech will appear voice trembling, dry mouth and other situations. Anxiety patients also tend to be startled by the slightest sound, or subtle movements, and have startle reactions.
2, depression: depressed patients clinically show loss of interest in things, loss of libido, reduced energy, physical weakness, mental depression, etc. They may even have somatic symptoms such as headache, dizziness, insomnia, chest pain, etc., but no substantial organ damage is found in clinical examination.
Third, treatment methods
For patients with anxiety and depression, psychotherapy plus medication is far more effective than single medication or psychotherapy. However, in terms of medication, the use of medication needs to be targeted.
1, anxiety disorders: the clinical selection of drugs, although also the choice of antidepressants, but will pay more attention to the anti-anxiety effect of drugs, such as norepinephrine reuptake inhibitors, the specific drugs are venlafaxine, paroxetine, escitalopram, etc..
2, depression: in addition to the application of norepinephrine reuptake inhibitors, the doctor should also give the relative disorders according to the specific situation of the patient, such as dopamine reuptake inhibitors, or some new antidepressants, such as agomelatine, vortioxetine, etc.
Fourth, psychometric
Depression: SCL-90, SDS and other clinical scales for depression suggest that the depression score is significantly higher than the anxiety score, while the anxiety score for anxiety disorders is greater than the depression score. Depression is often accompanied by anxiety symptoms, but depression is dominated by depressive symptoms, and anxiety symptoms are often just an emotional response exhibited by depressed patients.
2, anxiety disorder: the main emotional expression is excessive worry about what may happen in the future and suffering as a result. The dominant emotional component of depression is more complex and includes self-blame, self-guilt, low self-esteem, autism and sensitivity, in addition to emotional reactions with anxiety characteristics.
Extra attention should be paid to the fact that although people with anxiety disorders may have excessive worry about their well-being, they usually do not exhibit self-injurious behavior or try to avoid the problem by self-injury. In contrast, people with depression, who are severely depressed, will often resort to such extreme methods as self-injury or even suicide to escape their feelings of powerlessness. Therefore, when symptoms of both disorders are present, clinical priority is usually given to the diagnosis of depression to avoid malignant events.
Both anxiety and depression can have an impact on the patient’s study, life and work, and when it is difficult to judge, medical attention should be sought promptly.