How to Fight Depression and Anxiety from WebMD

[Charlie Brown]

How to Fight Depression and Anxiety

WebMD Feature from "Psychology Today" Magazine

What's the best way to deal with depression and anxiety? Quickly and definitively. Whatever kicks them off, depression and anxiety both are maintained by styles of thinking that magnify the initial insult and alter the workings of the brain in such a way that the longer an episode exists, the less it takes to set off future episodes.

Anxiety and depression are probably two faces of the same coin. Surveys have long shown that 60 to 70 percent of people with major depression also have an anxiety disorder, while half of those suffering anxiety also have symptoms of clinical depression.

The stress response system is overactive in both disorders. Excess activity of the stress response system sends emotional centers of the brain into overdrive so that negative events make a disproportionate impact and hijack rational response systems. You literally can't think straight. You ruminate over and over about the difficulties and disappointments you encounter until that's all you can focus on.

Researchers believe that some people react with anxiety to stressful life events, seeing danger lurking ahead everywhere—in applying for a job, asking for a favor, asking for a date. And some go beyond anxiety to become depressed, a kind of shutdown in response to anticipated danger.

People who have either condition typically overestimate the risk in a situation and underestimate their own resources for coping. Sufferers avoid what they fear instead of developing the skills to handle the kinds of situations that make them uncomfortable. Often enough, a lack of social skills is at the root. Some types of anxiety—obsessive-compulsive disorder, panic disorder, and social phobia—are particularly associated with depression.

The fact that anxiety usually precedes the development of depression presents a huge opportunity for the prevention of depression. Young people especially are not likely to outgrow anxiety on their own; they need to be taught specific mental skills.

Cognitive-behavioral therapy (CBT) gets at response patterns central to both conditions. And the drugs most commonly used against depression have also been proved effective against an array of anxiety disorders.

Although medication and CBT are equally effective in reducing anxiety/depression, CBT is better at preventing return of the disorder. Patients like it better, too, because it allows them to feel responsible for their own success. What's more, the active coping that CBT encourages creates new brain circuits that circumvent the dysfunctional response pathways.

Cognitive-behavioral therapy teaches people to monitor the environment for the troubling emotional landmines that seem to set them off. That actually changes metabolic activity in the cortex, the thinking brain, to modulate mood states. It works from the top down. Drugs, by contrast, work from the bottom up, modulating neurotransmitters in the brainstem, which drive basic emotional behaviors.

Treatment with CBT averages 12 to 15 weeks, and patients can expect to see significant improvement by six weeks. Drug therapy is typically recommended for months, if not years.

Exercise is an important adjunct to any therapy. Exercise directly alters levels of neurohormones involved in circuits of emotion. It calms the hyperactivity of the nervous system and improves function of the brain's emotion-sensing network. It also improves the ability of the body to tolerate stress. What's more, it changes people's perception of themselves, providing a sense of personal mastery and positive self-regard. It also reduces negative thinking.

However, just telling a distressed person to exercise is futile, as depression destroys initiative. The best thing a loved one can do is to simply announce: "Let's go for a walk." Then accompany the person out the door.



Originally published on July 9, 2007

[Guest]

Very interesting. Thanks for posting. It's a good reminder that exercise is so important, just like Lucinda says. And it's interesting that they say CBT takes about 15 weeks since that's the length of this program. I've been struggling with the idea of going on anti-depressant medication so this was a good thing to read. Thanks.

[Guest]

Hi Charlie Brown,

Great post....thankyou!
I enjoyed it as well as found it usefull.

MM

[Guest]

Glad you both found this helpful. For me, it's like taylor-made.

[epa]

Hi Charlie Brown.

That was a great article, and so TRUE. Because many anxious and depressed people tend to be "afraid" of exercising, maybe reading this will give them the accentive to try, knowing all of the benefits they'll get.
I use to be afraid to exercise because I would feel a little more anxious and I know it would've helped me.

[Guest]

[Guest]

Yes, it was great to read about the many benefits of exercise. I would get anxious about going to the gym at work, because I never knew who I was going to run into. Plus, I would tell myself that there really wasn't a lot of benefit from it anyway. It's nice to have some more ammo that I can use to tell myself to get my butt in there. Not to mention, I think I am worth spending half an hour on each day.

[Guest]

Enjoy the ammo.

[Guest]

That was indeed a great article. It has very insightful and I am glad to know that I am not the only one who suffers with excercise. I am too afraid to start even though I know I should.

[Guest]

Terry,
Don't be afraid to start. Like the program mentions you can begin with just a little bit of excercise at a time. Start with a simple walk and try to build up. The way it can make you feel can't be replaced by anything else. When I'm feeling lazy (see below) or anxious I try to remember how it feels after breaking a sweat. Good luck!!

Charlie,
Great article. I was thinking of all the reasons not to go to the gym today. I'm putting on my shoes now. Thanks.