Rich Silvestri

Can we be both anxious and depressed? The answer is yes

When anxiety and depression coexist

We are all familiar with the emotional reaction we would experience if confronted by a menacing animalfear. Now imagine feeling much the same reaction but not knowing what was causing itthis would be anxiety. Now let’s imagine our reaction to suffering a substantial loss, such as losing our job or discovering we have a serious medical problem. This would be depression. Now suppose that someone was depressed because of having lost their job and also anxious as to how they were going to get by. This would be anxiety mixed with depression, and it is common.

In fact, anxiety mixed with depression, and vice versa, is what we generally experience. Usually, when we feel depressed, we are also anxious about how this loss will affect our life, and in turn, when we are anxious, this has a depressing effect on our outlook.

Our brains are programmed to use anxiety and depression to mitigate one another, so they work in a kind of seesaw effect with one another. The hyperactivity of intense anxiety, for example, finally fatigues us to the point that we sink into depression as an escape mechanism. Eventually we become so disgusted with the nihilism and lack of accomplishment that we vault back into anxiety again.

So, if we are extremely anxious about losing our job, our brains will initiate a depressive reaction whereby we begin to lose interest in the job, and ultimately, if necessary, even accept the possibility of losing it as for the better. There’s no reason to worry about losing your job if you don’t want it anymore. Conversely, there’s no sense in trying to hang on to a highly desirable mate if your feeling that you’re not good enough for him or her is going to cause you constant anxietybetter to accept the loss and move on with no worries.

On the other hand, if time passes and we discover that finding a new job is much harder than we had imagined, especially given certain aspects of our employment record and the economy right now, we may be moved out of depression into intense anxiety again.

One of my clients told me that he broke off his engagement after nearly four years without much of an explanation other than that the thought of getting married, now that he and his beloved were starting to make arrangements, literally took his breath away. In fact, he ended up so upset he went to the emergency room, where the doctor told him he had an anxiety attack and suggested he see me. The young man told me that once he broke off the engagement, his anxieties seemed to dissipate and he soon felt he was back to his normal self. But then he began to feel that he might have been too hasty and decided to resume his relationship with his former fiancé. This was followed by a prolonged period of vacillation that was very hard on both of them. At his point, he said he would describe himself as more depressed than anxious, but he still had occasional anxiety attacks.


Many couples have lived with this kind of uncertainty for years before reaching a resolution. What seems to drive this cycle is that the person who has difficulty making a commitment is unable to manage the interplay between their anxieties about making a commitment and the prospects of losing the relationship. There are several possible resolutions to this dilemma, each of which may take years. In the first scenario, the person who is unable to overcome their anxieties about commitment, when confronted with the ultimatum that they either agree to get married or their partner will end the relationship, may decide to end the relationship and move on. But the person may ultimately find that the loneliness and depression triggered by the loss of their partner may prompt them to try to start up the relationship again or start a new one.

In the second scenario, the person may find that by stopping and then restarting their relationship their anxieties are eventually desensitized to the point where they can overcome them and get married. A third possibility is that their partner refuses to accept them back and breaks off the relationship with them permanently.

This situation illustrates the essence of the problem when a person finds themselves subjected to waves of anxiety followed by intervals of depression. The brain is programmed to alternately trigger anxiety and depression to prevent either emotion from becoming too strong and thereby incapacitating them. Unfortunately, the brain is not programmed to explain this to us and thus often ends up further confusing us. Once we understand this process, it is a lot easier to manage it effectively.