Is It Depression, or Is It Anxiety?

High rates of overlap and similar symptoms make diagnoses difficult. But in the future, that might not matter.

Erman Misirlisoy, PhD
Elemental
Published in
5 min readNov 5, 2019

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Illustration: Miju Lee

Where does anxiety end and depression begin?

In 2017, the World Health Organization estimated that 4.4% of the global population — more than 300 million people — suffer from depression, and that 3.6% of the global population — more than 250 million people — suffer from an anxiety disorder. But one fact complicates this picture: Many of the people who suffer from depression symptoms also suffer from anxiety symptoms, and vice versa. This can make it difficult to reliably and consistently diagnose each disorder.

The current mainstream approach to diagnosing mental health problems is to use a checklist system, such as the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A clinician works through a symptom list, comparing it against a person’s reported experiences. A person can be diagnosed with major depressive disorder if they persistently experience symptoms such as depressed mood and feelings of worthlessness. For a diagnosis of generalized anxiety disorder, people typically experience persistent worry and irritability. But when looking through all the criteria for each disorder, the commonalities are obvious. For example, both depression and anxiety can hinder life activities, prevent sleep, and drain energy.

The main difference between the two disorders is the primary state of a person’s emotions: Extreme sadness qualifies as depression, while extreme fear or worry qualifies as anxiety. But it’s easy to see the link between those two worlds. When people feel sad about their life and past experiences, they can also become anxious about where their life is headed. And when they feel anxious about the future, they can also become sad about how their life is currently playing out.

Laura Hack, a research fellow in psychiatry at Stanford University, describes some of the visible clues that help to distinguish between depression and anxiety. People with depression typically speak slowly and express tearfulness, while people with anxiety speak quickly and show signs of nervous stress such as sweating and shaking. But Hack explains that in a…

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Erman Misirlisoy, PhD
Elemental

Research Leader (Ex-Instagram / Chief Scientist at multiple startups). Author of the User Insight Newsletter: https://userinsight.substack.com/