Anti-anxiety and Antidepressant Medication: What's the Difference?

There are a number of medical therapies to address anxiety. It’s not unusual for a person experiencing anxiety to also experience depression; nearly 50 percent of anxiety sufferers also experience depression. The conditions are comorbid, occurring simultaneously in the same patient. In fact, some researchers believe anxiety and depression are the same illness, with different symptoms. In the past decade it’s become common to use antidepressants to treat anxiety; still, there are differences between anti-anxiety and antidepressant medications.

Anxiety with Depression

Many people who have suffered with anxiety disorder for a long time begin to feel depressed. This depression can grow into a problem in itself but does not usually eclipse the primary diagnosis of anxiety. This could be correlated because the person with anxiety begins to feel hopeless about recovering from the anxiety. Or it could be the mechanism in the body which caused anxiety also causes depression. Antidepressant medicines do often work on anxiety, and the other therapies can also be effective.

Depression with Anxiety

Many people who have depression have symptoms of anxiety such as nervousness and sleeplessness. The best way to determine if the patient presents with mainly depression might be to take one of the inventories that indicates severity of depression.

Psychometric Tests:

  • Beck Depression Inventory (BDI)
  • Zung Self-Rating Depression Scale
  • Patient Health Questionnaire(PHQ-9)
  • Hospital Anxiety and Depression Scale (HADS).

One and the Same?

Depression and anxiety are two separate disorders. The Diagnostic and Statistical Manual of Mental Disorders has them categorized separately, but each citation notes the relation to the other.

Some researchers, though, are finding more and more similarities between the two and are speculating they are, in fact, the same disorder, just with different manifestations. This idea, however, is still being debated and researched.

Differential Diagnosis

Since misdiagnosis can lead to administering the wrong type of medication, a differential diagnosis is important. Panic disorder, an anxiety disorder, needs to be treated differently than depression or chronic anxiety. Post-traumatic stress disorder, another anxiety disorder, also might require a specific treatment, but might be easily identified if the person has had a major trauma.

Some people who appear to have both depression and anxiety may indeed have a bipolar disorder, which can be very severe and can completely interrupt a person’s life with episodes of uncontrolled mania or debilitating depression. It must not be confused with either anxiety or depression. This differential diagnosis must be made because regular antidepressant drugs can cause a manic episode.

Medications for Anxiety

Anxiolytics is the general term for drugs that treat anxiety. There have been two major classes of these drugs--barbiturates and benzodiazepines. There are specific medications used for treating anxiety that do not work on depression and would be detrimental to depression.

Barbiturates were the type of drugs used for anxiet for decades . They calmed the patient, but often kept the person in a near-sleep state, unable to function. They were also addictive. For instance, Valium was the drug of choice for many years. It is still used today, but at lower does and for short periods of time. It brings immediate relief from a panic attack.

Benzodiazepines are the new families of anti-anxiety drugs. Popular ones such as Buspar and Xanax work by slowing down the brain's chemicals that may have become unbalanced, resulting in feeling less nervous tension.

Medications for Depression

Some of the following drugs can be used for anxiety as well as depression.

Tricyclic antidepressants were a breakthrough when they came out but have been phased out do to undesirable side effects. They also make more serotonin and norepinephrine available in the brain by blocking their re-uptake.

Monoamine Oxidase Inhibitors (MAOIs) -The earliest antidepressants, replaced because of side effects like food interactions. Makes more serotonin, norepinephrine and dopamine available by interfereing with an enzyme that breaks them down.

Benzodiazepines -These drugs enhance the functioning of the neurotransmitter GABA. They can have a sedative effect. Dangerous if overdosed.

Selective Serotonin Reuptake Inhibitors (SSRIs) -These modern medications make more serotonin available to the brain by blocking neurons from taking up the extra serotonin after a nerve spike.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) -SNRIs make more serotonin and also more norepinephrine (another neurotransmitter) available in the brain by, again, inhibiting reabsorption. These are especially used for generalized anxiety disorder.

While depression and anxiety share many symptoms, there is still a sufficient different between them that they should not be considered interchangeable. And while many medications designed for depression are helpful for anxiety, it is important to have a medical evaluation to declare a solid diagnosis and monitor any medications ingested.

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