How to cope with depression and anxiety
Anxiety and depression are two of the most common types of mental health conditions. Figures for England suggest six out of every 100 people are affected by generalised anxiety disorder (GAD) while three in every 100 have depression (i).
However the number of people who have mixed anxiety and depression makes the combination the most common mental health condition of all, with eight in 100 people affected (i). In fact we’ve known for some time that anxiety and depression can happen at the same time, with one study finding that half of those with either anxiety or depression have the other condition too (ii).
While anxiety and depression have different causes they often share similar symptoms and treatments. For instance, sleep problems can affect people who have anxiety as well as those with depression. Other shared symptoms include irritability and concentration difficulties. If, however, you want to find out if you or someone you know is experiencing one or the other condition – or even both – there are some differences to be aware of.
What are the signs of depression and anxiety?
You can find out more about depression and anxiety, including how both are treated, in our guides to Anxiety Symptoms and Depression Signs and Symptoms.
In the meantime, here are some of the most common signs and symptoms to look out for.
Signs of depression
The two core symptoms of depression are persistent sadness or low mood on a daily (or near-daily) basis, and loss of interest or pleasure in most of the things you do. To be officially diagnosed with depression you must have experienced at least one of these core symptoms along with three or four other symptoms such as:
Fatigue or lack of energy
Feelings of worthlessness or excessive/inappropriate guilt
Suicidal thoughts (or actual suicide attempts) or persistent thoughts of death
Inability to think or concentrate, or to make decisions
Not being able to sleep (insomnia) or sleeping too much (hypersomnia)
Poor appetite, with or without weight loss
Signs of anxiety
It’s normal to experience fear and worry from time to time – before a big event, for instance, or in the run-up to an exam. But if you worry and feel tense, panicky or on edge all the time, so much so that it interferes with your day-to-day life, you may have chronic anxiety or GAD. This can trigger a number of unpleasant physical symptoms, such as:
Palpitations (when you can feel your heart thumping)
If you recognise signs from both conditions, there’s a good chance that you, like many other people, have mixed depression and anxiety. Either way, if you haven’t already done so it’s highly advisable to see your GP for a proper diagnosis, so that you can get the ball rolling on a course of treatment.
What are the best ways to help yourself manage anxiety and depression?
Whether you’re experiencing anxiety, depression or a mixture of both, one of the recommendations from the NHS in terms of treatment that you can do yourself in your own time is to use self-help therapies (iii).
The advantage of using self-help psychological therapies is that you don’t have to sign up to doing them on a regular day at a regular time. You can simply slot them into your day whenever you have time off from your regular family and work commitments, plus you don’t have to leave the house if you can’t get out easily. Self-help therapies are also very useful if you want to try something where you can be anonymous.
In general self-help therapies aim to help you understand and combat your mental health problems. However, if you don’t feel self-help is working for you, you can ask your GP about other therapies you can try too.
There are different types of self-help therapies available, including:
Guided self-help on the NHS
This involves working through a self-help book or computer course with the support of a therapist. Your GP can refer you to NHS psychological therapies – including guided self-help – or you can refer yourself without your GP if you’re aged 18 or older and you live in England (find out more about the Improving Access to Psychological Therapies services and how you can find one locally by visiting nhs.uk).
Mental health apps and online tools
According to the NHS, research shows apps and online tools can be just as effective for some people as having face-to-face counselling with a therapist for both anxiety and depression (iii).
There are many apps you can use to help with your mental wellbeing, but if you want to make sure you’re using a recommended app try choosing one from the NHS app library.
Your GP may also recommend that you try an NHS online mental health tool, which may, for instance, be a self-help course based on cognitive behavioural therapy (CBT) that you complete with support from a therapist, or even live support from a therapist via instant messaging. However, whether or not you can access an online tool for mental health will often depend on the problems you’re experiencing, how severe they are, and whether there’s provision for such tools where you live.
As with apps there are many self-help books that may be helpful if you’re experiencing symptoms of anxiety or depression. Look for one that’s been written or recommended by a qualified health professional such as a counsellor or therapist, ideally someone registered with a recognised professional organisation such as the British Psychological Society or the Royal College of Psychiatrists.
Two websites you could try if you’re interested in using a self-help book are:
Reading Well Books On Prescription provides details of books recommended by health experts that you can borrow from your local library
Overcoming is a website for recommended books and CDs that cover a range of common mental health problems. You can buy them direct from the website, but they’re also available from bookshops and at libraries.
Joining an online community or forum for people with experience of mental health problems like yours can also be helpful, as you can learn a lot from chatting with others who’ve had similar issues. For example, the mental health charity Mind offers an online forum called Side by Side that allows you to join in conversations about mental health completely anonymously, or just read what others are talking about if you don’t feel like sharing.
Other online communities may be available through a referral from your GP, or simply ask your GP if they can recommend a forum they believe would be helpful.
Are there other ways to help cope with depression and anxiety?
There are also many other things you can do to start feeling more like yourself, whether you have anxiety or depression, including:
Another thing your GP may recommend is that you join an exercise class led by a qualified professional that’s designed for people with a mental health condition such as depression or anxiety. But if you can’t get a referral, it’s worth bearing in mind that regular exercise of any type can help lift your mood and distract you enough to give you a break from troubling or sad thoughts. It’s also a great thing to do for your overall health. Try to find a gentle activity you can enjoy and stick at in the long term, even if it’s just a daily walk around the block.
This doesn’t just mean having expensive treatments at a health spa or splashing out on getting your hair or nails done. Self-care simply entails thinking about and focusing on yourself and what makes you happy for a while, and making yourself feel good. It can be anything from treating yourself to your favourite healthy snack, listening to your favourite music, flipping through a magazine, reading a book, watching a movie you love or spending time with someone who makes you laugh. Whatever you do, the aim is to spend less time feeling low or anxious, so choose something that can take you away from your problems for a while.
Create a routine
Having a routine to stick to can be helpful if you have anxiety or depression, as it can give you a sense of structure and control. If you find a routine for your entire day is unmanageable or impractical, try creating a plan for just your morning, your afternoon or your evening.
Sleep as well as you can
Mental health problems such as anxiety or depression can play havoc with your sleep. However getting the sleep you need will help you feel so much better than after a night of tossing and turning. Try getting into a regular sleep routing by going to bed and getting up at the same time every day, even if you’re tempted to stay up and sleep in late. Take a look at our guide to Sleep and Insomnia to find more tips on sleeping more soundly.
Eat a nutritious diet
It’s not always easy to eat well when you feel low or anxious, and many people who experience depression or anxiety don’t eat very healthily or even very much, as these and other mental health conditions can affect your appetite. So try to stick to regular mealtimes, even if you don’t feel particularly hungry, and aim for the golden rule of having five portions of fruit and vegetables every day (if you can do that, you’re well on your way to eating healthily).
However if you find yourself regularly falling short of the Five A Day mark, try making a rule for yourself to eat something that’s good for you – like a few nuts, some seeds or a piece of fruit – once or twice every day. Taking nutritional supplements (see What natural support can you try for anxiety and depression?, below) may also help if you diet isn’t up to scratch and you’re at risk of becoming low in essential nutrients.
Alcohol, depression and anxiety
Alcohol may seem to ease the symptoms of anxiety and depression in the short term, but over time it can make them worse. To drink safely so that the harm alcohol does to your health is kept at a minimum, aim to stick to the 14 units of alcohol a week limit, as recommended by the UK’s Chief Medical Officers. For more tips and advice on cutting down on alcohol, read our guide to Alcohol Misuse.
Talk to a friend
Connecting with someone you know and trust – a friend, co-worker or family member, for instance – can really help you to get things off your chest and feel better, even if just for a while. Choose someone you’re close to who you feel can give you the support and encouragement you need, and schedule in regular chats.
As well as all of the above there are ways to help yourself that are more specific to depression and anxiety separately. Even if you’re experiencing mixed anxiety and depression there may be times when certain types of symptoms are more of a problem than others.
Self help tips for depression
There are lots of things you can do to help yourself manage the symptoms of depression. Here are a few you can try today:
Keep yourself motivated If you’re feeling low, your natural reaction may be to withdraw from the outside world. But it’s important to keep busy and engage with other people, even when you feel like bolting your front door. Start by making a list every morning of all the things you need to do and places you have to go to that day, and try to throw in a few activities that will help you feel good about yourself.
Challenge unhelpful thoughts Try to learn to recognise unhelpful thoughts that creep into your head and challenge them before they start to affect you. Unhelpful thoughts include things like, ‘I’m not good enough’, ‘everything’s hopeless’, ‘I’m stupid’ and ‘my life is a disaster’. When you catch yourself having thoughts like these, write them down then ask yourself what evidence you have for thinking them, and whether or not there’s another way you could think that’s less negative. Try to come up with an alternative, more positive thought to replace the unhelpful one.
Keep a journal If you like the idea of working through your issues by writing them down, another thing you can do is to keep a record of your moods on a daily basis. Start recording when you feel good, when you feel down and what you were doing at the time. You may start to notice patterns emerging – for instance, some people, activities or places may make you feel better (or worse). You could even try using a mood-tracking app such as MoodPanda.
Go to a green space There’s lots of evidence that spending time in nature can help with mental health conditions such as depression. If you don’t have a garden, try walking to a near-by park or anywhere where you can connect with nature. During the colder and wetter months you could also try bringing nature indoors by caring for house plants and listening to recordings of the sounds of nature, such as birdsong, rainfall or waves breaking on a beach. Even watching a nature programme on TV or hanging prints of natural scenes on your walls can be soothing.
Be more mindful Mindfulness is a technique that aims to help you become more in tune with your thoughts, feelings, sensations and surroundings. The idea is that, by becoming more aware of the here and now, you may be able to deal with negative thoughts more easily. You can find out more about it by reading our guide to Using Mindfulness to Manage Stress.
Self help tips for managing anxiety
Tips on coping with anxiety include the following:
Aim to relax more There are many ways to relax, and what works for someone else may not work for you. So try to find out what helps make you feel calmer and less worried. You could, for instance, do something simple like having a relaxing bath or reading a good book, or get involved in an absorbing hobby. Meanwhile if you like the idea of audio guided relaxation, try playing some of the techniques featured at nhs.uk.
Understand your feelings To be more aware of what makes you anxious, try keeping a diary of what you’re feeling as well as what you’re doing at the time. You may start to notice that you become more anxious in certain situations or at certain times of the day. Being aware of your anxiety triggers could eventually help you get the better of them.
Set aside some worry time It’s normal to worry now and then, but if you’re worried all the time it can take over your life. Decide on a time of day and length of time when it’s okay for you to worry, then try to put worrying thoughts aside during the rest of the time. Start by scheduling around 15 minutes of worry time each day, during which you can worry as much as you like without feeling guilty about it. Then as time goes on, try to reduce the amount of time you spend worrying – at some point you may even find you don’t need any worry time any more.
Focus on the bigger picture If you tend to worry a lot about little things and details that most other people wouldn’t give a second thought to, try to look at things differently. Ask yourself if the things you’re worrying about will be important tomorrow, or next week. Try to see the big picture, or imagine how someone else might see your problem or situation.
Breathe deeply Practise some easy breathing exercises to feel calmer quickly. Make yourself comfortable – either sitting or lying down – and start focusing on your breath. Try to breathe in a steady rhythm – in for five, hold for five, out for five, hold for five, and so on (use whatever number you feel most comfortable with). If you find your thoughts straying to whatever you’re anxious about, just acknowledge them and consciously bring your focus back to the sound of your breathing. Continue for a few minutes, or until you feel calmer.
Use your senses A good way to distract yourself from anxious or unhelpful thoughts is to focus on what you can see, feel, hear, smell and taste at that particular moment. Try to notice how many things your senses are experiencing, working on one sense at a time. You will find that some of your senses experience many more things than others – for instance, you will probably see many things, but taste none or just one.
Meanwhile if your anxiety is at a level where it’s causing panic attacks, find out ways of dealing with them by reading our guide How to Deal With Panic Attacks.
What are natural remedies for anxiety and depression?
Eating a healthy, nutritious diet is essential for mental and physical health. But if you’re experiencing symptoms of anxiety and/or depression, you may not be eating as well as you should. If this is the case, you can help support your health in general by taking certain nutritional supplements, such as:
Multivitamin and mineral
Not only does taking a good-quality multivitamin and mineral supplement provide your body with the nutrients it needs to stay healthy, there’s evidence it may also reduce stress and anxiety symptoms (iv) and help you cope with stressful situations more effectively (v). There are lots of different multivitamin and mineral formulations to choose from – read our guide to Multivitamins and daily requirements to find out how to choose one that would suit you.
A very important mineral, magnesium is needed by many parts of your body including your heart, your nervous system, your muscles and your bones. It also involved with energy production, as it helps your body create energy from food. Yet many of us may not be getting the magnesium we need from our diets – which is where a daily supplement can be useful. Studies also suggest taking a daily magnesium supplement may benefit people who are experiencing mental and physical stress, helping them to sleep better and improving their mood (vi). If want to try a magnesium supplement, try choosing one with a good absorption rate, such as magnesium citrate.
High-strength fish oils
The omega-3 fatty acids found in oily fish such as salmon, fresh tuna, pilchards and mackerel are widely thought to have several benefits for general health, including your brain and mental health. If stress is making your symptoms worse, for instance, scientists believe omega-3s may help reduce levels of cortisol, a stress hormone, making your body better able to deal with the effects of stress (vii). Vegetarians and vegans can now benefit from these omega-3s too, since supplements that source the fatty acids from marine algae instead of fish are now more widely available.
Meanwhile supplements that are more specifically aimed at relieving symptoms associated with anxiety and depression include the following:
This herb has a history of traditional use for the temporary relief of mild anxiety as well as sleep problems, with studies suggesting it may help you feel more calm during stressful situations (viii). The US-based National Institutes of Health also notes that valerian has sedative properties (ix).
5-hydroxytryptophan (5-HTP) is an amino acid often recommended by nutritional therapists as a treatment for depression and low mood. This compound is converted in the brain to serotonin – a neurotransmitter (or brain chemical) often referred to as the ‘happy’ hormone – with studies suggesting it may be as effective as conventional antidepressants (x). Researchers have also found 5-HTP may help with anxiety disorders (xi).
St John’s wort
This is a popular herbal remedy used for the relief of slightly low mood and mild anxiety, based on traditional use only. A review of studies suggests St John’s wort extracts may be significantly more effective than placebo with at least similar efficacy and better tolerability compared to standard antidepressant drugs (xii), while another concludes it may be an option for patients who cannot tolerate conventional antidepressant drugs (xiii).
A non-protein amino acid found almost exclusively in green, black, oolong and pekoe tea, theanine is also available in nutritional supplements. It’s thought to make you feel more cam by helping your brain produce alpha waves. And while some conventional medicines that help you relax can make you feel sleepy too, studies suggest theanine supplements can calm you down but still keep you feeling awake and alert (xiv). Researchers have also found theanine may help you feel calm when faced with a stressful situation by reducing your heart rate (xv).
Herbal therapists often recommend tea made using the herb lemon balm (Melissa officinalis) to help with relaxation. Indeed there’s some evidence it could help reduce anxiety levels (xvi). You can, of course, take lemon balm in supplement form too.
Used in the Indian natural healing system Ayurveda for centuries, ashwagandha is a herb that’s often used to help with stress. Studies suggest it may help reduce levels of the stress hormone cortisol (xvii), with researchers elsewhere finding ashwagandha is a safe and effective supplement to take alongside conventional antidepressants in people with generalised anxiety disorder symptoms (xviii).
Used traditionally in Europe for stress release, rhodiola is a herb whose roots contain a number of active ingredients such as rosavin and salidroside. Researchers have found it may help reduce anxiety and stress more effectively than a placebo (xix).
This fragrant essential oil is often marketed as an aid to relaxation, and there is even some science to back this up. One study, for instance, suggests lavender oil may be an effective natural way of treating the signs of anxiety (xx), while another has found it may be more effective for GAD than a placebo (xxi). These particular studies were based on lavender oil capsules taken orally, but you can experience the benefits of lavender oil whenever you need them by simply taking a warm bath with a couple of drops or adding a small amount to an aromatherapy diffuser.
If you’re experiencing anxiety, depression or a combination of both, life can seem very difficult at times. There are many treatments available, however, including self-care methods you can use yourself in the comfort of your own home. This guide offers a few suggestions to help get you feeling more like your old self again – however they should not replace advice from a qualified health professional. Find out more about a wide range of conditions that can affect your mental and physical wellbeing by taking a look around our pharmacy health library
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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.