Living with Depression and Anxiety Together: Why It Happens and How to Actually Feel Better
You wake up anxious about the day ahead. By midday, you feel completely numb and hopeless. By evening, the worry is back. Only now it's mixed with a deep, heavy sadness.
Sound familiar?
If you're experiencing both depression and anxiety at the same time, you're not imagining it. You're not "broken." And you're definitely not alone.
Up to 60% of people with depression also experience significant anxiety. It's one of the most common, and most exhausting, mental health experiences, yet it's rarely talked about as a combined experience.
As a psychotherapist in Elsternwick and Malvern East, I work with people navigating this exact combination daily. Let me explain what's happening, why these two conditions so often show up together, and what actually helps.
Depression and Anxiety: The Unwelcome Duo
First, let's understand what each one actually feels like:
Depression isn't just "feeling sad"
Depression is:
A persistent heaviness that doesn't lift
Feeling disconnected from yourself and others
Loss of motivation or interest in things you once enjoyed
Exhaustion that sleep doesn't fix
Negative thoughts that feel like absolute truths
A sense of emptiness, numbness, or hopelessness
Difficulty seeing a positive future
Sometimes anger or irritability rather than sadness
Physical symptoms (pain, fatigue, sleep changes)
Feeling like everything is pointless
Anxiety isn't just "feeling worried"
Anxiety is:
A persistent sense of dread or unease
Racing thoughts that won't stop
Constant "what if" thinking
Physical symptoms (tight chest, racing heart, muscle tension, stomach issues)
Feeling on edge or hypervigilant
Avoiding situations that trigger worry
Difficulty relaxing or being present
Overthinking every decision
Fear of the future
A feeling that something bad is always about to happen
When both show up together:
The experience becomes particularly cruel. Anxiety keeps your nervous system wound up and racing. Depression drains your energy and motivation. Together they create a cycle:
Anxiety exhausts you → Depression sets in from the exhaustion → Depression makes you withdraw → Withdrawal increases anxiety → Anxiety exhausts you further → And the cycle continues.
It's draining. It's confusing. And it can make you feel like you're losing your mind.
Why Depression and Anxiety Often Occur Together
1. Shared Roots
Depression and anxiety aren't as different as we think. Research shows they share common underlying factors:
Similar brain chemistry: Both involve imbalances in serotonin, dopamine, and other neurotransmitters
Similar nervous system responses: Both involve dysregulation of the stress response system
Similar cognitive patterns: Negative thinking, catastrophizing, and rumination fuel both conditions
2. One Triggers the Other
They often develop in a cycle:
Anxiety first: Chronic, unmanaged anxiety eventually depletes your system. Your nervous system stays on high alert for so long that it burns out—leading to depression.
Depression first: When you're depressed, you withdraw from life. Isolation, inactivity, and disconnection create worry about the future, relationships, and your ability to cope—leading to anxiety.
3. Shared Life Experiences
Certain experiences commonly trigger both:
Trauma (past or present)
Chronic stress or burnout
Relationship difficulties
Loss or grief
Major life transitions
Childhood experiences and attachment wounds
Feeling unsafe or unsupported
4. Attachment and Early Experience
How you learned to connect (or disconnect) from others as a child affects both conditions. If love felt inconsistent, unsafe, or conditional, your nervous system learned to stay alert (anxiety) and your sense of self became fragile (depression).
5. The Modern World
Living in a constantly connected, always-on world contributes to both:
Social media comparison feeds depression
Constant stimulation and pressure feeds anxiety
Lack of genuine connection feeds both
Impossible standards create hopelessness and worry simultaneously
How to Know If You're Experiencing Both
You might be living with depression AND anxiety if you experience:
✓ Feeling worried and hopeless at the same time
✓ Exhaustion that coexists with restless, racing thoughts
✓ Withdrawing from life while simultaneously worrying about doing so
✓ Physical symptoms like chest tightness, stomach issues, and fatigue
✓ Difficulty sleeping (either from anxious thoughts or from depression)
✓ Feeling numb most of the day but anxious at night
✓ Using substances or behaviors to manage feelings
✓ Feeling like you're constantly going through the motions
✓ Struggling to enjoy anything while simultaneously worrying about everything
✓ Feeling stuck—too anxious to act, too depressed to care
If several of these resonate, you're likely experiencing both conditions simultaneously.
What Doesn't Work (And Why)
Before we talk about what helps, let's address the advice that keeps circulating that actually makes things worse:
"Just think positive!"
Why it doesn't work: Depression literally changes how your brain processes information. Telling someone with depression to "think positive" is like telling someone with a broken leg to "just walk it off." It dismisses the real neurological and psychological experience.
"Exercise will fix it!"
Why it's incomplete: Yes, exercise helps. Research supports it. But for someone living with both depression and anxiety, "just exercise" ignores the massive barriers these conditions create (low motivation, exhaustion, overwhelm). Exercise is ONE tool, not a cure.
"Everyone feels like this sometimes"
Why it's harmful: Occasional worry or a bad week is normal. Persistent, debilitating depression and anxiety that interfere with your life are clinical conditions. Minimizing the experience prevents people from seeking help.
"Have you tried meditation?"
Why it's complicated: Meditation can actually increase anxiety for some people, especially those with trauma. It needs to be approached carefully and isn't appropriate for everyone in the same way.
"You should try medication"
Why it's not the only answer: Medication can be helpful for some people. But therapy, particularly the right type of therapy, is equally or more effective for many people with depression and anxiety. And often a combination works best. It's not either/or.
What Actually Helps: Evidence-Based Approaches
1. Therapy (The Foundation)
Therapy is the most effective, sustainable treatment for depression and anxiety—especially when they occur together.
Why therapy works:
Addresses ROOT CAUSES, not just symptoms
Helps you understand your specific patterns
Develops personalized coping strategies
Processes past experiences affecting present mood
Builds self-awareness and emotional regulation
Creates lasting change, not just temporary relief
Specific approaches that help:
Acceptance and Commitment Therapy (ACT):
Rather than fighting anxious and depressive thoughts, ACT teaches you to acknowledge them without being controlled by them. You learn to act according to your values even when depression and anxiety are loud.
Great for: People stuck in the cycle of fighting their own thoughts
Cognitive Behavioral Therapy (CBT):
Identifies and challenges the unhelpful thought patterns that fuel both depression and anxiety. Helps you recognize when your thinking is distorting reality.
Great for: People who notice negative thought spirals
Psychodynamic Therapy:
Explores the deeper roots of your depression and anxiety—understanding how past experiences, attachment patterns, and unconscious beliefs contribute to your current struggles.
Great for: People wanting to understand WHY they're struggling, not just manage symptoms
Narrative Therapy:
Helps you examine and rewrite the stories you tell yourself. When depression says "I'm worthless" and anxiety says "everything will go wrong," narrative therapy helps you question these stories and create new ones.
Great for: People whose identity has become entangled with their depression or anxiety
Person-Centered Therapy:
Creates a safe, non-judgmental space where you feel truly heard and accepted. The relationship itself becomes therapeutic, helping rebuild trust in yourself and others.
Great for: People who feel deeply alone in their experience
As an integrative therapist, I combine these approaches based on what YOU need.
2. Nervous System Regulation
Both depression and anxiety involve nervous system dysregulation. Learning to regulate your nervous system is essential.
Practical techniques:
Breathing exercises:
Box breathing: In for 4, hold for 4, out for 4, hold for 4
Extended exhale: In for 4, out for 6-8 (activates parasympathetic nervous system)
Try this for 2-3 minutes when you notice symptoms rising
Grounding:
5-4-3-2-1 technique (senses grounding)
Hold something cold or textured
Feel your feet firmly on the floor
Name 5 things you can see right now
Gentle movement:
Walking (especially in nature)
Stretching or yoga
Dancing to music you enjoy
Even small movements help when depression makes everything feel heavy
Vagal toning (strengthening your calming response):
Cold water on your face
Humming or singing
Gargling
Slow, deep breathing
3. Connection (Not Isolation)
Both depression and anxiety drive isolation. Depression says "what's the point?" Anxiety says "it's safer alone."
But connection is medicine.
Start small:
Text one person today
Sit in a cafe even if you don't talk to anyone
Call a friend for 10 minutes
Pet an animal
Join a low-pressure group or class
You don't need to explain everything. Sometimes just being near another human helps.
4. Routine and Structure (Without Pressure)
Depression thrives in chaos. Anxiety thrives in uncertainty. A gentle, flexible routine addresses both.
Key elements:
Consistent wake time (even on weekends)
Regular meals (blood sugar affects mood significantly)
One small thing each morning that's just for you
One activity per day that provides purpose or connection
A wind-down routine before bed
Built-in rest without guilt
Important: This isn't about being perfect or productive. It's about creating gentle predictability for your nervous system.
5. Sleep
Both depression and anxiety wreak havoc on sleep. And poor sleep makes both dramatically worse.
Sleep hygiene basics:
Consistent sleep and wake times
No screens 30-60 minutes before bed
Cool, dark room
Limit caffeine after midday
Avoid alcohol before bed (disrupts sleep quality)
Wind-down routine (reading, gentle stretching, bath)
If sleep is severely disrupted, discuss this with your therapist or GP. Sleep deprivation maintains both conditions.
6. Address the Root Causes
Surface strategies help manage symptoms. But lasting relief requires addressing what's underneath.
Common root causes that need attention:
Unprocessed trauma
Attachment wounds from childhood
Toxic or unhealthy relationships
Chronic stress without adequate support
Living inauthentically (ignoring your needs and values)
Grief or loss that hasn't been processed
Core beliefs about your worth and safety
This is where therapy becomes essential. You can't self-help your way out of deep, entrenched patterns.
Living Day-to-Day with Depression and Anxiety
When you're in the thick of it, everything feels impossible. Here's how to get through:
On the hard days:
Lower the bar. Survival is enough.
Do ONE thing. Just one.
Be incredibly gentle with yourself
Reach out to someone—even just a text
Use grounding techniques
Remember: this feeling isn't permanent
On the okay days:
Notice and appreciate that it's an okay day
Do something that brings even a small amount of joy
Practice a coping strategy
Connect with someone
Rest without guilt
On the better days:
Don't push too hard (this can trigger a crash)
Do something meaningful to you
Notice what helped and remember it
Continue therapy and practices
Be grateful without pressure
Always remember:
Recovery isn't linear
Bad days don't erase good ones
You're not failing if you have setbacks
Small steps count
You deserve support
When to Seek Immediate Help
Please reach out immediately if you're experiencing:
Thoughts of suicide or self-harm
Feeling unable to keep yourself safe
Complete inability to function or care for yourself
Psychotic symptoms (hallucinations, delusions)
Severe panic attacks you can't manage
Contact:
Emergency services: 000
Lifeline: 13 11 14 (24/7)
Beyond Blue: 1300 22 4636
Crisis Text Line: Text SHOUT to 61061
You matter. Your life matters. Help is available right now.
Breaking the Cycle: What's Actually Possible
Here's what I want you to know:
Depression and anxiety together feel like being trapped. The cycle feels endless. The exhaustion feels permanent.
But it's not.
With the right support, you can:
Feel like yourself again
Enjoy things that used to bring you pleasure
Manage worry without it controlling your life
Sleep properly
Connect with people again
Find meaning and purpose
Develop genuine resilience (not just coping)
Build a life that actually feels worth living
This isn't toxic positivity. This is what I've witnessed in my practice, repeatedly, with people who felt exactly like you do right now.
Change is possible. Real, lasting, meaningful change.
But it usually requires professional support to get there.
Ready to Feel Better?
I'm Indi Bruch, an integrative psychotherapist in Elsternwick and Malvern East (also offering telehealth across Australia). I specialize in helping people living with depression, anxiety, and the combination of both—addressing root causes, not just managing symptoms.
What you can expect working with me:
Trauma-informed, non-judgmental care
A flexible approach tailored to your specific experience
Deep exploration of what's actually driving your depression and anxiety
Practical tools for day-to-day management
A safe space to be completely honest about how you're feeling
Support through the ups and downs of recovery
Currently accepting new clients for in-person and telehealth therapy.
📧 Book your free consultation: www.indibruch.com.au
You don't have to keep living in this cycle. Let's work together to break it.
FAQ: Depression and Anxiety
Can depression and anxiety be treated at the same time?
Absolutely. In fact, treating them together often produces better outcomes than treating each in isolation. An integrative therapist can address both simultaneously.
Do I need medication for depression and anxiety?
Not necessarily. Therapy is equally effective for many people, particularly for mild to moderate symptoms. For some people, a combination of therapy and medication works best. This is a conversation to have with your therapist and GP.
How long does treatment take?
This varies significantly depending on severity, root causes, and individual factors. Some people notice improvement within weeks. Deeper, lasting change often takes months. There's no "right" timeline.
Will I always have depression and anxiety?
Many people experience significant improvement and even full remission with appropriate treatment. Even if some vulnerability remains, you can learn to manage it effectively and live a full, meaningful life.
Is it my fault I have depression and anxiety?
Absolutely not. These conditions are influenced by genetics, neurobiology, life experiences, and environment. Having depression or anxiety is no more your "fault" than having diabetes or a broken bone.
