Depression and anxiety are emotional states that may occur together or at different times. They can be short and transitory, or extend for years and block progress. Often, depression relates to self-esteem and motivation, while anxiety relates to feelings of fear, dread, or general nervousness. Either condition can cause a person to feel stuck, hopeless, isolated, or unable to move forward.

Symptoms of depression can include disturbance of physical appetites (either decreased or excessive) for sleep, food, or sex. Depression may result in weight loss or gain, feeling tired for no reason, lack of energy, poor concentration, indecisiveness, agitation, guilt or shame, mood changes during the day, crying, restlessness, or irritability. Some people experience extreme mood swings, ranging from deep depression to elation, indicating bipolar disorder, a condition formerly known as manic-depression.

Similarly, anxiety disorders may bring reports of uncontrollable worrying about events or activities over an extended period, feeling restless, “keyed up” or “on edge,” easily tired, difficulty concentrating or the mind “going blank,” irritability, muscle tension, and sleep or appetite disturbance. Anxiety might seem to stem from an identifiable root event, such as a traumatic experience, or there may be no clear cause.

Either way, if a loved one or an acquaintance complains of depression or anxiety, it is important not to dismiss or disbelieve the complaints. Accept that the person is telling the truth about how they feel. Simply having someone to talk to who listens without judging can help.

Anyone can feel down or worried. Such normal human experiences do not require treatment, but rather simple acceptance and moving on. It becomes problematic when emotions seem so distressing and insurmountable that moving on appears impossible. Whether or not anxiety or depression is unhealthy or normal is a matter of degree. Clinical depression or severe anxiety may be understood as chronic manifestations of symptoms experienced to a lesser degree in common living, but both conditions are real and can seem overpowering.

Treatment for depression and anxiety is readily available and need not involve medication. In fact, self-medication with drugs or alcohol is likely to make matters worse. Sometimes prescriptions help, but do not start with the assumption that they are needed.

When mental health symptoms are sufficiently distressing, or interfere with daily functioning, a good start often involves a visit to a primary care doctor for a general check-up to rule out possible causes like iron or vitamin deficiencies, endocrine or hormonal imbalances, or other systemic problems best treated medically.

If bloodwork and a physical exam do not identify deficiencies or problems, seeing a mental health practitioner might help. Talking problems through in a confidential setting with a healthcare professional who is willing to take time to listen and provide feedback can lead to a different perspective, with resulting improvement of mood or a decrease in worries. Cognitive-behavioral therapy can include systematic desensitization and learning to recognize, reexamine and replace anxiety-producing thoughts. Counseling or psychotherapy for depression or anxiety will generally show best results after six to eight weeks of regular attendance. It may continue longer, but does not have to in order to provide relief.

Some people benefit from antidepressants, and a few of these also help to decrease anxiety. There are risks with any drug, but the benefits of pharmacotherapy might be great enough to make them worth trying, especially if the depression is severe enough to have fatal consequences if left untreated. Some anti-anxiety drugs and sleep medications may pose a higher risk for developing tolerance and increased use than the class of antidepressants that increase the presence of serotonin, dopamine, or other neurotransmitters in the brain.

Non-pharmaceutical measures to take for depression include increased physical activity, sunlight (or light therapy), better nutrition, social supports, and psychotherapy. Similar interventions for anxiety might be regular daily physical exercise, establishing good sleep hygiene, considering new hobbies or social activities, avoiding harmful intakes (alcohol, tobacco, caffeine and other substances), and mental health counseling.

A supportive listening ear can help, especially if the listener can do so without judging or giving directions. If no supports are immediately available, do not hesitate to look for help. Call a professional or crisis hotline for suggestions on how to begin. In Sullivan County, call 845/791-7123 or 800/710-7082; in Orange County call 888/750-2266; in Wayne County call 570/253-0321; or in Pike County call 570-992-0879. Any of these crisis hotlines can offer telephone counseling or lead to face-to-face follow up.