Anxiety Or MDD (Major Depressive Disorder)? Or Both? It's Just One of Those Days.

Have you ever just had one of those days? Where you know something is off? It feels like the sky is literally falling. Nothing goes right. Every little thing sets you off. And the worst part about it? You can't even pinpoint why or where it's coming from. Yesterday was one of those days for me.

Nothing catastrophic happened. The sky didn't actually fall. Quite honestly, nothing bad even happened. Yet I just couldn't shake that feeling. That sense of dread or impending doom that causes your muscles to tighten up, your pulse to beat in your throat, followed by sharp pains in your chest. You know the ones I'm talking about, don't you? This is what anxiety or a panic attack feels like for me with a panic attack having all the same symptoms but magnified by 1,000.

Along with the physical symptoms are the mental ones. I've always told myself, I would rather deal with the physical, no matter how painful, because there is something to be said about watching those wounds heal or actually feeling the physical symptoms slowly dissipate. It's cathartic. But the mental stuff? Not as easy to manage some days.

Just what are those mental symptoms? I'm so glad you asked. The graphic below does a fantastic job of showing the physical and mental symptoms for both depression and anxiety as well as which parts overlap.

Depression vs Anxiety: Symptoms of each and where they overlap.

Can you imagine the inner struggle? Some days are rough, others are just mild. Having lived so long in constant physical pain has certainly exacerbated the mental part, and it is also one of the underlying causes. It's truly a vicious cycle. The trauma from my youth caused not only multiple mental disorders but also physical manifestations of pain. This 'circuit', once it is created, is extremely hard to break. The brain gets on a loop between the mental and physical aspects of pain and it takes time and dedication to overcome that. Hence the never-ending circuit of crap one deals with on the regular.

As my rheumatologist once told me, 'You need to be kinder to yourself.' I recall shrugging it off and looking at my lap. He reiterated it several more times in that appointment along with the need to learn to love and forgive myself. Those things are so much easier said than done. When you are dealing with the things mentioned in the graphic above and the symptoms listed below, it isn't in your nature to 'be kind to yourself.' Forgiving myself is and will always be the hardest of struggles to overcome. I am nowhere near there yet but at least I can acknowledge that.

Anxiety versus Major Depressive Disorder: The Battle is On

According to ICD-11, Major Depressive Disorder is characterized as having the presence or history of at least one depressive episode (depressed mood or diminished interest in activities) for most of the day, every day for at least two weeks accompanied by the following symptoms: difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation (pacing, tapping toes, rapid talking, etc.) and reduced energy or fatigue.

Whereas (generalized) anxiety's diagnostic requirements include the following features: general apprehensiveness, excessive worry about negative events occurring (that impending sense of doom), muscle tension or motor restlessness, sympathetic autonomic overactivity (those pesky heart palpitations and chest pain), that being 'on edge' feeling, difficulty sleeping and irritability.

Be kind, for everyone you meet is fighting a hard battle. - Plato

These are the clinical indicators as listed in the ICD-11 for both disorders. As you can see, there are some similarities and several major differences as well. Now imagine having both those issues (and a few others not mentioned in this post) at any given time. A comment I heard recently rang true, females tend to have at least "45 tabs" open in their brains at all times similar to an internet browser. THIS. IS. ME. I am the female with at least 45 tabs open and I'm bouncing back and forth between all of them, wondering which thing will go wrong now, why does this always happens to me, and if I had only been better or done better this wouldn't have even happened to begin with.

The connection between anxiety and depression is high.

The connection between the two is strong as evidenced by the graphic above. It's as if the two work in tandem with one another to see which one can be the 'worse child' for the day. And if that wasn't enough, I can't even get my brain to 'shut down' long enough to get more than a few hours of sleep a night. Find a good sleep app, track your progress, and remember what you did on the days you got a good night's rest. Don't spend your time while you're in bed, watching TV, or surfing your phone just before you're trying to sleep. You need your brain and body to wind down, not up. Your bed should be your sanctuary, the place where you go to get the much-needed rest or relaxation you need. It's one of the most important ways we heal ourselves. Mentally and physically.

Supporting Someone with Anxiety and/or MDD: What We Want You to Know

Many folks are of the mindset that if you can't see it, it doesn't exist or my personal favorite, you should just get over it already. After all, you have no reason to be depressed. What they don't understand is that there doesn't have to be a rhyme or reason for it. You can 'have it all' or at least that is what you let everyone see and believe but then again, most individuals that have these disorders are great actors. They do a brilliant job of disguising all the turmoil that is going on just beneath the surface until they reach a certain point and it spills over into the visible realm. We literally do everything we can to appear normal, to not let what we often perceive as weakness show. Especially because there is such a strong stigma surrounding mental illness that we don't want to be labeled as 'one of those people' or 'crazy.' We don't need you to tell us we're crazy, we think that all on our own (or at least I do some days.) But here are a few things you can do to support a loved one with a mental disorder.

First, understand that you cannot and will never truly comprehend the depression and anxiety we are going through. We don't necessarily comprehend it ourselves and we live with it day in and day out. So telling us you understand what we are going through doesn't truly provide any actual relief to us. Second, and this is probably one of the most important ones, be there for them when they need you. Typically, when someone is in the middle of an episode, myself included, we are trying to come back from a place that no person should ever be. It's a deep dark place where the worst of your self-loathing and evil thoughts reside. It is exhausting both mentally and physically. Having my support person just be there and give me a bear hug or sit with me (sometimes in silence) is all I need to help calm my raging soul.

Next up on the list? Don't be surprised if people who suffer from major depression and anxiety are super sensitive. It is challenging enough to deal with all the self-doubt and constant criticism we inflict upon ourselves. If we open up to you and you respond negatively or critically, chances are likely we will shut down almost instantly and never run the risk of opening up to you again. It is hard enough for us to open up about our mental illnesses and if you say we are acting 'crazy,' being 'dumb' or 'blowing things out of proportion' you will do much more harm than you probably intended.

Please know that we are doing our very best and trying like hell. Every. Single. Day. There isn't a day that goes by that we aren't trying like hell to not be how we are. Some days we win the struggle and some days we don't. But make no mistake, we are giving it a 100% effort at any given moment. I have always said, 'I refuse to let the demons win.' So no matter how hard it is, I will never stop trying. My childhood mantra that saw me through some of the toughest times and years (yes years) of my life will always ring true for me. So much in fact that I had it inked on my shoulder as a reminder.

Motivational quote by Victor Hugo, a French Romantic writer.

And the number one thing we want to be sure you know? Never, ever, give up on us. We know it isn't easy dealing with us. You have seen us on good days, great days, and some really bad (horrendous, in fact) days. There are days I struggle to want to do anything, let alone be a responsible adult who goes to work, cooks, cleans, exercises, socializes with family and friends, etc. Even more than that. There are days I struggle just to care about anything, myself included. The sense of worthlessness is usually pretty strong those days. You can't imagine and probably don't realize how much your love and unfailing support means to us. It can be the difference between giving up completely and deciding to push through knowing that you are waiting on the other side of that episode. We may be difficult to love at times, but you will never find someone who is so loyal or loves you more. From the bottom of our hearts, we thank you for never giving up on us.