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If you’ve ever experienced anxiety and depression — in the clinical sense, I mean.
You will know that they can feel really different.
With anxiety, you’re all ramped up.
And with depression, you’re very, very down.
Yet they tend to go together.
And a lot of medications, especially certain types of antidepressants,
can be used to treat both.
We still don’t know a ton
about how exactly anxiety and depression work in the brain — or
how antidepressants work to treat them.
But over time, psychologists have come to realize
that the two types of conditions are surprisingly similar.
They may feel very different in the moment.
But they actually have a lot of symptoms in common,
and involve some very similar thought patterns.
They might even have similar brain chemistries.
So if you’re looking to understand a little more
about how anxiety and depression manifest themselves
whether for yourself or themselves for someone else in your life
those connections are a good place to start.
Depression and anxiety aren’t really specific disorders
They’re generic terms for types of disorders.
But the most common, and most closely linked,
are major depressive disorder, or MDD, and
generalized anxiety disorder, or GAD.
In any given year in the U.S., where it’s easiest to find detailed statistics,
about 7 % of the population will have MDD,
and about 3 % will have GAD.
Lots of those people have both:
About 2/3 of people with major depression also have some kind of anxiety disorder,
and about 2/3 of people with generalized anxiety disorder also have major depression.
无论你患有焦虑症 或是抑郁症 或是两者都有
And whether you have one or the other or both,
the same medications are often at the top
of the list to help treat it — usually antidepressants.
Unsurprisingly,psychologists have noticed these statistics.
But for a long time,
we’ve thought of generalized anxiety and major depression as very different things,
and understandably so.
Probably the most noticeable symptom of anxiety is arousal,
which in psychology is a technical term
rather than a specifically sexual thing.
It basically just means being on high alert
还是生理上 心跳加速 手心出汗
whether psychologically, with increased awareness,or physically,
with things like a racing heart and sweaty palms.
Arousal isn’t part of major depression,though.
And there’s a key symptom of MDD that
doesn’t usually show up in generalized anxiety: low positive affect,
which is the technical term for not getting much pleasure out of life
and feeling lethargic and just kind of … blah.
So there are important differences between anxiety and depression,
which is part of why they’re still considered separate classes of disorders.
But when you look at the other symptoms, you start to realize that
major depression and generalized anxiety have almost everything else in common.
有躁动 疲劳 易怒 注意力不集中
There’s restlessness, fatigue, irritability, problems with concentration,
sleep disturbances … the list goes on.
And that’s just in the official diagnostic criteria.
因此 几十年来 心理学家一直在研究
So for decades, psychologists have been examining the models
they use to describe anxiety and depression in the brain to see
if they point to a similar source for both types of disorders.
They’ve come up with lots of different ideas,as researchers do,
but the most common ones tend to center around the fight or flight response to stress.
Fight or flight kicks in when you’re confronted
with something your mind sees as a threat,
and it automatically prepares you to either fight or run away.
And when you think about it,
anxiety and depression are just different types of flight.
Psychologists often characterize anxiety as a sense of helplessness, at its core
and depression as a sense of hopelessness.
Anxiety might feel like you’re looking for ways to fight back.
But part of what makes it a disorder is
that it’s not a short-lived feeling
that’s easily resolved once you have a plan.
Of course, as with all things mental health,
anxiety disorders can be deeply personal and
won’t feel the same for everybody.
But clinical anxiety does tend to be more pervasive.
The worry sticks around and starts to take over your life
because it doesn’t feel like something you can conquer.
因此 焦虑和抑郁可能都是逃避反应 只是方式不同
So anxiety and depression might just be slightly different ways of expressing the same flight response:
helplessness or hopelessness.
And maybe that’s part of why they so often go together.
That connection also shows up on the biochemical side of the stress response.
There are a lot of hormones involved in this response,
and their effects interact in super complex ways
that scientists still don’t fully understand.
But both depressive and anxiety disorders
are closely associated with an oversensitive stress response system.
Researchers think that’s one reason both of these types of disorders are so much more
common in people who’ve experienced major stresses like trauma or childhood abuse.
Those stressors could make their stress response system more sensitive.
The main hormones involved aren’t always the same,
but the changes can cause some of the same symptoms
problems with sleep,for example.
So anxiety and depression seem to be two sides of a similar reaction to stress,
in terms of both thought processes and hormones.
Still,that doesn’t really explain
why some antidepressants can treat both anxiety and depression.
Because those medications primarily affect neurotransmitters,
the molecules your brain cells use to send messages to each other.
If you thought we had a lot left to learn about how the stress response works,
we know even less about what the brain chemistry of anxiety and depression looks like,
or how antidepressants help.
But if the thought processes and physical responses
that go along with these disorders aren’t quite as different as they seem on the surface,
it makes sense that the brain chemistry would be similar, too.
And that’s exactly what scientists have found.
更具体而言 许多研究表明 神经递质血清素水平较低
More specifically, lots of studies have pointed to lower levels of the neurotransmitter known
as serotonin as a major factor in both anxiety and depression.
Researchers have even identified some more specific cellular
receptors that seem to be involved in both.
另有证据表明 大脑处理另一种神经递质 去甲肾上腺素的方式
There’s also some evidence that the way the brain handles another neurotransmitter, norepinephrine,
can be similar in both anxiety and depression.
Since most antidepressants work by increasing serotonin levels,
and some of them also affect norepinephrine,
that could explain why they’re so helpful for both anxiety and depression.
Although again, there’s a lot we don’t know about their exact mechanisms.
Ultimately,there’s no denying that in the moment,
anxiety and depression can seem like very different feelings.
And if someone has both types of disorders — well,
it’s easy to see how that could feel overwhelming.
Like,it’s hard enough treating
generalized anxiety or major depression on their own.
And it’s true that it is often harder to treat these conditions when someone has both.
But maybe not twice as hard.
After all, anxiety and depressive disorders have a lot in common,
from their symptoms to the basic brain chemistry behind them
to some of the treatments that can help.
The fact that they often go together can be really tough.
But understanding more about why that is
has also pointed us toward better treatments and
more effective therapies, that really can help.
Thanks for watching this episode of SciShow Psych.
If you’re looking for someone to talk toabout your mental health,
we left a few resources in this video’s description.
And if you’d like to learn more general info about treatments,
you can watch our episode on misconceptions about antidepressants.
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