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O, The Oprah Magazine

STRESSED OR SAD?

DIAGNOSING MENTAL ILLNESS is a tricky business. To meet the clinical definition of major depression, for instance, you need to feel sad or hopeless most days of the week or experience a loss of motivation and interest in things you once enjoyed—for at least two weeks straight. Sounds pretty clear-cut, but here’s where the confusion starts: Depression shares a whole list of symptoms with anxiety, which many people think of as the other side of the same coin (to meet the clinical definition of generalized anxiety, you need to feel excessive anxiety and worry more days than not for at least six months). “There’s a huge overlap between depression and anxiety, and in some ways, the mind doesn’t distinguish between the two,” says John Lauriello, MD, chief of the department of psychiatry at the University of Missouri School of Medicine. The conditions can even trigger each other. For example, people who don’t find relief from anxiety might believe their worrying will never end and, in turn, become depressed, says Erin Spahr, a licensed counselor with the Baltimore Therapy Group in Towson, Maryland.

But even when symptoms look and feel the same, they might be occurring for different reasons. Several treatments can help both depression and anxiety at once, including psychotherapy (like cognitive-behavioral therapy) and medication (such as antidepressants like certain SSRIs). However, the approach (like what to focus on in therapy) and dosage or mix of meds may vary depending on which condition is causing most of the distress.

We asked our experts to sort out some of the symptoms. If you recognize them in yourself, talk to a doctor or a therapist.

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