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Blog authors:
Dr Djuna Hallsworth, Support Group Peer Leader at One Door Mental Health djuna.hallsworth@onedoor.org.au.
Dr Richard Schweizer, Policy Officer at One Door Mental Health richard.schweizer@onedoor.org.au.
Definition, Discussion and Treatments
Anxiety and depression are frequently cited as being amongst the most common mental illnesses in contemporary Australia.1 Research suggests that these conditions can affect people across age groups, genders, sexualities, ethnicities, cultures and locations. Indeed, the prevalence of anxiety and depression has attracted considerable attention from policy makers, government and media; possibly more so than other mental illnesses.
Both anxiety and depression appear with variable intensity and duration. In fact, it’s common for anyone to experience feelings of both anxiousness and low mood at some point in their life; this does not necessarily constitute a mental health condition.
At what point, then, do these feelings meet the criteria for a mental illness diagnosis?
The World Health Organisation’s International Classification of Diseases (11th Edition) (ICD-11), which is considered the world standard for categorising health conditions, outlines the features of anxiety diagnosis:
“Anxiety and fear-related disorders are characterised by excessive fear and anxiety and related behavioural disturbances, with symptoms that are severe enough to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.”2
Anxiety also encompasses:
- Generalized Anxiety Disorder
- Panic Disorder
- Agoraphobia
- Specific Phobia
- Social Anxiety Disorder
- Separation Anxiety Disorder
- Selective Mutism
- Other Specified Anxiety or Fear-Related Disorders
Depression disorders, of which there are many, have common features that are outlined in the ICD-11:
“Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly affect the individual’s ability to function. A depressive disorder should not be diagnosed in individuals who have ever experienced a manic, mixed or hypomanic episode, which would indicate the presence of a bipolar disorder.”3
Some manifestations of depression, which falls under the broader category of mood disorders, include dysthymic disorder (persistent depression), single-episode depression (which might co-occur with panic attacks, psychosis or other symptoms, or in response to external changes), and mixed anxiety and depression disorder.
So, we have a definition of our key terms. Hopefully this will help people experiencing chronic anxiety or depression to identify what they are going through, and to seek help.
What these definitions do not capture, however, are the personal experiences of anxiety and depression, as every person experiences their own mind in a different way. Insofar as these mental health conditions interact with different external stimuli (such as trauma or drug use), they can vary in intensity and duration, and affect different areas of a person’s life.
What can anxiety and depression actually feel like? Anxiety can feel like severe nervousness; being at a tipping point into panic; unable to quell unhelpful thoughts; like having fire in your nerves or a lead weight in your belly. Depression can feel like a deep internal emptiness or falling into some lightless pit; like no amount of sleep will cure your bone-deep exhaustion; lacking motivation to do anything – even the things that can help you improve your mental health.
What can we do when we are suffering due to anxiety or depression?
Perhaps the most common recommendation is to see a medical professional, such as a general practitioner (GP) who has a strong knowledge of mental health. A GP can create a mental health care plan that may include partial support for sessions with a psychologist. Research has suggested that psychoeducation—where clients and carers learn condition-specific information to empower them and inform decision-making—is a highly effective aspect of recovery.4 Common “talking therapies” such as Cognitive Behavioural Therapy, or Acceptance and Commitment Therapy, may help.
A GP, or a psychiatrist, can also prescribe medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) or Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) that target the chemistry of depression in the brain. There is evidence that these medications can help certain anxiety disorders too.5 Medications like these might be recommended for short-term or long-term use, and are often used in conjunction with lifestyle interventions. These interventions include regular exercise, getting enough quality sleep, eating a balanced and nutritious diet, having access to the emotional and practical support of friends and loved ones, and allowing time for mental rest or meditation.
As October is Mental Health Month in New South Wales, we can all take steps to improve the mental health of those around us. We can work to de-stigmatise these illnesses, and perhaps query whether we want to use a word like “illnesses” at all! We can use our courage to speak openly about out personal experiences and recovery journeys. We may engage in psychoeducation, and hold people accountable when they are repeat untruths or use stigmatising language. And, of course, we can be compassionate with ourselves if we come to personally know these most human of experiences.
1https://www.abs.gov.au/media-centre/media-releases/two-five-australians-have-experienced-mental-disorder
2https://icd.who.int/browse/2024-01/mms/en#1336943699
3https://icd.who.int/browse/2024-01/mms/en#1563440232
4Motlova, L.B., Balon, R., Beresin, E.V. et al., 2017. Psychoeducation as an Opportunity for Patients, Psychiatrists, and Psychiatric Educators: Why Do We Ignore It? Acad Psychiatry. 41, pp.447–451.
Lukens, E. and Mcfarlane, W., 2004. Psychoeducation as Evidence-Based Practice: Considerations for Practice, Research, and Policy. Brief Treatment and Crisis Intervention. 4(3), pp.205-225.
Morgado T, Lopes V, Carvalho D, and Santos E., 2022. The Effectiveness of Psychoeducational Interventions in Adolescents' Anxiety: A Systematic Review Protocol. Nursing Reports. 12(1), pp.217-225.
5Dunlop, B.W. and Davis, P.G., 2008. Combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression: a review. Prim Care Companion J Clin Psychiatry, 10(3), pp.222-228.