Are you missing these signs of anxiety or depression?

It's easy to overlook the clues that you may need help for one of these common conditions.


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The signs of mental illness aren't always obvious. Subtle changes in mood or behavior are often attributed to aging, just like weaker muscles and fuzzy thinking. "There's a tendency to dismiss it as, 'Well, of course I'm worried, I have heart disease,' or, 'Of course I'm sad, I'm not as relevant as I once was,'" says Dr. Michael Craig Miller, an assistant professor of psychiatry at Harvard Medical School.

But depression (extreme sadness, worthlessness, or hopelessness) and anxiety (debilitating worry and agitation) do not need to be routine parts of aging. Getting help for these feelings can help you maintain your health and enjoy life to the fullest.

Symptoms

Sometimes recognizing depression and anxiety takes a little honest reflection about your behaviors, feelings, and habits. Here are some signposts:

  • Apathy. Have you lost interest in the activities that used to bring you joy? Has life lost so much meaning that you feel empty? Those are classic signs of depression.

  • Helplessness or hopelessness. Do you feel there is little you or anyone can do to improve your life? Helplessness and hopelessness also are classic signs of depression.

  • Changes in habits. Sleeping or eating too much or too little can be a sign of depression. So can drinking more alcohol than usual or engaging in risky behavior.

  • Persistent fatigue. It's normal to be tired at the end of the day. But if you're tired all the time, it could be due to depression or anxiety. Or it may be related to an underlying medical condition, such as an underactive thyroid or heart failure.

  • Difficulty focusing or making decisions. "People who are depressed and anxious have difficulty making decisions because they worry whatever they do will be wrong," says Dr. Miller. Or you may have trouble concentrating or paying attention to others.

  • Mood swings. If you're easily irritated (or extremely impatient or overly self-critical), or if you experience frequent mood swings, it could be a sign of depression or anxiety.

  • Unending worry. "Are you anticipating every possible problem and focusing on it rather than looking at the lake or sky or enjoying being with your grandchild?" Dr. Miller asks. He says that kind of worry could be due to an anxiety disorder.

  • Wanting to be alone. "If you enjoy solitude because you like the time to read or meditate, that's fine. But that's different from staying home because it takes too much energy to interact with others. That's a sign of depression," says Dr. Miller.

What you should do

Just because you're experiencing one of those symptoms doesn't mean you'll be diagnosed with an anxiety disorder or depression. "But if you're too caught up in one feeling or another, having less pleasure in life or having trouble doing what you need to do, then certainly get help," says Dr. Miller.

Reaching out to family and friends may be a good way to start the process. "Talk to people who might be understanding, compassionate, and helpful," Dr. Miller says. If you feel embarrassed to share your feelings or worries with those close to you, make an appointment with your doctor.

Treatment

Help for depression and anxiety can come in a variety of forms, such as treating underlying conditions that may be causing depression, taking anti-depressant medications, or taking part in talk therapy.

There are also plenty of pill-free approaches that can help. Exercise is an important one. A daily walk can help you maintain your overall mood, energy, and positivity. "Increased blood flow to the brain seems to make nerves healthier. They plump up and make firmer connections," Dr. Miller explains.

Another strategy is staying connected socially. Social connections are associated with reduced stress, improved immune system function, and longer life. People with more social connections also have lower levels of anxiety and depression, higher self-esteem, and a better overall sense of well-being.

The takeaway

You don't have to suffer with depression or anxiety, no matter what your age. "It's useful to find a way to manage it better so you can live your life fully and experience being alive," says Dr. Miller. "You want to feel like every day that you wake up is a good day."

For more information, check out the Harvard Special Health Report Understanding Depression (www.health.harvard.edu/ud).