There is a large overlap between people who suffer from major depression and people who suffer from social anxiety disorder. This makes a certain amount of sense to anyone who has struggled with either or both of these conditions. Depression causes you to be irritable and socially isolated. You don’t want to bring others down or embarrass yourself. If you suffer from social anxiety disorder, you may experience extreme distress in anticipation of even moderately challenging social situations. Social anxiety is often limiting and isolating. Feeling isolated, lonely, and unable to overcome your fears can lead to depression.
Connecting Anxiety and Depression
A recent study led by Julia Langer, a psychologist from Washington University in St. Louis, sought to identify the specific ways that depression and social anxiety disorder are related. The team recognized that many symptoms of depression and social anxiety overlap and they wanted to better understand how one condition leads to the other. They used a statistical modeling approach to identify “bridge symptoms” that might connect the two disorders, hoping that if patients could address these specific symptoms, they might improve both conditions at once.
The study examined 130 women between the ages of 18 and 59 who had been diagnosed with both major depression and social anxiety disorder. They analyzed the women’s scores on measures of social phobia/anxiety, depression, and neuroticism and extraversion scores from the Five-Factor Inventory personality test to identify possible bridge symptoms. The team specifically looked at seven possible “nodes” they thought might connect social anxiety and depression. These included:
- Anxiety when in an embarrassing situation with a specific person
- Anxiety when having to speak in front of a specific other person
- Intensity of feelings of depression
- Inability to feel happy
- Feelings of worthlessness
- Unstable mood, especially under stress
The team found connections between many of these attributes, but the strongest bridge symptoms turned out to be “feelings of worthlessness.” Feeling worthless connected social fears to depressed mood and mood instability. By comparison, depressed mood and social fear did not appear to be directly connected. That is, it’s possible to have social fear or feel depressed, but one is not likely to lead to the other without feelings of worthlessness.
The results of this study may have direct implications for treatment of people with both conditions. Instead of treating both conditions in a general way, it may be more effective to target the feelings of worthlessness that connect the two conditions and make them mutually reinforcing.
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