Can Anxiety Cause Depression if Left Untreated?

It depends. If your anxiety is a temporary emotional response, it’s not likely it may lead to symptoms of depression.

But if you notice that your signs of anxiety become a recurring experience, you may be living with an anxiety disorder. In this case, research suggests that it’s possible that anxiety leads to depression, or makes the existing symptoms of depression feel worse.

In that case, depression may be a side effect of anxiety.

Here’s why and how the untreated effects of anxiety may cause depression symptoms to develop:

Avoidant behaviors

Anxiety is related to the stress response. When you live with anxiety, your brain is constantly or often alert.

As a natural response to fear, your brain starts asking you to avoid anything that causes significant nervous or anxious feelings, says Kathryn Ely, a licensed professional counselor in Birmingham, Alabama.

For example, if even the thought of public speaking activates your stress response, you may start avoiding giving presentations at work as much as possible.

“Anxiety shrinks lives by keeping us in our comfort zones, which is a misnomer because our comfort zones aren’t really comfortable,” she says.

We tend to feel anxious about things that are important to us, she adds. “If you avoid what is important to you long enough, your life becomes less enjoyable and you may not like who you are. That is where depression comes in.”

Avoidance may also lead you to isolate yourself from other people, particularly if you live with symptoms of social anxiety. In some cases, social anxiety and feelings of loneliness can lead to depression.

Changes in self-perception

If you find yourself unable to start or follow through with things you need to do due to anxiety, it can change the way you view yourself and your ability to handle tough moments, says Ely.

A sense of worthlessness is a formal symptom of depression. When you live with low self-esteem and self-confidence for long enough, you may be more likely to develop other symptoms of depression.

“Anxiety tells you, ‘I can’t do this. This is scary.’ So you don’t go to the dance, or you find a way to pass off the presentation at work. Now, self-criticism starts because you didn’t do the hard thing that was important to you, that you wish you had done,” Ely explains. “This is another way anxiety leads to depression.”

Depletion of resources

When you feel fear, adrenaline is released in your body to help you face the perceived threat, says Katie Luman, a licensed professional counselor in Marietta, Georgia.

“Hypervigilance — when fight or flight is triggered easily and often — can deplete and wear out our stress hormones,” she says. “It can also result in the disruption of sleep and appetite, which can result in a depressed mood.”

Anxiety can be paralyzing, which can make it difficult to reach out for help.

It’s understandable. But try to keep in mind that research shows that untreated, or under-treated, anxiety symptoms can lead to a reduced quality of life in multiple areas, including your social, work, and educational settings.

You may find it useful to think of your emotional bandwidth as a cup, says Luman. If that cup becomes full of anxiety, panic, or fear, there’s limited room for emotions like joy, happiness, and peace.

“The contents of your cup then overflow, and out come all of those negative emotions which commonly look like depression, sadness, or hopelessness,” she explains.

Left untreated, an anxiety disorder can lead to:

• depression
• emotional dysregulation
• limited ability to work
• lowered immune system function
• substance use
• increased likelihood of self-harm

Older research shows that chronic stress and anxiety can also change certain parts of your brain. For example, your hippocampus, which is responsible for learning and memory. This can increase your chance for neurodegenerative diseases, like dementia.

Rather than waiting for things to get to a breaking point, consider reaching out to a therapist for support.

Developing coping skills and practicing relaxation techniques and grounding exercises can help you anticipate an anxious response as well as calm down quickly when you need to.

Research shows that 60% of people living with depression do not seek help for it.

Yet, major depressive disorder is a condition that often warrants support and treatment, especially when coupled with an anxiety disorder.

If you believe you may be living with depression, it’s highly advisable to seek the guidance of a mental health professional.

They’ll be able to assess whether or not you meet the diagnostic criteria for depression, as listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

In order to receive a diagnosis, at least five of nine formal symptoms must be present for longer than 2 weeks.

The formal symptoms of depression include:

• persistent low mood that may include sadness, hopelessness, and irritability
• disinterest in things you used to love
• trouble with concentration and memory
• changes in the way you talk and move, usually to a slower pace
• changes in sleep patterns
• appetite changes that may lead to weight fluctuation
• unexplained aches and pains and fatigue
• thoughts of self-harm or suicide

If you’re living with anxiety and you think it’s causing depression symptoms as well, you don’t have to go through this alone. You may find it useful to work with a therapist who is familiar with anxiety, depression, and the overlap between the two.

There are many types of treatment options available, but Ely recommends Acceptance Commitment Therapy (ACT) and cognitive behavioral therapy (CBT) as a great place to start.

Ely adds these modalities can help you:

• uncover negative core beliefs
• identify unhelpful or distorted thoughts
• widen your comfort zone
• increase your self-esteem

“In therapy, we focus on changing your negative narrative about yourself to one that is strength and value-focused,” she says. “By combining these methods, we see clients move from anxiety and depression, to self-confidence and more fulfilling lives.”

In some cases, living with the effects of anxiety can cause depression symptoms to develop. It could also intensify these symptoms if you already live with both conditions.

Left untreated, anxiety disorders can have a negative impact on your overall quality of life in multiple areas, like your home life, relationships, work, or school.

Developing coping mechanisms and seeking the help of a professional can help and have been found effective in the relief of symptoms.