Never Let Go of Hope, Even When Depressed and Anxious

Linda, Lake of the Woods Run, 15 K

Image by ex_magician via Flickr

Self-Care Tip #214 – Never let go of hope, even when depressed and anxious.

Some blog-posts ago, Be Aware of Your Feelings was written and “M” asked,

What is the difference between depression and anxiety?

Anxiety and depression are like brother and sister.  They often go together.  When we think of “paradigms,” we think of an arch that might intersect with another arch.  However, when I think of the affective (or mood) spectrum intersecting with the anxiety spectrum, I see them weaving, interlaced or chasing each other.  Not a line and nothing tidy.  So understanding the difference also includes understanding their relationship.

In training, I remember presenting a patient with anxiety and depression to my psychiatry attending physician.  I hadn’t clarified the timeline of onset of symptoms.

When presenting, every resident physician knows the moment when they are found out.  The other residents on the rounding team instinctively lean back, try to take a step away even, so the lightening doesn’t singe them when it strikes.  I’m sure I smelled like fear too.

The reason the time of onset of symptoms is important, is that it tells us the primary disease process.  Knowing that, influences the speculations on patient recovery, duration of illness and our choices for treatment.  Some medications for depression can really activate anxiety and the patient might not enjoy the free-fall into hell after starting the antidepressants.  Also, there are some treatments that work better for different disease processes and such.

It’s common for someone who has suffered from depression on and off for years, but never from anxiety, to have their first panic-attack out of the blue, without trigger.  Bummer!  Then they start to roll.  Bam!  Bamm!  BAm! BAAM! BBBAm!  The panic attacks may come in spurts and then go away for a time.  The opposite is also true, starting off with anxiety, and followed by depression.

I don’t think anyone, including “M,” is asking me to talk about the differences between anxiety and depression in that depression is a state of sadness, and anxiety is a state of autonomic nervous system activation.  Rather there is the wonder of why they follow each other in course, why the are so often in each other’s company, why so many medications that treat one will treat the other, why they run in family histories and/or why they are both “so common.”  We have some ideas we use to answer but we don’t have enough objective information to explain.

Some of the good news is that these diseases are treatable.  The sooner they are treated and when treated to full recovery, the better the hope for long-term brain health is.  I have seen people feel defined by these diseases and trapped.  My job isn’t to minimize that, but rather to highlight what might bring hope.  Selling hope turns out to be one of my biggest jobs.  The same attending physician I mentioned above told me that.  He never stopped talking about hope.  Even for me.

Questions:  How do you answer “M’s” question?  How have you seen depression and anxiety move together and how have you responded to it?  What has given you hope when they did?  Or, when you saw this in someone else.  Please tell me your story.

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18 thoughts on “Never Let Go of Hope, Even When Depressed and Anxious

  1. The very first panic attack I ever had scared the crap out of me…then I started having them more often. Family doc sent me to a cardiologist who said my heart was fine, no farther explanation. It was only when I went in to my routine gyno apt. that my female dr, explained what was happening and sent me to the appropriate health professional for help. Fortunately, I haven’t had another one in years, but thinking about it still sends me on edge.


    • “I haven’t had another one in years, but thinking about it still sends me on edge.” – thank u for sharing that. it’s hard for anyone who hasn’t gone through this terror to grasp how terrible it is. many of us feel less alone because of your story. keep talking


  2. Pingback: A Step Backwards « LIVING WITH MANIC DEPRESSION

  3. I like Carl’s quote from Frankl very much, too. I’m thinking that I have come this far in my life – through my life – only because of hope, but I’m not sure that I actually always recognized it as hope. It was, much of the time, belief in a God who wouldn’t let go of me. It was a grandmother who believed in me always; a husband who hung in with me when others would have walked away; children who have always made themselves available to us, even when I was too sick to be aware of their presence; a relative who picked up where my grandmother left off; and, now, a granddaughter who lights up my life. They all made me believe, through the depression and anxiety (which I, for some reason, can only see as a dropped rope hammock or tangled Christmas lights – too intertwined to ever easily straighten out), that there was a reason to keep on keeping on…a reason to hope.


  4. Hope Is The Answer! A Major Element To Success Through Diversity! The one ingredient that will hold the frazzled robe fibers together! The positive actions in recovering, will be the mending bands of fibers interweaving together. Strengthening as they continue onward. Hope is of an untangeble substance. You cannot hold in your hand; you cannot purchase it. It is not of a certain color, shape, or density. I guess to try & explain its properties. It would be of a matter of substance; held within one’s heart. It can be somewhat placed in a “Hope Chest” of Memories; Values; Physical/Emotional abilities can be the main ingredients for the inner strength one has in definition. In Hoping for the needed changes; inward & outward surroundings/conditions…there must be a purpose or a goal set to adhere to. Depending on the intensity of the journey traveled; “Hope” needs to be continually running side-by-side; enduring the race! Hope is transformed into various formations by each participant. Some are petitioned or laid in respect of their spiritual beliefs. Most labor excessively towards their decided goal. Others find resolution through friends, physicians, yes and even strangers have heard many stories. Look at hair salons,.bar tenders. and doctors. They have had many confiding in their expertice. The anedote for “Hope” is answered by each individual’s life…Myself; I need to look at a strength that man cannot fully offer…We are to encourage and offer hope to one another! That is our purpose to help care for our fellowman; woman; children. Our true strength does comes from our creator; who holds us in HIS Heart..but, we need to give HIM our allowance to show us really what “Hope” means. Many miracles are seen in HIS Hope. Because in Hope; there first needs to be Love. Love Is The Main Ingredient To Life!!! Katherin


  5. “I have seen people feel defined by these diseases and trapped. My job isn’t to minimize that, but rather to highlight what might bring hope.”

    BINGO! Hope is the wind on which self-care soars.


  6. Thanks for the discussion. To me it feels like this:
    Anxiety is a confined and trapped feeling with an extremely unfulfilled urgency to escape. Anxiety scares me.
    Depression is endless sadness and despair. Depression tires me.
    Then you get depressed for being susceptible to depression, etc.
    Some are sorry that they are alcoholics but some do quit consuming. Not so for the depressed. Wouldn’t it be great to say “I am a recovering depressoholic” and haven’t had an episode for 20 years?
    It is very helpful to have this forum, Sana.

    ps: when I went to post this the first time, WordPress deleted it and that made me sad.


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