This recent article by the Guardian, “Why do identical twins end up leading such different lives?” adds yet more weight to the argument that even though our genes may predispose us to certain traits, and therefore give us strengths and vulnerabilities, our epigenetic makeup, i.e., the pattern by which certain genes are expressed or not through of our interactions with the world, will make a huge contribution to the building of our personality.
Depression with Anxiety: a common problem
Very often, psychotherapists in London and elsewhere will mention under the same breath that they help people with “anxiety and depression”, almost as if it were one and the same thing. This is probably because, according to the ONS, there are almost three times more people who suffer from both depression and anxiety that people who suffer from depression alone. Indeed, depression with anxiety is experienced by 9.2% of people in Britain, while depression without anxiety by 2.8%.
What is the relationship between anxiety and depression?
It is hard to say if unmanageable anxiety triggers depression, or if a state of depression generates anxiety. It depends highly on individual cases and even then It often feels like a circular situation and in my experience it is not helpful to try and find out what came first. The essential is to help the client address these feelings as a whole in their therapy, and to consider anxiety and depression as intricately linked as opposed to separate phenomena requiring different approaches.
An apparent paradox
It sometimes seems paradoxical that depression, whose symptoms are said to be mostly negative (i.e., describing the absence of something), can co-exist with anxiety, whose symptoms are mostly positive (i.e., describing the presence of something). For example, in depression, sufferers experience lowered mood, loss of motivation, loss of meaning and loss of concentration, while in anxiety it is the positive symptoms that seem to prevail, for example, increased heart rate, presence of recurrent unpleasant thoughts and restlessness.
How to approach individual treatment of mixed anxiety and depression
As an experienced counsellor having helped many people deal with issues of mixed anxiety and depression in London, I have noticed that people suffering from this problem fall in three very broad categories:
- those who feel that they will benefit more from guidance and education, and expect from the therapist clear instructions and coping strategies,
- those who prefer a non-directive approach and want to explore their experience in an open, unstructured manner,
- and those who feel that it is most helpful for them to experience both in their therapy.
As an integrative psychotherapist, I believe that it is best to offer my clients what is going to be helpful to them and not just what a specific approach says I should do. This is why I mostly offer my clients a space to be with themselves and also a forum where they can clarify, understand and plan concrete life changes.