Introduction: A Personal Note
For many of us in recovery, we came to DA thinking we just had depression—until we realized we were also battling something else beneath the surface: anxiety.
This was certainly true for me, sure I had dealt with anxious moments and looking back I can see that I interpreted anxiety as stress. However these weren’t regular concerns and were at best sporadic, until I found myself in a severe depressive episode for 3 years, following which I was diagnosed with MDD, Major Depressive Disorder.
The anxiety was secondary to the bone deep sadness but it was there, a constant that would rear up. At the very least it would complicate my depression further but at times it felt like my heart would suddenly stop because it was beating so fast.
Whether it showed up as racing thoughts, obsessive worries, social dread, or chest-tightening panic, anxiety often walks hand-in-hand with depression, complicating both diagnosis and healing. These two conditions can seem like opposites, one sluggish, one agitated, but in truth, they often share the same root system.
Understanding how anxiety and depression intersect can help us untangle our emotions, validate our lived experiences, and take more effective steps toward recovery. This article explores how they relate, why they frequently show up together, and what we can do when they do.
I hope it helps.
Section 1: Shared Symptoms, Different Faces
“Having anxiety and depression is like being scared and tired at the same time. It’s the fear of failure, coupled with no urge to be productive. It’s wanting friends but hating socializing. It’s wanting to be alone but not wanting to be lonely.”
— From “What Does Depression Feel Like?”
Anxiety and depression are distinct diagnoses, but they often present overlapping symptoms that can confuse even experienced clinicians. This overlap can also lead to misdiagnosis or underdiagnosis, especially in people who have learned to mask or intellectualize their distress.
| Shared Symptom |
Anxiety |
Depression |
| Trouble sleeping |
Racing thoughts, restlessness |
Early waking, low energy |
| Poor concentration |
Distracted by fear and worry |
Foggy thinking, low motivation |
| Physical tension |
Muscle tightness, stomach issues |
Heaviness, body fatigue |
| Irritability |
Hyper-alert, easily triggered |
Easily overwhelmed, emotionally numb |
| Sense of dread |
Fear of what might happen |
Hopelessness that nothing will change |
What differs is the direction of energy. Anxiety feels like a motor revving too high. Depression feels like the battery’s gone flat. But both come from a dysregulated nervous system—just two sides of the same storm. In practice, many people swing between both poles, which can make day-to-day functioning unpredictable and exhausting.
Section 2: Why They Show Up Together
“Worrying doesn’t empty tomorrow of its sorrows; it empties today of its strengths.”
— Corrie Ten Boom
Roughly 60–70% of people with depression also experience anxiety. It’s not a coincidence—these conditions often grow from the same soil and thrive in the same environments. If we think of them as plants, anxiety is the vine wrapping tightly around your chest, and depression is the slow wilting of your will to move.
Brain Chemistry Imbalance:
Both conditions involve disrupted neurotransmitters—serotonin, dopamine, and norepinephrine—which affect mood, motivation, and stress response. When these chemicals are out of balance, even basic functions like sleep, appetite, and attention become compromised.
Chronic Stress and Cortisol:
When the body is under constant stress, it releases cortisol. Over time, this “stress hormone” wears down your brain’s fear-regulation and mood-regulation centers. Think of it like an alarm that never gets shut off—it keeps the system on high alert until it crashes. This wears down the hippocampus, impairs memory, and can shrink the prefrontal cortex—the area responsible for decision-making and emotional regulation.
Neuroplasticity (In Simple Terms):
The brain learns from experience, good or bad. The more time we spend in anxious or depressed states, the more wired-in they become. But the reverse is also true: we can rewire our brains through new, healing experiences. Every time we reach out for help, take a small risk, or try something new, we plant seeds of recovery in our neural pathways.
Emotional Exhaustion:
Living with constant anxiety such as hypervigilance, intrusive thoughts and shame can wear us down until collapse. That collapse is often depression. Likewise, being stuck in depression, feeling useless or numb, can trigger anxiety about falling behind, failing others, or never recovering.
This collapse is not weakness. It’s a nervous system that’s overloaded and out of balance. It’s a biological and psychological consequence of too much fear with too little relief.
That’s why recovery can feel so confusing: do we treat the sadness or the fear? The answer is both. Because they often show up together—and heal together too. DA provides a structure for emotional and spiritual maintenance, but it’s okay to seek support beyond it if you’re navigating both conditions at once.
Section 3: The Cycle of Mutual Reinforcement
“Anxiety is a thin stream of fear trickling through the mind. If encouraged, it cuts a channel into which all other thoughts are drained.”
— Arthur Somers Roche
Anxiety and depression feed off each other. They create what I call “A Paralyzing Spiral”—a loop of fear, shame, and inaction that deepens the longer it runs. Once inside this loop, we often lose access to clarity, motivation, and even language for what we’re experiencing.
Here’s how that can look:
What if I mess up the meeting?
→ “I’m going to fail again.”
→ “Why even bother?”
→ Isolation, numbness, more fear next time.
→ Delay, dread, despair.
→ Repeat.
Avoidance plays a key role. You might put off checking your bank balance, calling a friend, or starting something important. Anxiety says “What if it goes badly?” Depression follows up with “Why try?” Eventually, you stop doing the things that once brought relief, further deepening the cycle.
The more we avoid, the more guilt and dread we feel—just like the addiction cycle. Many of us in DA know this rhythm well: discomfort → avoid → short-term relief → worse long-term pain. The spiral is exhausting—but it can be interrupted. Naming the pattern is the first step to weakening it.
Section 4: What This Means in Recovery
“Good humor is a tonic for mind and body. It is the best antidote for anxiety and depression…”
— Grenville Kleiser
If you’re working the Steps and still feel stuck, anxious, or flooded—it’s not a failure. It might be anxiety interfering with your ability to heal. Recovery is rarely linear, and our emotional barriers often surface at different points in the journey.
- You’ve done Step 4, but you lie awake replaying what you should have said.
- You want a sponsor, but the idea of reaching out makes your chest tighten.
- You want to share in a meeting, but you’re convinced you’ll say the wrong thing.
- You start to feel better—and then panic, waiting for the other shoe to drop.
This isn’t laziness or resistance, it’s often unconscious self-sabotage driven by fear. For trauma survivors, it can also be emotional flashbacks such as when an interaction triggers a flood of emotion from the past, and you suddenly feel unsafe, ashamed, or small. These flashbacks are not memories in the traditional sense but full-body reactions that reflect unresolved emotional trauma.
DA work may stir old wounds.
Knowing this can help you approach your recovery with more self-compassion, not judgment. Bringing these patterns into the light with a sponsor or trusted peer can ease the intensity and help you stay present for the process.
Section 5: Tools That Help Both
“When you’re going through hell, keep going.”
— Winston Churchill
The best part? Many of the tools that help with depression also soothe anxiety—when practiced with intention and patience. Even small, imperfect efforts can send signals of safety to a nervous system stuck in survival mode.
Why Behavioral Activation Works:
Action creates feedback. When we move our body, make a call, or complete something small, it tells the brain: “I can do hard things.” This rewires the circuits of avoidance and helplessness. The reward doesn’t come first—it comes after we take the step. The trick is doing the thing even if it feels pointless in the moment.
Three Step-Focused Practices for Anxiety Awareness:
- 10th Step Check-ins: Ask “What fear drove my choices today?” Write it down or voice-note it.
- Fear Inventory in Step 4: Write out fears as patterns, not just events. Look for recurring beliefs: “I’m not good enough,” “They’ll leave me,” etc.
- DA Call and Response: When anxious, call someone with a structure: “Here’s what I’m afraid of, here’s what I’m doing anyway.” Even just voicing the fear can take away its power.
When to Seek Clinical Help:
If anxiety or depression blocks you from doing basic DA work (eating, sleeping, sharing, calling), it’s okay to seek therapy or medication. These are not betrayals of the Steps—they can make the Steps more accessible. Sometimes we need support regulating the nervous system before we can fully show up emotionally or spiritually.
Section 6: A Word on Shame
“I often wonder how many others are sitting near me, stuck in their own quiet battles…”
— Carlee J. Hansen
Shame is the silent partner to both anxiety and depression. It tells us we’re broken, unlovable, or weak for feeling this way. It tells us we’re a burden. That we’re falling behind. That we should be better by now.
Here’s the truth: there’s a difference between toxic shame and healthy remorse.
- Remorse says, “I made a mistake.”
- Toxic shame says, “I am a mistake.”
As Brené Brown writes, “Shame is the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.”
This is what’s called a disconnection wound—the kind of emotional pain that comes from being unseen, unheard, or unaccepted by the people we needed most. That wound doesn’t disappear just because we join a program. In fact, recovery often exposes how deep that wound runs.
Sometimes, depression and anxiety aren’t just brain chemistry—they’re survival strategies. Emotional numbness is often how the body protects itself from overwhelming feelings, especially if those feelings were never safe to express. Many of us grew up learning that vulnerability was dangerous, that tears meant weakness, or that we had to hold it all together.
If that’s your story, you’re not lazy. You’re not cold. You’re healing. And you’re not alone.
Conclusion: Calm Within the Storm
Anxiety screams. Depression whispers. But both are asking the same thing: Am I safe? Am I allowed to feel this?
It’s okay not to have the answer yet.
“Anxiety is the lightning. Depression is the fog. But both can clear when we step outside our heads and into connection.”
So take one small step. Call someone. Go to a meeting. Do something that tells your brain, “I’m allowed to live.” Even a deep breath counts.
Recovery isn’t about doing it perfectly. It’s about knowing you don’t have to do it alone.
