Which comes first: depression or anxiety? This is the question researchers have begun to answer in a new study reported in the Archives of General Psychiatry.
It has been believed that generalized anxiety disorder (GAD) typically precedes the development of depression. However, researchers now assert that depression occurs before anxiety as frequently as anxiety manifests before depression, and that the two disorders often develop at the same time.
The observations are from a long-term New Zealand study that followed 1,037 people and examined them for anxiety and depression at seven intervals between ages 11–32. In 37% of those diagnosed with depression, anxiety surfaced before or at the same time as depression, while in those diagnosed with anxiety, depression began before or concurrently with anxiety in 32%. Seventy-two percent of lifetime anxiety cases had a history of depression, while 48% of lifetime depression cases had anxiety. As adults, 12% of the participants had been diagnosed with both GAD and major depressive disorder; of these people, 66% had recurrent depression, 47% had recurrent anxiety, 64% had used mental health services, 47% had taken psychiatric medication, 8% had been hospitalized, and 11% had attempted suicide.
The authors suggested that the lifetime prevalence of coexisting anxiety and depression is probably higher than typically estimated, and that the two conditions could be classified in one category of distress disorders. [This study was reported in the Archives of General Psychiatry, Volume 64, page 651.]
