Texas Tech University Health Sciences Center
Do You Have Anxiety or Depression?

Do You Have Anxiety or Depression?

Do You Have Anxiety or Depression?

Sarah Mallard Wakefield, MD

Everyone at one time or another has suffered a bad mental health day. But when is struggling to get out of bed or feeling constant tension at work considered anxiety or depression? The Centers for Disease Control and Prevention (CDC) reported substantial increases in self-reported behavioral health symptoms began after the pandemic. One CDC report which surveyed adults across the U.S. in late June of 2020, showed 31% of respondents reported symptoms of anxiety or depression, 13% reported having started or increased substance use, 26% reported stress- related symptoms and 11% reported having serious thoughts of suicide in the past 30 days.

Sarah Mallard Wakefield, M.D., chair of the Texas Tech University Health Sciences Center Department of Psychiatry, said anxiety is maladaptive fear.

“Anxiety is where the fear doesn't subside,” Wakefield said. “It actually hurts us. It's fear that makes us stay inside and not go see our friends. It's fear that makes us not engage in things that would bring us happiness. It's fear that makes us isolated and alone. Anxiety is fear on steroids.”

The National Alliance on Mental Illness said people typically experience one or more of the following symptoms:


  • Feelings of apprehension or dread
  • Feeling tense or jumpy
  • Restlessness or irritability
  • Anticipating the worst and being watchful for signs of danger


  • Pounding or racing heart and shortness of breath
  • Sweating, tremors and twitches
  • Headaches, fatigue and insomnia
  • Upset stomach, frequent urination or diarrhea Symptoms of Depression can include:
  • Feeling sad or anxious often or all the time
  • Not wanting to do activities that used to be fun
  • Feeling irritable‚ easily frustrated or restless
  • Having trouble falling asleep or staying asleep
  • Waking up too early or sleeping too much
  • Eating more or less than usual or having no appetite
  • Feeling guilty, worthless or helpless
  • Thinking about suicide or hurting yourself

“When you have depression, you don't feel sad, irritable or mad only in response to things that would make you feel sad, irritable or mad,” Wakefield said. “You might just feel down all the time and you can't figure out ‘why am I feeling like this?’ I often explain it is like thinking through mud, functioning through mud; everything's just heavier. The weight of the world is heavier. It's harder to think and to get your body up to do something.”

Wakefield said a person can suffer from both anxiety and depression—both are neurotransmitter related illnesses.

Stress and sleep and anxiety and depression are all interlinked. One of the major neurotransmitters that contributes to anxiety and depression also regulates sleep.

“When we have too little serotonin, it can cause us to be sleepless and also cause us to have anxiety and depression. We see sleeplessness or insomnia, or waking up frequently overnight, or waking up too early being signs and symptoms of anxiety and depression. Over time, when your sleep gets disrupted, it disrupts that that serotonin chemical and then can lead to anxiety and depression.

Exercise can help with depression and anxiety. Ten to 20 minutes of vigorous exercise can release endorphins and release neurotransmitters and can boost serotonin production.

“If you're having a really bad day, feeling low, or you're in the midst of a depression, if you can get yourself to just go do 10 to 20 minutes of vigorous exercise, it actually will release the hormones, those neurotransmitters that we're targeting with many of the medications,” Wakefield said. “Mental health is really just health. It's a component of your health. And when your body overall is healthier, then you tend to have healthier mental health as well.”

Speak to a physician if you think a neurotransmitter is at play. Care is very individualized from person to person.

“Medicine is not always the answer,” Wakefield said. “We have great therapeutic interventions. We know learning new coping strategies, being with friends who make us feel good about ourselves, eating right, taking care of our health. And then there are other interventions like transcranial magnetic stimulation that we know can help when we have resistant types of depression.”