Depression and Anxiety in Teens: What Makes Them Different and How Do They Connect?

Anxiety and depression in teens: is it possible to have both? Unfortunately, yes.

As with many mental health conditions, anxiety and depression can occur simultaneously in a teen. This co-occurrence can create a confusing sense of constant alertness and worry, as well as fatigue and low motivation. By themselves, anxiety and depression can have serious impacts on a teen’s well-being. However, together they can create a contradicting whirlpool of emotions, thoughts, and bodily sensations.¹

If you’re concerned that you or someone you care about has anxiety or depression – or both – support and advice are available. This article can help by highlighting:

The difference between anxiety and depression in teens
The symptoms of anxiety vs. depression in teens
Whether teenagers can have both anxiety and depression
How anxiety and depression overlap in teens
How to manage co-occurring anxiety and depression in teenagers
Treatment options for both anxiety and depression
When to seek help for co-occurring anxiety and depression in teens

Difference Between Anxiety and Depression in Teens

Globally, it is believed that roughly one in seven youths aged between 1–19 years of age experience the symptoms of at least one mental health condition. However, many of these cases go both unrecognized and untreated.

Anxiety is the most common of these mental health conditions in adolescents, closely followed by depression. Because both anxiety and depression can affect a teen’s moods and emotions, there’s often confusion between the symptoms of each. Moreover, this confusion can increase if there are signs of both.^2,3

Symptoms of Anxiety vs. Depression in Adolescents

If you’re concerned that a teen may have anxiety or depression, the following symptoms may help draw a distinction between both and guide your next steps.

There’s a variety of potential reasons for the higher rate of depression in adolescent girls, including the following:

Symptoms of Anxiety in Adolescents

Symptoms of anxiety in adolescents can be emotional and behavioral, and can include signs such as the following.⁴

Emotional Signs of Anxiety in Adolescents:

Excessive worry about everyday things
Worries about things that happened in the past, are happening in the present, or could happen in the future
Difficulties controlling how much they worry
Awareness that their fears and worries are out of control
Going round and round in their minds about the same thoughts
Feeling constantly “on edge”
Difficulties relaxing
Problems concentrating
Irritability

Behavioral Signs of Anxiety in Adolescents:

Appearing restless
Reassurance seeking
Avoidance of feared situations
Seeming “twitchy”
Tiredness and fatigue
Frequent physical complaints, such as headaches, stomach pains, and muscle tension
Difficulties sleeping
Lightheadedness
Shortness of breath
Intense sweating
Frequent urination

Teens may feel especially anxious about things like school and academic performance, catastrophes or natural disasters, and the health of loved ones.⁴

Symptoms of Depression in Adolescents

Like anxiety, depression also has emotional and behavioral signs in teenagers, including the following:⁵

Emotional Signs of Depression in Adolescents:

Feeling hopeless, “numb,” or “empty”
Becoming overwhelmed by negative emotions such as sadness
A loss of interest in hobbies, activities, and friend groups they once enjoyed
Low self-esteem, self-blame, and feelings of “worthlessness”
Seeing themselves as a “failure” based on their past accomplishments
Frequent irritation, frustration, or anger – often without clear triggers
Difficulties recalling memories, both positive and negative
Increased awareness of negative emotions
Long-term feelings of stress
Lack of motivation to plan for the future as they see it as “bleak”
Issues with concentration and problem-solving
Suicide ideation, or thinking about death

Behavioral Signs of Depression in Adolescents:

Increased or decreased time spent sleeping
Frequently seeming fatigued or exhausted
Speaking negatively about themselves, such as saying they’re “worthless” or “to blame”
Seeming slower than usual to physically react or speak
Changes in appetite (eating more or less than usual)
Poor performance and lower attendance at school, or even dropping out
Appearing frequently agitated or stressed
Withdrawing from family and friends
Complaining of frequent physical pain, such as stomach pain, headaches, and muscle tension
Changes in how they care for their appearance, such as personal hygiene
Becoming argumentative or showing outbursts of anger or aggression without a clear reason as to why
Engaging in risky behaviors and showing poor impulse control

To sum up the core differences between the symptoms of anxiety and depression, these are:

Anxiety is marked by excessive fears and worries.	Depression is characterized by persistent sadness and hopelessness
Anxiety causes worry about the past, present, and future	Depression causes a low-self view, worthlessness, and guilt
Anxiety leads to avoidance of feared situations	Depression can cause withdrawal from interests and loved ones

These differences are, by no means, the only distinctions between anxiety and depression, but they can act as a quick guide. It’s also possible that a teen may show both excessive worry about the past, as well as feelings of hopelessness – potentially indicating the presence of both anxiety and depression.

Can Teenagers Have Both Anxiety and Depression?

The answer to “Can Teenagers have both anxiety and depression at the same time?” is, unfortunately, “Yes.” It is not only possible for a teen to have both conditions, but common. What’s more, having one of these mental health conditions can lead to the development of the other over time, if left untreated.⁶

How Anxiety and Depression Overlap in Teens

The following are five ways that anxiety and depression can overlap in teens.

1. Anxiety and Depression Cause Mood Changes in Teens

A teen with anxiety or depression – or both – can exhibit mood swings or persistent low mood. They may come across as irritable, frustrated, aggressive, or tearful – often without a clear reason as to why. This mood change could come down to how both conditions involve changes in the chemicals of the brain’s “reward system.”^7,8

2. Anxiety and Depression Can Cause Problems Concentrating

Difficulty concentrating is a common symptom of both anxiety and depression in teens, but could come down to different reasons why. Teens with anxiety may feel so caught up in fears or worries that they struggle to focus their minds. However, teens with depression have shown to have differences in their brain structures and chemicals which can affect concentration and memory.^9,10

3. Anxiety and Depression Can Lead to Sleep Disturbances in Teens

Teenagers with anxiety and depression often report difficulties falling or staying asleep, contributing to mood issues, problems concentrating, and worse symptoms of anxiety and depression. These sleep problems are likely to be due to a restless mind; teens with anxiety and depression may experience troubling thoughts which prohibit them from relaxing.^11,12

4. Anxiety and Depression Can Cause Physical Pain

Although anxiety and depression are typically considered to be “emotional” conditions, teens with either or both may frequently report symptoms of physical illness – without any clear medical cause. The pains reported by teens with depression or anxiety are similar; stomach pains, headaches, gastrointestinal discomfort, and muscle tension. This overlap could come down to the mind-body connection in teens with anxiety and depression, as increased stress, distress, and changes in brain chemicals can lead to physical pain.¹³

5. Anxiety and Depression Can Impair a Teen’s Ability to Function

Due to mood problems, difficulties concentrating, a lack of sleep, and physical pain, both anxiety and depression can affect a teenager’s ability to lead a full, satisfying life. These issues can impact relationships, school performance, and overall well-being in both the short and long term.

Managing Co-Occurring Anxiety and Depression in Teenagers

If you’re concerned that you or someone you care about has co-occurring anxiety and depression, it’s important to seek advice from a mental health professional. Both of these conditions can impact a teenager’s emotional and physical well-being in both short and long-term ways, especially if left untreated.

What’s more, having one of these conditions can potentially lead to the development of the other over time. Early intervention is key for the best outcomes for a teen’s mental health – but it’s never too late to treat the symptoms of anxiety and depression.

The best way to manage co-occurring anxiety and depression is to speak to a doctor or mental health professional for advice and make lifestyle changes, such as increasing support, exercising, and incorporating relaxation and self-care.

The following steps can help.

1. Gently Encourage Them to Open Up to You:

You can’t force a teen to talk about their mental health. However, you can gently encourage them to share their feelings by expressing that you’re concerned and want to be there for them. If they’re willing to talk to you, let them know that you’re proud of them for doing so and will be there for them, no matter what. You could also offer to help them in practical ways, such as by helping them find professional support.

If they’re not willing to open up yet, don’t give up. Try again when they seem more approachable or ask a third party, such as a school counselor or mental health professional, for advice.

2. Promote Exercise

Regular exercise can release “feel good” chemicals in the brain and naturally relieve the symptoms of anxiety and depression. What’s more, exercise can help a teen sleep better, distract them from negative thoughts and emotions, and strengthen their social circle if they choose to exercise with others.

If a teen struggles to muster up the energy for intense exercise, encourage them to try gentle routines for a short amount of time. Eventually, they may feel more motivated to try longer or more strenuous activities.

3. Build Self Care Into A Routine

Self care, such as eating a balanced diet, getting enough sleep, and taking time to relax, is important for everyone – but especially a teen with co-occurring anxiety and depression. Teens with anxiety and depression may neglect aspects of self-care, so help them to get the nutrients they need, make sure they’re not using their phone before bed, and encourage them to take part in activities they enjoy, such as time with friends or family.

These steps can help a teen with co-occurring anxiety and depression, but they’re only one part of a much larger picture. Teens with anxiety and depression likely find daily life highly challenging, which can lead to unhealthy coping strategies – and even self-harm or thoughts of death. Professional treatment for teens with co-occurring anxiety and depression is the best choice for their well-being.

Treatment Options for Teens With Both Anxiety and Depression

If you’re concerned that a teen has both anxiety and depression, it’s important to seek support. Neither anxiety nor depression go away without the right treatment, and they can get worse over time. By themselves, anxiety and depression can seriously affect a teen’s life – together, they can double the negative impact.

You don’t have to cope with the effects of co-occurring anxiety and depression alone. A mental health professional can talk you through the best options for your mental health or that of a loved one. The most effective therapy options for anxiety and depression often include the following:

Therapy Options for Comorbid Anxiety and Depression in Teens

Cognitive Behavioral Therapy (CBT)

CBT is not only proven to be effective in treating anxiety and depression, it also helps reduce the physical pain that often accompanies these conditions. It can assist teens with co-occurring anxiety and depression identify and challenge negative thoughts, build healthy ways of coping with them, and transition these skills into the world outside of therapy.

Eye Movement Desensitization and Reprocessing (EMDR)

While EMDR is more frequently associated with trauma that can lead to depression, it is also effective in treating anxiety – especially when these conditions co-occur due to previous experiences. EMDR changes the way trauma is stored in the brain and helps a teen build more positive self-beliefs and ways of coping with life’s challenges.

Interpersonal Therapy

Co-occurring anxiety and depression in teens can stem from problems in relationships. Interpersonal therapy can help them work through these issues and figure out better ways of coping to improve their mental health.

Transcranial Magnetic Stimulation

TMS can be effective in treating treatment-resistant depression. It’s a non-invasive treatment that uses magnetic fields to activate nerve cells in targeted areas of the brain – improving outlook and mood.

Each of these therapies can be used to treat different types of teen depression and anxiety in both residential mental health treatment programs and outpatient programs, depending on a teen’s needs. A doctor may also talk about the option of medication for co-occurring anxiety and depression. Yet, it’s important to bear in mind that anxiolytics and antidepressants work best when accompanied by therapy.

When to Seek Help for Co-Occurring Anxiety and Depression in Teens

If co-occurring anxiety and depression are affecting a teen’s happiness, ability to function, and well-being, it’s important to seek help. These issues don’t go away without support – and they’re too much of a burden for anyone to carry by themselves.

Mission Prep can help. Our team of trained mental health professionals offers personalized anxiety treatment and depression treatment for teens in various locations. With our care and support, teens can understand how to cope with anxiety and depression, live in the moment, and feel motivated to work towards a bright future. Contact us today for support and advice.

References

Kalin, N. H. (2020). The critical relationship between anxiety and depression. American Journal of Psychiatry, 177(5), 365–367. https://doi.org/10.1176/appi.ajp.2020.20030305
American Psychiatric Association. (n.d.). Anxiety disorders. Retrieved February 27, 2025, from https://www.psychiatry.org/patients-families/anxiety-disorders
World Health Organization. (2024, October 10). Mental health of adolescents. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
National Institute of Mental Health. (n.d.). Generalized anxiety disorder: When worry gets out of control. U.S. Department of Health and Human Services. Retrieved February 27, 2025, from https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad
Mayo Clinic Staff. (n.d.). Teen depression: Symptoms and causes. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985
Garber, J., & Weersing, V. R. (2010). Comorbidity of Anxiety and Depression in Youth: Implications for Treatment and Prevention. Clinical Psychology : A Publication of the Division of Clinical Psychology of the American Psychological Association, 17(4), 293. https://doi.org/10.1111/j.1468-2850.2010.01221.x
Martin, E. I., Ressler, K. J., Binder, E., & Nemeroff, C. B. (2009). The Neurobiology of Anxiety Disorders: Brain Imaging, Genetics, and Psychoneuroendocrinology. The Psychiatric Clinics of North America, 32(3), 549. https://doi.org/10.1016/j.psc.2009.05.004
Rădulescu, I., Drăgoi, A. M., Trifu, S. C., & Cristea, M. B. (2021). Neuroplasticity and depression: Rewiring the brain’s networks through pharmacological therapy (Review). Experimental and Therapeutic Medicine, 22(4), 1131. https://doi.org/10.3892/etm.2021.10565
Gilbert, P., & Gilbert, J. (2003). Entrapment and arrested fight and flight in depression: An exploration using focus groups. Psychological Psychotherapy, 76(2), 173-188. https://doi.org/10.1348/147608303765951203
Dillon, D. G., & Pizzagalli, D. A. (2018). Mechanisms of Memory Disruption in Depression. Trends in Neurosciences, 41(3), 137. https://doi.org/10.1016/j.tins.2017.12.006
Sleep Foundation. (n.d.). Anxiety and sleep. Retrieved February 27, 2025, from https://www.sleepfoundation.org/mental-health/anxiety-and-sleep
Sleep Foundation. (n.d.). Depression and sleep. Retrieved February 27, 2025, from https://www.sleepfoundation.org/mental-health/depression-and-sleep
Harvard Health Publishing. (2021, September 16). Pain, anxiety, and depression. Harvard Medical School. https://www.health.harvard.edu/mind-and-mood/pain-anxiety-and-depression

Depression and Anxiety in Teens: What Makes Them Different and How Do They Connect?

Difference Between Anxiety and Depression in Teens

Symptoms of Anxiety vs. Depression in Adolescents

Symptoms of Anxiety in Adolescents

Emotional Signs of Anxiety in Adolescents:

Behavioral Signs of Anxiety in Adolescents:

Symptoms of Depression in Adolescents

Emotional Signs of Depression in Adolescents:

Behavioral Signs of Depression in Adolescents:

Can Teenagers Have Both Anxiety and Depression?

How Anxiety and Depression Overlap in Teens

1. Anxiety and Depression Cause Mood Changes in Teens

2. Anxiety and Depression Can Cause Problems Concentrating

3. Anxiety and Depression Can Lead to Sleep Disturbances in Teens

4. Anxiety and Depression Can Cause Physical Pain

5. Anxiety and Depression Can Impair a Teen’s Ability to Function

Managing Co-Occurring Anxiety and Depression in Teenagers

1. Gently Encourage Them to Open Up to You:

2. Promote Exercise

3. Build Self Care Into A Routine

Treatment Options for Teens With Both Anxiety and Depression

Therapy Options for Comorbid Anxiety and Depression in Teens

Cognitive Behavioral Therapy (CBT)

Eye Movement Desensitization and Reprocessing (EMDR)

Interpersonal Therapy

Transcranial Magnetic Stimulation

When to Seek Help for Co-Occurring Anxiety and Depression in Teens

References

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