Anxiety and depression: Calming the emotional roller coaster

By Carrie Milligan, M.D., psychiatrist, Providence Behavioral Health

Between running careers, families and households, women are multitasking all the time in a society that hasn't quite formed itself around our multiple needs for maternity leave, child care, elder care and other support systems. With so much on our plates, it's no wonder that anxiety and depression are twice as common in women as in men.

It's normal to feel blue once in a while, but if your mood has started affecting your day-to-day functioning, it's time to get advice from a professional. Feelings of nervousness, irritability, sadness, guilt, exhaustion or hopelessness that go on and on could be signs of an anxiety disorder, depression or both. A visit with your primary care provider can help sort out what's going on and point you toward appropriate care and resources. Fortunately, there are many effective therapies – as well as things you can do for yourself – that can help calm the emotional roller coaster.

Professional help

Anxiety and depression are often linked, and the treatments for them are similar. For mild cases of anxiety or depression, therapy from a counselor or psychiatrist can be very helpful. Therapy addresses the feelings, thoughts and behaviors that are associated with depression and anxiety disorders. People tend to have patterns in their lives that often perpetuate these disorders. Identifying your patterns and learning to change them can ease the negative feelings significantly and help you head off relapses in the future.

If anxiety or depression is moderate to severe, medications may help in addition to therapy. The most commonly prescribed medications for both anxiety and depression are a class of drugs known as selective serotonin reuptake inhibitors, or SSRIs. Fluoxetine (trade name Prozac) is the SSRI that most people have heard of, but there are many others as well. SSRIs are very effective, but typically take around six weeks to fully kick in. If your anxiety is severe and you can't wait for the SSRI to take effect, faster-acting short-term medications can be added to bridge the gap.


In addition to taking advantage of help from medical professionals, there are many things you can do to help yourself:

Practice stress management. For those of us who are rabid multitaskers, simply learning how to prioritize and break down those endless to-do lists into short-term goals can really help reduce anxiety. Yoga, meditation, deep breathing and other techniques can help as well. 

Make sleep a priority. You probably already know how much sleep you need to feel good and function well – and you're probably not getting that. It's a cycle that's hard to break out of: Stress causes sleeplessness and sleeplessness causes more stress. But it's important to make sleep a priority, because depression and anxiety are hard to treat in people who don't get enough sleep. Medication can help, but before you resort to that, commit to making some changes in your sleep habits, like shutting off the computer or TV well before lights out, going to bed and getting up at the same time every day, and banishing light from the bedroom. 

Lean on your support systems. Women tend to take on more responsibility than they should – and to shoulder it almost entirely on their own. If you have a partner, have a talk about sharing the load a bit more, or bringing in someone to help. If you are carrying an unmanageable load at work, talk with your supervisor about helping to prioritize tasks. And don't drop social engagements due to lack of time – now is the time you need your friends for venting, laughing and relaxing.

Don't underestimate the benefits of healthy living. To keep anxiety and depression at bay, I can't emphasize enough the importance of eating a healthy diet and getting regular physical activity. Even small amounts of exercise can make a big difference, both physically and emotionally – especially if you can get outside in a garden or a park for some fresh air, natural light and a change of scenery. Depression can be associated with weight gain, and in my experience, patients who've made healthy lifestyle changes have found that these changes significantly supported their overall recovery.

Emergency help

If your anxiety or depression has led you to start abusing alcohol or drugs, if your behavior is becoming reckless or dangerous, or if you are having thoughts about harming yourself, do not attempt to ride out your feelings: Make an urgent appointment with your primary care provider or therapist. If you are at imminent risk of harming yourself, call your county mental health crisis line or go directly to a hospital emergency room.

Stop the roller coaster

It's normal to feel a little anxious or depressed sometimes. It is not normal to feel that way all the time. Get in the habit of checking in with yourself frequently. If you're suffering from normal stress, practicing the self-help strategies just mentioned can make a big difference. But if you find yourself struggling with no end in sight, give your doctor a call. Appropriate treatment can calm the roller coaster and make life a much smoother ride.

For a referral to inpatient our outpatient counseling for anxiety or depression, call Providence Behavioral Health at 503-574-9235.