When we’re not feeling our best or upset by something, and we talk to a friend, we may want to express our feelings but struggle to find the right words.
Beyond feelings of sadness, we may struggle with intrusive thoughts and somatic symptoms such as shortness of breath, chest pain, and panic attacks that affect our daily activities.
Anxiety and depression symptoms show up as fatigue, headaches, pain, and sleeplessness. Stomach aches and other gastrointestinal symptoms are common too because your body is often where stress is held.
70 percent of all doctors' visits are related to stress because there is always a physical outcome of prolonged periods of stress and upset.
Getting to the bottom of your symptoms and knowing if you have a clinical diagnosis of anxiety, OCD, or depression, can help identify your or your child’s symptoms and seek the right treatment to calm the brain and address unhealthy behaviors.
The question is, when is a sad event or period of sadness a clinical issue, and when is it stress or anxiety?
When is it okay to shed tears over a cup of ice cream or cry when we can’t get the toy we want? And when do we visit a therapist? Here are a few tips to tell apart feelings of sadness, anxiety, and major depression.
Feelings of Sadness
Sadness is one of the primal human emotions. Sadness is part of the ups and downs of life, and we all experience periods of sadness in direct response to something happening in our life. Whether it is a lost friendship, an argument between friends or siblings, or not getting the part you want in a school play, there are just times we feel sad.
When we make ourselves vulnerable to family, friends, relationships, and dreams — and things go wrong, we feel sad over losing something valuable. And that is okay. Sadness is healthy in small amounts as long as we don’t get stuck in the sadness.
Feeling sad is a process, and being sad can help one make sense of things, know what is important, and how to do better next time. Sad experiences are a learning lesson for kids and adults.
As much as we don’t want our children to feel sad, it is an emotion that children should learn to recognize what it physically feels like and how to tolerate it. It is through these experiences, that children learn to manage uncomfortable thoughts, sensations, and feelings so they can be good problem solvers.
Sadness can be associated with many experiences and other emotions, so it is important to help children and teens recognize the physical signs and have conversations about how it can show up in other ways and with other feelings.
Sadness is associated with the following more specific emotions:
- Feelings of disadvantage
- Broken heart
Sadness can also co-occur with other emotions, including:
Sometimes feelings of unhappiness and low mood can be fairly mild, while they can be more intense in other cases. For example, tears can be an expression of sadness that is perfectly normal, with some experiencing occasional periods of tearfulness and others weeping daily. When any behavior reflects sadness for long periods of time, depression should be considered.
Sadness can affect how you feel physically, as one may become quiet or lethargic, unfocused, and experience stomach upset.
Sadness is temporary and transitory. It can usually be managed by the child or individual on their own or with minimal support.
Here are the best tips for managing sadness:
- Have confidence that things will improve and your feelings will lessen with time and effort.
- Be honest with yourself and open up to someone you can trust
- With children and teens, spend time together and create opportunities for discussion
- Use art and nonverbal activities to help release sadness from the body
- Do things that you enjoy and that are good for you. Listen to music, go outside, read a book, or call a friend.
- Tackle one problem at a time.
- Practice mindfulness-based stress reduction activities such as meditation and breathwork
- Strive for healthy sleep and eating patterns.
- Get moving and be outside, as they are known to reduce stress
- Journal your feelings or have a child draw them
- Attend a support group.
However, prolonged sadness can turn into depressive disorders or anxiety disorders. It is important to seek help from a mental health professional if you feel that things are beyond your control.
What is Depression?
Nowadays, the call for mental health awareness is louder than ever. Many are experiencing anxiety, depression, OCD, and suicidal feelings. With social media toxicity, loneliness during the pandemic, school bullying, peer pressure, and teenage insecurities — depression is on the rise.
A mood disorder develops from prolonged feelings of sadness, hopelessness, guilt, worthlessness, and emptiness. Depression can also frequently result from compound stressors or long periods of anxiety. The body and mind get physically depleted when it tries to manage the strain of stress. This can happen just as easily with children and teens as it does with adults, as no one is immune from chronic stress.
I recall working with an 11-year-old named Blake, who became lethargic and easily upset and tearful in the fifth grade. His parents knew he was a worrier, but he did well in school and had friends, so they assumed everything was okay until he started getting upset and weepy. After getting a QEEG brain map at our center, it was clear that his brain had become depressed after being anxious for a long time. His body couldn’t keep pushing out cortisol, nor could his microbiome stay balanced under constant stress. Blake was able to get his gut and cortisol levels back on track with supplements, calm his brain with PEMF and learn new coping skills in therapy. His parents also learned ways to help him manage negative emotions without accommodating him so much.
Learning how to manage negative emotions is an important skill that will help you throughout your life. Negative emotions can be managed by acceptance of self, opening up to others, positive mantras, coping skills, and lifestyle techniques such as prioritizing exercise, sleep, and eating brain-optimizing foods to avoid depression.
There are many factors that can contribute to the emergence of mental health problems and depression, including
- Previous depression
- Family history of depression or anxiety
- Suicide of a friend or family
- Recent or multiple stressors
- Grief and loss
- Physical illness
- Relationship problems
- Substance Abuse
Depression is treatable, but early action can be helpful so individuals can be connected to the right resources. Gaining coping skills to manage stress and upset is a critical component in managing a mood disorder. Gaining a resiliency mindset™ means you just don’t view stressors in the same way, so you aren’t as activated, and one’s mood is more stable.
If you, a family member, or someone is going through depression, you are not alone. Reaching out to a counselor can be the first step to healing.
Effects of Clinical Depression
Depression or major depressive disorder is a common and serious mental health disorder that negatively affects emotions and decision-making. It is often defined as a mental health condition that impacts mood, behavior, and health. Attention, how one responds to stress, manages relationships, is able to focus, and is motivated enough to complete tasks.
Symptoms of depression include sadness, hopelessness, and a lack of interest in activities you used to enjoy. It can result in physical and emotional issues and decrease one’s engagement and productivity at work and home. Ultimately, it reduces the enjoyment of life.
Children and teens will describe feeling “flat” and not experiencing joyfulness. Their motivation is low, so that makes getting home and school tasks are done a challenge. Their low motivation can be misinterpreted as “laziness,” and arguments at home are common as a result. Signs of depression can easily be misinterpreted as willful behavior when in reality, they don’t just have the mental or physical energy to start or complete tasks.
Depression is common, with one in 20 adults worldwide experiencing depression. The figure is higher in the US, where one in 15 adults is diagnosed yearly. One in six people will experience depression at least once in their life.
Children aren't immune from depression either. According to the CDC, 4.4% of children aged 3-17 years (approximately 2.7 million) have diagnosed with depression in 2016-2019.
Depression can happen to anyone, but some demographics are more vulnerable. Teens and young adults are likely to experience their first episodes of depression usually during their late teens to mid-20s. In patriarchal societies where the oppression of women is imminent, women are more likely to experience depression. Studies have found that one-third of women will experience major depression within their lifetime.
Depression runs in families and has a 40% chance of heritability. The question is, is it genetic or behavioral inheritance? When you live in a home with someone who is struggling with mental health, children pick up behaviors. Children learn through observation, and that means they see healthy and unhealthy behaviors and act in the way they see their parents' behaviors. So depressive behaviors can be learned on a subconscious level.
As noted before, depression can result from long-term stress and anxiety, as the body and mind become physically depleted.
Symptoms of depression fall on a broad spectrum and range from mild to severe. Some people are internalizers, and some are externalizers. Internalizers with depression experience less outwardly observable symptoms such as sadness, difficulty focusing, and a sense of hopelessness. Externalizers, on the other hand, show their depression behaviorally, with impulsive behaviors, anger, moodiness, or a short fuse. Externalizers may be miss diagnosed with Oppositional Defiant Disorder or ADHD.
While feelings of sadness or loneliness are entirely normal, consult a provider if the following symptoms last for two or more weeks.
- Lingering sadness
- Loss of interest in hobbies
- Change in eating patterns
- Change in sleeping patterns
- Noticeable unnecessary movements, restlessness, delayed movements or speech
- Guilt and insecurities
- Lack of focus, unable to make decisions
- Suicidal thoughts, death wishes
Low self-esteem is also a risk factor for depression. Negative thinking and low self-confidence are common in those with mood disorders. Looping negative beliefs makes it hard for a depressed child or person to take those all-important microsteps that turn it around.
Depression may also lead to alcohol or substance abuse due to a lack of healthy coping mechanisms. Addiction is more common when it is prevalent within the family as well.
Certain medical conditions can mimic symptoms of depression. In diagnosing depression, it is essential to rule out the following conditions
- Brain tumors
- Thyroid problems
- Autoimmune disease
- Vitamin deficiency(ies)
- Infectious diseases
- COVID and Epstein-Barr
- Tick-borne illness
- Streptococcus infection
Types of Depression That Affect Adults and Children
Related to cause and symptoms, there are various types of depression that affect adults and children. Postpartum depression affects many women, with one in 10 women in the US experiencing it. Most women recover with treatment.
Types of Depression:
- Persistent Depressive Disorder
- Major Depressive Disorder
- Postpartum depression
- Psychotic depression
- Seasonal Affective Disorder
- Bipolar disorder
Depression can be managed with professional help. Integrative wellness treatments such as Neurofeedback and PEMF can reduce depressive symptoms. Psychotherapy, somatic therapy, talk therapy, and interpersonal therapy, healthful lifestyle changes with a focus on exercise, outdoor activity, a non-inflammatory diet, and having a support system can help one recover.
Everyone gets a bad day once in a while, but depression is different. Finding and remembering the things that make life worth living and making micro steps toward macro change are very important in achieving mental wellness.
What is Anxiety?
Anxiety occurs when we feel uneasy, worried, or nervous. Such as when we’re taking an exam or something exciting is coming up, such as a graduation or promotion. Mild anxiety can pass easily after the exam is over, but clinical anxiety is different. One would worry about exams all the time, and it interferes with your daily functioning.
Compound stressors can lead to clinical anxiety that causes our nervous system to stay in a heightened fight, flight, or freeze state. Anxiety can manifest whenever we are triggered by environmental, sensory, emotional, or experiences that activate our nervous system, causing unhealthy physical and emotional unease. It can be really uncomfortable when activated and some are aware of the triggers, and others are not.
Change and social interactions can lead to anxiety too. Teens are more prone to it as they go through physical transformations and social changes at a fast pace. They must let go of childhood habits and step into more responsibilities as they enter high school, where they are also exposed to peer pressure and heartbreaks. They may have insecurities and fears about academic success and peer relationships that can lead to feelings of anxiety.
I worked with one anxious teenager, Marnie, who was a happy kid until she succumbed to the pressures of perfectionism and straight “A’s.” Her parents put zero pressure on her other than to be healthy and happy and find something she loves to do. As Marie explained it, “Unless you are a straight A student in honors classes, kids think less of you.”
Symptoms of Anxiety
A person with anxiety may experience one or more of the following symptoms:
- Confusion or difficulty concentrating
- Intrusive thoughts
- Negative thinking
- Pounding heart, sweating, shaking, or trembling
- Feeling like you're in danger even when there is no danger present
- Fear of losing control or racing thoughts
- Gastrointestinal symptoms
- Easily tearful or emotional
- Anger or rage
Clinical anxiety refers to negative or worrying thoughts or fears that go beyond what an average person experiences and impedes everyday life. The thoughts can be intrusive and lead to compulsive thoughts and behaviors, such as in Obsessive Compulsive Disorder OCD.
When overwhelmed with anxiety, we may focus on our fears and worries and forget to be in the moment and be productive. Your child may worry about their grades so much that they imagine receiving low marks instead of focusing on their studies and doing their homework. They also may worry about something completely irrational that may not make sense to you.
There are actually several types of anxiety disorders that affect adults and children. The average age of onset for anxiety disorder is age six, so knowing the signs is needed to get kids and teens the resources they need.
Various disorders are grouped under the term anxiety disorders and include:
- Generalized Anxiety Disorder (GAD)
- Panic Disorder
- Social Anxiety Disorder
Some anxiety symptoms are specific to particular disorders, while others are more general. Symptoms can be more related to worried thoughts or can manifest as purely somatic symptoms. Adults and kids alike report worried and fearful thinking that feels out of their control.
General symptoms of anxiety include:
- Stomach aches
- Strong feelings of worry
- Racing heart
- Looping thoughts
- Easily activated
It's completely normal to feel anxious once in a while. Humans are equipped with flight responses to help us survive dangerous situations. However, it is important to turn off our flight response when we are perfectly safe. To do this, find something that relaxes you. EFT tapping, music, a cup of tea, or essential oils are some ways to calm yourself when you experience symptoms.
Anxiety vs. Depression
Anxiety often co-occurs with depression, so the distinction between the two may be hard to discern at first glance.
Independent clinical records report that as much as 60% of patients with anxiety also exhibit symptoms of depression. The same is true the other way around.
There are ways that depression and anxiety are similar. People with anxiety or depression tend to self-isolate and not reach out for help. Negative thinking and poor self-concept are often seen in those with anxiety or depression. Both groups can also experience a variety of overlapping symptoms.
Symptoms present in anxiety and depression
- Resistance to help
- Sleep problems
- Lack of focus
- Focus issues
- Negative thinking
- Easy activation
- Somatic symptoms
- Can be highly “functional” or struggling to get out of bed
How are Anxiety and Depression Different?
While anxiety and depression have similarities, they also have their differences.
Here are common differences between anxiety and depression:
- People with anxiety worry about the future and appear to have more energy. People around them can find them in “overdrive” because they are overly concerned with events that have not happened yet. They are constantly thinking about or fearful of future events.
- On the other hand, depression usually stems from past events such as traumas, betrayals, and heartaches. Depressed people have lower energy and worry about things that have already happened. They may exhibit some symptoms of anxiety, being anxious about the things they could have done differently. There is a deep sense of hopelessness and a lack of joy when you are clinically depressed.
- While people with anxiety appear to care too much, people with depression may appear to not care at all. Depressed individuals are often mistakenly referred to as “unmotivated” or “don’t care.”
Often a Dual Diagnosis
Comorbidity occurs when a person suffers from two or more disorders at a time. Interestingly depression and anxiety have a 60% chance of being comorbid together.
One theory is that both disorders possess similar biological mechanisms and may show up together in the brain. Another reason that they may be diagnosed together is due to mindset loops or one is stuck in a constant worry cycle that strains the brain and body.
For example, someone may have anxious, pervasive worry. Then they may feel bad about having the worries and look back over their life and feel like a failure. These constant intrusive thoughts wear one down mentally and physically and may lead to depression.
While this may not happen to everyone, some individuals weave through signs of depression and anxiety in this course.
Integrative Wellness Treatments for Anxiety and Depression
As anxiety and depression may occur together, they may also be addressed all at once with integrative wellness treatments that are evidence-based, natural, and with no lasting side effects.
They are healthier options than prescription drugs. Antidepressant medications may cause anxiety, indigestion, stomach aches, diarrhea, constipation, loss of appetite, and dizziness. Drugs for anxiety may lead to nausea, headaches, anxiety, sweating, dizziness, agitation, weight gain, dry mouth, and sexual difficulties.
Medications for ADHD are often used for both anxiety and depression and can have serious side effects. These medications are viewed as “safe,” but in reality, there are a host of short-term and long-term side effects that can really harm the brain and set a person back.
Primary integrative wellness treatments for anxiety and depression include Neurofeedback and PEMF to calm the brain and reduce symptoms. The best part about these science-backed treatments is they are effective and safe.
Relief methods and self-help techniques such as EFT Tapping may relieve feelings of anxiousness.
Art therapy, positive parenting, guided meditation, and essential oils are helpful complementary treatments.
At our CT Neurofeedback center and with our virtual clients, we are committed to providing children, teens, and families natural options to calm the brain and cultivate behavior change. If you are ready for change, then apply to work with us in our premier one-to-one BrainBehaviorReset™ Program. We only accept a few clients a month who are ready to be done with their anxiety, OCD, depression, or other clinical issues holding them back.
Browse additional resources at https://drroseann.com/blog
Ask your health care provider for integrative wellness options.
Better Health Channel (2022), It's Okay to Feel Sad
Psycom (2020), Living with Sadness: How Does Sadness Differ from Depression?
National Institute of Mental Health (2022), Anxiety Disorders
National Institute of Mental Health (2022), Depression
Very Well Mind (2021), What is Sadness
Always remember… “Calm Brain, Happy Family™”
Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime.
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Dr. Roseann is a Children’s Mental Health Expert and Therapist who has been featured in/on hundreds of media outlets including, CBS, NBC, FOX News, PIX11 NYC, The New York Times, The Washington Post,, Business Insider, USA Today, CNET, Marth Stewart, and PARENTS. FORBES called her, “A thought leader in children’s mental health.”
She is the founder and director of The Global Institute of Children’s Mental Health and Dr. Roseann Capanna-Hodge. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Medicine Mental Health Provider (CMHIMP) and an Amen Clinic Certified Brain Health Coach. She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF) International Society for Neurofeedback and Research (ISNR) and The Association of Applied Psychophysiology and Biofeedback (AAPB).
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