Stress and depression can look and feel very similar to each other. Some of the common symptoms for both include issues with sleeping, eating, concentration, and mood, as well as difficulties performing daily tasks. Physically, there’s a lot of overlap between stress and depression, as both affect the immune system, leading to an increase in certain inflammatory markers.
For depressed patients, the changes in their brain are similar to what is observed in chronic stress. And chronic stress, when left untreated, can lead to depression. For example, adults who experienced a high level of adversity during their childhood, which results in toxic stress, have much higher rates of depression.
“The biology is not the same, but they share a lot of similarities,” says Philip Muskin, a professor of psychiatry at Columbia University.
Here’s how to tell the difference between stress and depression.
Stress is phasic
When it comes to stress versus depression, there are distinct differences, especially when it comes to effective treatment options. One of the primary ways stress and depression differ is that stress can come and go.
“Stress is something that is phasic for most people. You have a stressful period and you come out of it,” Muskin says. “Depression is not like that. Depression goes on for years in some people. It can spontaneously remit in some people, but not everybody.”
For example, if a happy event happens, such as friends or loved ones coming for a visit, a stressed person will be able to feel happy in that moment, although the stress will probably return once they have left. For a depressed person, they won’t be able to feel happiness in that moment, even when they know they should.
“If you can get home from work and still recharge, that’s not major, clinical depression,” says Sheryl Ziegler, a psychologist and author of the book Mummy Burnout: How to Reclaim Your Life and Raise Healthier Children in the Process. “Clinical depression doesn’t come and go.”
So, what’s the treatment for stress? Reducing it, Muskin advises, through measures like exercise, meditation, and mindfulness, as well as reducing the source of the stress.
Depression is an illness
For a depressed person, although stress-reducing measures — such as exercise or going out into nature — can help, it will not cure them.
“At certain levels of depression, nothing but medication will help,” Muskin says.
Depression is, at its core, an illness of the brain. Just like we treat an infection with antibiotics, depression often requires medication. For someone with severe depression, no amount of “mind over matter” or “willing it away” will work. Instead, a person with depression needs medical treatment.
“Depression is no different than any other illness,” Muskin says. “It is a medical illness.”
If you are experiencing either stress or depression, the most important thing to know is that help is available, and that it can get better. For stress, that involves reducing the source of stress and finding ways to cope. For depression, that involves treatment, such as therapy and medication.
Whatever the right solution may be, know that there is one, and that taking the first step to getting the help you need may be the most important one of them all.