Lack of Positive Relationships Matter for Links Between Depression and Anxiety

Upset millennial outsider feel offended lack company, young outcast guy suffer from discrimination, jealous of friends hang out together in cafe, envious male loner depressed sit alone in coffeeshop

It is estimated that more than half of people suffering from depression will also develop an anxiety disorder sometime during their lives, and vice versa. The reason for these associations are unclear, but important to understand. People who have both depression and anxiety, instead of just one or the other, are likely to have more severe symptoms, more daily impairment, and lower quality of life. Theories suggest that poor interpersonal relations can be critical components of both illnesses. Therefore, this MIDUS study tested whether having positive relations with others affected the connections between depression and anxiety.

Participants completed three waves of assessment (at Time 1, Time 2, and Time 3) spaced about nine years apart. At each time point, they reported on the following for the previous 12 months:

    • Major depressive disorder: how often they lost interest in most things or felt down on themselves, no good, or worthless.
    • Generalized anxiety disorder: how often they were keyed up, on edge, or had a lot of nervous energy; or were irritable because of their worry.

The quality of positive relations with others was measured at Time 2 by asking if participants agreed with statements such as:

    • “Maintaining close relationships has been difficult and frustrating for me.”
    • “I have not experienced many warm and trusting relationships with others.”

Results showed that:

    • Having more severe depression at Time 1 was associated with having lower positive relations at Time 2, which in turn predicted more severe anxiety symptoms at Time 3.
    • Also, having more severe anxiety at Time 1 predicted lower Time 2 positive relations, which in turn predicted more severe depression at Time 3.
    • This was true after controlling for age, gender, education, and Time 1 depression and anxiety symptoms.

Why would having less quality ties to others be a way in which depression or anxiety can lead to each other over the long term? The authors theorize that people with depression or anxiety disorders may find it difficult to form or sustain positive relationships because they:

    • may isolate themselves/avoid social situations
    • tend to perceive social situations as unfavorable
    • have trouble problem-solving in social situations
    • tend to interpret social information negatively
    • overreact to feeling excluded in social situations.

Lack of positive relationships may also increase feelings of loneliness and rejection, which can lead to depression or worsen social anxiety. In addition, having fewer relationships can make it hard to get support when facing significant challenges, which can also increase depression and/or anxiety. In sum, these results suggest that interventions seeking to improve relationships may help with both depression and anxiety, and may prevent the double whammy of suffering from both.

Source: Barber, K. E., Zainal, N. H., & Newman, M. G. (2023). Positive relations mediate the bidirectional connections between depression and anxiety symptoms. Journal of Affective Disorders, 324, 387-394.

Read the full article at: