Signs of Anxiety and Depression You May Be Overlooking

Anxiety and depression do not always show up the way you might expect. The signs can be subtle, physical, or easy to dismiss until they begin to impact your daily life.

At Adventist Health Glendale’s La Cañada Primary Care clinic, Sevana Manukian, MD, MPH, provides comprehensive care for patients of all ages, including support for common mental health concerns like anxiety and depression. We asked her to share what to look for, when to talk to a doctor, and how to take the first steps toward feeling better.

Q: What are some signs of anxiety or depression that people may overlook in themselves or a loved one — and when should they talk to a doctor?

While there are some similarities between symptoms of anxiety and depression, there are also important differences, so I will discuss them separately.

Generally speaking, if you notice changes in a loved one’s normal demeanor, mood, or level of interaction, especially in a way that affects their work, school, health, or relationships, it may be a good opportunity to check in. If you notice similar changes in your own mood, particularly if they are impacting your daily life, you should feel comfortable reaching out to your physician. It is important to let a physician know right away if you have thoughts of harming yourself or others.

In terms of depression, most may be familiar with the typical mood symptoms, which include sadness, negativity, worthlessness, guilt, or withdrawal, as well as more serious signs such as thoughts of self-harm. Some of the more overlooked symptoms include irritability and difficulty concentrating.

Signs of depression may include:
• Sadness, negativity, worthlessness, or guilt
• Withdrawal from others
• Thoughts of self-harm
• Irritability
• Difficulty concentrating

Depression can also have physical manifestations that affect appetite, sleep, energy levels, and movement.

Physical manifestations of depression can include:
• Changes in appetite (increased or decreased)
• Changes in sleep (sleeping more or less than usual)
• Changes in energy levels
• Slower movements or speech than usual
• Feeling physically heavy or weighed down

It is especially important to recognize physical signs in children, because mood changes may not be immediately obvious. Complaints of headaches, abdominal pain, or nausea can be signs of depression.
Regarding anxiety, most are familiar with the excessive worry and anxiousness that feels overwhelming and difficult to control. Potentially overlooked symptoms of anxiety include irritability or feeling constantly on edge or unable to relax, which can make it hard to sleep.

Signs of anxiety may include:
• Excessive worry or anxiousness that feels overwhelming or difficult to control
• Irritability
• Feeling constantly on edge or unable to relax
• Difficulty winding down or sleeping
• Muscle tension
• Restlessness
• Fatigue
• Abdominal pain or nausea

Q: Do patients need to see a mental health specialist to receive treatment?

Not necessarily. Primary care physicians, including family medicine and internal medicine physicians, are trained to recognize and assess common mood concerns and help guide patients toward appropriate treatment and support.

They may offer a range of options, such as talk therapy, medication, or referral to psychiatry if needed.

Q: If someone feels like they’ve been in a slump, what are some first steps they can take to support their mental health?

When someone is feeling very depressed or in a slump, they can start to neglect basic needs such as meals, hydration, and bathing. I would start by addressing those basic needs.

For example, if making a meal feels difficult, having nutritious, easy-to-access snacks and water nearby can help. When simple tasks like taking a shower or washing the dishes can feel overwhelming, it can help to choose a smaller, more manageable task. Starting with smaller, manageable tasks can help build momentum and make larger tasks feel more achievable. For example, if a shower feels too difficult, aim to simply wash your face. A smaller task can activate you and serve as positive reinforcement, motivating you to take on a bigger task.

One of the most evidence-based treatments for depression is exercise. Going for a short walk, jog, or yoga session can have immediate mood-boosting effects.

Finally, when someone is in a slump, they may want to withdraw and avoid reaching out so they do not feel like a burden. However, it can be helpful to connect with someone, whether that means help with a meal, a task you have been putting off, or joining you for a physical activity. Sometimes that is all you need.

If you’ve noticed changes in your mood or overall well-being, care can start with a simple conversation.

At Adventist Health Glendale’s La Cañada Primary Care clinic, we provide comprehensive care for your health, with same-day appointments, extended hours, and a commitment to clinical excellence.

Call 818-630-8685 to book an appointment with Dr. Manukian.