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Anxiety, Depression and Quality of Life—A Systematic Review of Evidence from Longitudinal Observational Studies

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This review aimed to systematically review observational studies investigating the longitudinal association between anxiety, depression and quality of life (QoL). A systematic search of five electronic databases (PubMed, PsycINFO, PSYNDEX, NHS EED and EconLit) as well as forward/backward reference searches were conducted to identify observational studies on the longitudinal association between anxiety, depression and QoL. Studies were synthesized narratively. Additionally, a random-effects meta-analysis was performed using studies applying the mental and physical summary scores (MCS, PCS) of the Short Form Health Survey. The review was prospectively registered with PROSPERO and a study protocol was published. n = 47 studies on heterogeneous research questions were included, with sample sizes ranging from n = 28 to 43,093. Narrative synthesis indicated that QoL was reduced before disorder onset, dropped further during the disorder and improved with remission. Before onset and after remission, QoL was lower in comparison to healthy comparisons. n = 8 studies were included in random-effects meta-analyses. The pooled estimates of QoL at follow-up (FU) were of small to large effect sizes and showed that QoL at FU differed by disorder status at baseline as well as by disorder course over time. Disorder course groups differed in their MCS scores at baseline. Effect sizes were generally larger for MCS relative to PCS. The results highlight the relevance of preventive measures and treatment. Future research should consider individual QoL domains, individual anxiety/depressive disorders as well as the course of both over time to allow more differentiated statements in a meta-analysis.

1. Introduction

The World Health Organization [ 1 ] estimates that 264 million people worldwide were suffering from an anxiety disorder and 322 million from a depressive disorder in 2015, corresponding to prevalence rates of 3.6% and 4.4%. While their prevalence varies slightly by age and gender [ 1 ], they are among the most common mental disorders in the general population [ 2 , 3 , 4 , 5 , 6 ]. During the COVID-19 pandemic, multiple challenges have arisen for many, such as loneliness [ 7 ] or financial hardship. A meta-analysis showed a prevalence of anxiety of about 32% (95% CI: 28–37) and a prevalence of depression ( n = 14 studies) of about 34% (95% CI: 28–41) in general populations during the COVID-19 pandemic [ 8 ].

Anxiety and depression have been associated with adverse societal and individual correlates, including higher health care costs [ 9 , 10 , 11 ] and an increased risk for physical comorbidities, such as cardiovascular illnesses [ 12 , 13 ]. Moreover, they have been linked to a reduced quality of life (QoL) in numerous cross-sectional as well as longitudinal studies in which they significantly predicted QoL outcomes [ 14 , 15 , 16 , 17 , 18 ]. Other studies have reported a reverse association, whereby QoL was predictive of mental health outcomes [ 19 ] or a bi-directional association [ 20 , 21 ]. Some very recent studies also examined these associations among quite different samples (e.g., [ 22 , 23 , 24 , 25 ]).

Looking at longitudinal rather than cross-sectional data from observational studies has several advantages. It allows for the identification of trajectories over time within the same individuals rather than focusing on group differences at one point in time only [ 26 ]. Moreover, when appropriate methods are applied to longitudinal data, intraindividual heterogeneity can be taken into account, resulting in more consistent estimates [ 27 ]. This has previously been demonstrated in QoL research [ 28 ]. A need to analyze longitudinal changes in QoL domains in QoL research in people with mental disorders has also been previously identified [ 29 ]. Beyond individual longitudinal studies suggesting a link between anxiety or depression and QoL, several systematic reviews have synthesized longitudinal evidence on these associations and mostly reported negative associations between the variables. These reviews have tended to focus on specific age groups, such as older adults [ 30 ], samples with specific diseases [ 31 , 32 ], or have investigated the effect of specific treatments on QoL in patients with anxiety [ 33 ]. Investigating these associations in samples without these limitations could reduce the effect of specific conditions and treatments on the association and strengthen the conclusions that can be drawn.

In light of the previous findings, this study aims to add to the present literature by systematically synthesizing evidence from observational studies on the longitudinal association between anxiety, depression and QoL across all age groups in samples who do not have other specific illnesses and do not receive specific treatments.

2. Materials and Methods

This review was registered with PROSPERO (CRD42018108008) and a study protocol was published [ 34 ].

2.1. Search Strategy

Five electronic databases from several fields of research (PubMed, PsycINFO, PSYNDEX, NHS EED and EconLit) were examined until December 2020. Where possible, search terms were entered as Medical Subject Headings (MeSH) or as keywords in the title/abstract. The PubMed search strategy was: (anxi*[Title/Abstract] or depress*[Title/Abstract] or anxiety disorder[MeSH] or depressive disorder[MeSH]) and quality of life[MeSH] and longitudinal study[MeSH]. Please note that “*” is a truncation symbol. Time or location were not restricted. In addition, we applied backward and forward reference searches of included studies to identify additional references. The forward reference search was conducted until January 2021 using Web of Science to identify cited papers.

2.2. Study Selection Process

The study selection process is displayed in Figure 1 . Most identified studies were screened in a two-step process (title/abstract; full-text screening) independently by two reviewers (J.K.H., E.Q.) against defined criteria (see Table 1 ). The last updated literature screening before submission was conducted by one reviewer (J.K.H.) and encompassed 9% of the studies included for title/abstract screening. Before the final criteria were applied, they were pretested and refined. Disagreements during the selection process were resolved through discussion or by the inclusion of a third party (A.H.) if a consensus could not be reached.

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Object name is ijerph-18-12022-g001.jpg

Study flow (PRISMA flow chart).

Study selection criteria.

Studies were eligible for inclusion if they:
(i) Were observational studies analyzing the longitudinal association between anxiety or depression (disorders as well as symptom severity) and QoL,
(ii) Analyzed samples without a specific disease or disorder other than anxiety and depression,
(iii) Applied appropriate, validated measures for the main variables (e.g., for anxiety/depression: psychiatric diagnosis according to criteria of the International Classification of Diseases (ICD), the Diagnostic and Statistical Manual of Mental Disorders (DSM), or using a valid self-report screening tool), and
(iv) Were published in English or German in a peer-reviewed journal.
Studies were excluded if they:
(i) Analyzed samples where participants were suffering or recovering from conditions other than anxiety/depression,
(ii) Analyzed samples receiving or recovering from a specific intervention or treatment,
(iii) Had no observational study design,
(iv) Used a measure for the main variables other than those defined, or
(v) Had publication characteristics that were different than those defined (e.g., were published in a language other than German or English, as well as not published in a scientific, peer-reviewed journal).
After pre-testing, the following refinements were made to the screening criteria (ii) and (iii):
(ii) Regarding the samples of interest, we decided to exclude studies analyzing dyads such as caregivers or partners to ill family members, due to possible spillover-effects on the individual’s QoL, which has been demonstrated in previous studies [ , ]. Additionally, samples consisting exclusively of people with anxiety or depressive disorders may receive some unspecific type of care for their mental health problems. We eliminated studies evaluating the effects of treatments using pre–post-treatment comparisons. Only studies where some naturalistic treatment that is usual for mental health problems that began prior to study baseline (BL) were included. Studies indicating that treatment was initiated at or after study BL (e.g., before or at admission to a psychiatric clinic) were excluded.
(iii) Lastly, we specified the QoL assessments. In health and medicine research, numerous QoL instruments are used [ ]. Guided by previous literature reviews [ , , ]), we compiled a list of ten validated QoL assessments that have been used in children, adolescents or adults from the general population and/or samples with mental health problems, and that are frequently used in QoL research. Versions of the following instruments were included: Short Form Health Survey (e.g., SF-36, SF-12), EuroQol (e.g., EQ-5D, EQ-5D-Y), WHOQOL (e.g., WHOQOL-100, WHOQOL-BREF), Quality of Well-Being Scale, Quality of Life Scale, Pediatric Quality of Life Inventory, KIDSCREEN, KINDL, Quality of Life in Depression Scale, and the Quality of Life Enjoyment and Satisfaction Questionnaire.

Abbreviations: QoL = quality of life; ICD = International Classification of Diseases; DSM = Diagnostic and Statistical Manual of Mental Disorders; BL = study baseline; KIDSCREEN = Health Related Quality of Life Questionnaire for Children and Young People and their Parents; KINDL = German generic quality of life instrument for children

2.3. Data Extraction and Synthesis

We extracted information regarding the study design, operationalization of the variables, sample characteristics, statistical methods and results regarding the research question of interest. If several analyses were presented for the same research question, we extracted the final covariate-adjusted model for narrative synthesis. Data were extracted by one reviewer (J.K.H.) and cross-checked by a second reviewer (E.Q.). If needed, extracted data were standardized (e.g., by calculating the weighted average means when combining groups) to present comparable information. If clarification was needed, the corresponding authors were contacted.

For the narrative synthesis, all studies were first grouped by research question, e.g., whether disorders or the degree of symptoms were analyzed, which comparison groups were used, which QoL domains were considered, and at which waves the variables of interest were considered in the analyses. Because research questions and analyses were heterogeneous, a concise narrative synthesis of the main results of all studies was not feasible. Therefore, we provide an overview of all identified studies in the tables and a detailed narrative synthesis of those studies, analyzing trajectories of disorders or changes in symptoms in association with changes in QoL over time.

Additionally, we examined whether data were appropriate for meta-analysis. The specific research questions, the operationalization of main variables and statistical methods were heterogeneous across studies and not all the statistical estimates needed could be obtained from covariate-adjusted analyses. Therefore, to enhance the comparability of the underlying data and the interpretation of the pooled estimates, we used descriptive information. Because most papers applied variations of the Short Form Health Survey and analyzed mental and physical component scores (MCS, PCS), we considered these studies as eligible for meta-analysis. The necessary information could be obtained for 8 publications. Random-effects meta-analysis was used for pooling. Heterogeneity was assessed by means of I 2 , with higher values representing a larger degree of heterogeneity in terms of variability in effect size estimates between studies [ 41 ]. Pooled estimates are reported as Hedge’s g standardized mean difference (SMD), representing the difference in mean outcomes between groups relative to outcome measure variability [ 42 ]. According to Cohen (as cited in [ 43 ]), SMDs can be grouped into small ≤0.20, medium = 0.50 and large effects ≥0.80. Stata 16 was used for meta-analyses.

2.4. Quality/Risk of Bias Assessment

Two reviewers (J.K.H., E.Q.) independently assessed the quality and risk of bias of the included studies using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, which was developed by the National Heart, Lung, and Blood Institute [ 44 ].

3.1. Selection Process

The literature search yielded 4027 unique references. After title/abstract screening, 215 studies were included for full-text screening. Finally, 47 publications were included in the final synthesis. During full-text screening, most studies were excluded because they exclusively analyzed data on a cross-sectional level (56.5%). For further details, see the PRISMA flow chart ( Figure 1 ).

3.2. Overview of Included Studies

Descriptive characteristics and quality/risk of bias assessment of the included studies are provided in Table S1 (Supplementary Material) . In short, sample size ranged from 28 to 43,093. Most studies focused on adults; only four analyzed children/adolescents. Regarding the settings, 17 of the analyzed samples were exclusively recruited in a health care setting, 12 of the studies analyzed general population samples, 14 recruited in another or in several settings, and all studies on children/adolescents recruited in schools ( n = 4). Twenty studies (42.6%) applied data from the same seven underlying datasets. Most studies reported on depression ( n = 36), less reported on anxiety ( n = 20) and some reported on the comorbidity between depression and anxiety ( n = 7). To assess mental disorders, half (48.9%) used structured interviews. Regarding QoL, most studies applied variations of the Short Form Health Survey (SF, n = 27) or the WHOQOL ( n = 12). A total of 38.3% of the studies were rated as “good”, 55.3% as “fair” and 6.4% as “poor” in the quality assessment.

3.3. Overview of Studies on the Association between Anxiety/Depression as Independent Variables and QoL Outcomes

Detailed results on all studies investigating the association between anxiety/depression as independent variables and QoL outcomes are reported in Table 2 . As described in the methods section, the following paragraphs give an overview of those studies focusing on disorder trajectories/changes in symptoms over time and changes in QoL outcomes over time, because they allow for more differentiated interpretations.

Studies on depression/anxiety as independent variables and QoL outcomes.

First Author (Year)Disorder or Symptoms Analyzed; QoL Domains AnalyzedResearch Question Regarding QoLMethodsResults
Årdal (2013) [ ]Controls and patients in the acute phase of recurrent MD and FU (DSM-IV, HDRS); SF-36 (physical functioning, role physical, vitality, bodily pain, mental health, role emotional, social functioning, general health, as well as summary scores PCS, MCS and total score)(a) Whether QoL scores differ between MD patients and healthy comparisons across domains over time.
(b) Whether QoL in patients with recurrent MDD differed between acute phase and recovery.
(a) ANOVA
(b) Paired-sample -tests
(a) There was a significant interaction effect between time, QoL domain and group, indicating that QoL scores differed between MD patients and controls over time. Compared to the healthy control group, the MDD group had reduced QoL in all domains at BL and reduced QoL in several domains at FU (significant for general health, social, emotional role, mental health, PCS, MCS and total score).
(b) In the MD group, QoL scores significantly improved during recovery from recurrent MDD in most domains (significant for physical functioning, physical role, vitality, social functioning, role emotional, mental health, PCS, MCS and total score).
Buist-Bouwman (2004) [ ] Onset, acute phase and subsequent remission from MDE (CIDI); comorbid anxiety disorder (CIDI); SF-36 (physical functioning, physical role, vitality, pain, psychological health, psychological role, social functioning and general health)(a) Whether incident MDE and recovery from MDE are associated with changes in QoL and whether pre- and post-morbid QoL scores in the MD group differ from the comparison group without MD.
(b) In the subgroup with worse QoL after MDE: whether the severity of depression and number of depressive episodes were associated with worse QoL.
(c) Whether comorbid anxiety during MDE is associated with reduced QoL (i.e., lower QoL after MDE compared to before MDE).
(a)–(c) Multivariate logistic regression(a) Incident MDE was associated with a drop in QoL (significant for vitality, psychological, psychological role and social functioning). Subsequent recovery from MDE was associated with an improvement in QoL (significant for physical role, vitality, psychological health, psychological role, social functioning and general health). Comparing pre- and post-morbid levels, QoL did not differ or was higher after MDE in some domains (significantly higher for psychological health and psychological role). Moreover, before MD onset, QoL was significantly lower compared to healthy controls in all domains. After remission from MDE, QoL scores in nearly all domains (not significant for psychological role) were significantly lower compared to healthy controls.
(b) About 40% of the MDE group had worse QoL after recovery from MDE compared to pre-morbid levels. The severity of depression was associated with worse QoL only for the psychological health domain, but no other domains. The number of depressive episodes was not significantly associated with worsening QoL in any domain.
(c) In the MDE cohort, comorbid anxiety was associated with a significant reduction in QoL (significant for physical role and psychological health).
Cabello (2014) [ ] Chronic MD (AUDADIS interview; summary score of the number of symptoms to identify severity); SF-12, “disability” (i.e., domain-specific reduced QoL, defined as score ≤ 25th percentile in the subscale; physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role and mental health)(a) Whether chronic MD is associated with the incidence/persistence of “disability” (i.e., reduced QoL) in a general population sample.
(b) Whether the severity of depressive symptoms is associated with the incidence/persistence of “disability” (i.e., reduced QoL) in the MD subgroup of the sample.
Both (a) and (b) Generalized Estimating Equations and logistic regressions(a) In the general population, chronic MD was a significant risk factor for the persistence of disability (i.e., reduced QoL) in all domains and of the incidence of disability (i.e., reduced QoL) in all domains except for the physical role.
(b) In the chronic MD subgroup, the severity of depressive symptoms was associated with the persistence of disability (i.e., reduced QoL) (significant for general health, social functioning, emotional role and mental health) and not significantly associated with the incidence of reduced QoL in any domain.
Cerne (2013) [ ] Number of depressive episodes over time according to CIDI; number of episodes of panic and other anxiety syndromes over time (PHQ); SF-12 (PCS, MCS)Whether the pooled number of
(a) depressive episodes over time,
(b) panic and anxiety episodes over time are
are associated with the pooled QoL over time.
(a) and (b) Multivariate linear regression(a) A higher number of depressive episodes over time was associated with lower pooled PCS and MCS.
(b) a higher number of pooled panic episodes over time was associated with a lower mean MCS but not PCS. A higher number of pooled other anxiety syndrome episodes over time was not associated with the mean MCS or PCS.
Chin (2015) [ ]Depression according to PHQ-9 (>9), clinician’s diagnosis; SF-12v2 (PCS, MCS)(a) Whether depressive symptoms and a clinician’s detection of depression at BL are associated with QoL at FU.
(b) Whether a clinician’s detection of depression at BL is associated with a change in QoL.
(a) Multivariable non-linear mixed-effects regression
(b) Independent -tests
(a) Depressive symptoms and a clinician’s detection of depression at BL were not predictive of QoL at FU.
(b) A clinician’s detection of depression at BL was related to change (improvement) in MCS, but not PCS over time in a primary care sample screened as positive for depression.
Chung (2012) [ ]Depression diagnosis and symptoms (DSM-IV, HRSD depression scale, HADS depression scale); anxiety symptoms (HRSD anxiety scale, HADS anxiety scale; SF-36 (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, mental health, PCS and MCS)(a) Whether BL depressive symptoms are associated with QoL at FU.
(b) Whether BL depressive symptoms or changes in depressive symptoms are associated with changes in QoL over time.
(c) Whether BL anxiety symptoms are associated with QoL at FU.
(d) Whether BL anxiety symptoms or changes in anxiety symptoms are associated with changes in QoL over time.
(a)–(d) Hierarchical regression(a) BL depressive symptoms were not associated with any QoL domain at FU.
(b) BL depressive symptoms were not associated with changes in any QoL domain over time. Changes in depressive symptoms were significantly associated with changes in some QoL domains over time (significant for: general health, vitality, mental health and MCS).
(c) BL anxiety symptoms were not associated with any QoL domain at FU.
(d) BL anxiety symptoms were not associated with changes in any QoL domain over time. Changes in anxiety symptoms were significantly associated with changes in some QoL domains over time (significant for: bodily pain, general health and mental health).
Diehr (2006) [ ]Depression according to CIDI, CES-D (>16); QLDS, WHOQOL-Bref (environmental, physical, psychological and social), SF-12 (PCS, MCS)(a) Whether the quartile of change in depressive symptoms is associated with changes in QoL.
(b) Whether the remission of depression at FU is associated with changes in QoL.
Regression(a) No/little change in CES-D associated with changes in QoL over time (significant for SF-12 MCS). Every other quartile of change in depressive symptoms was significantly associated with changes in QoL in most scales/domains (significant for: QLDS, all domains of WHOQOL-Bref and SF-12 MCS), meaning a higher reduction in depressive symptoms was associated with a higher increase in QoL, and more severe depressive symptoms were associated with a reduction in QoL.
(b) Remission of depression at FU was associated with improvement in all QoL measures and domains (SF-12, QLDS and WHOQOL-Bref). There was no significant change in QoL in those with persistent clinical depression at FU.
Hajek (2015) [ ]Depressive symptoms (GDS); EQ-VASWhether an initial change in depressive symptoms is associated with a subsequent change in QoL in the whole sample and by sex.Vector autoregressive modelsNo significant association between an initial change in depression score and a subsequent change in QoL was found for the whole sample or stratified by sex.
Hasche (2010) [ ] Depression status at BL (according to DIS diagnosis and CES-D ≥ 9); SF-8 (PCS, MCS)(a) Whether depression status groups at BL differed according to QoL at FU.
(b) Whether depression status groups at BL differed according to QoL changes in score over time.
(a) -tests
(b) Linear mixed effects regression models
(a) At 6- and 12-month FU, those with and without depression at BL differed significantly in QoL scores, with the depression group reporting lower QoL at FUs (significant for MCS and PCS).
(b) While depression at BL was significantly related to improvements in MCS (but not PCS) scores over time, those with depression still reported lower QoL compared to those without.
Heo (2008) [ ]Depression (BDI ≥ 10); SF-36 (decrease in total score over time)Whether FU depression is associated with a reduction in QoL over time.Binary logistic regressionDepression at FU was associated with a significant reduction in QoL total score over time.
Ho (2014) [ ]Depression (according to GDS ≥ 5); SF-12 (PCS, MCS)Whether depression at BL is associated with QoL at FU.Linear regressionBL depression was associated with lower QoL at FU (significant for MCS and PCS).
Hussain (2016) [ ]Depressive disorders (SCID, MINI); current PTSD, specific phobias, other anxiety disorders (SCID, MINI); WHOQOL-Bref (general QoL and hrqol) (a) Whether current depressive disorders at BL predict QoL at FU.
(b) Whether current PTSD, specific phobias and other anxiety disorders at BL predict QoL at FU.
(a) and (b) Multiple linear regression(a) Depressive disorders at BL predicted reduced QoL at FU (significant for general QoL and hrqol).
(b) PTSD, but not specific phobias or other anxiety disorders, predicted reduced general QoL at FU. None of the anxiety disorders predicted hrqol at FU.
Joffe (2012) [ ]Lifetime history of depression (according to SCID); anxiety disorder (according to SCID); SF-36 (impaired QoL according to 25th percentile of SF-36; social functioning, role emotional, role physical, pain and vitality)(a) Whether a lifetime history of depression is associated with impaired QoL during FU.
(b) Whether a prior lifetime history of anxiety disorder (compared to no depression or anxiety) is associated with reduced QoL during FU.
(c) Whether a lifetime history of comorbid depression and anxiety is associated with impaired QoL during FU.
(a)–(c) Repeated measure multilevel regression(a) A history of depression only was associated with reduced QoL during FU (significant for social functioning and pain).
(b) Prior lifetime history of anxiety disorder was associated with reduced QoL (significant for physical role).
(c) A history of comorbid anxiety and depression was associated with reduced QoL during FU (significant for social functioning, emotional role, physical role and pain).
Johansen (2007)
[ ]
Level of PTSD symptoms according to IES-15; WHOQOL-Bref (physical health, psychological health, social relationships and environment)Whether PTSD symptoms predict QoL at FU.Structural equation modelMore severe PTSD symptoms predicted QoL at FU (significant positive association between FU1 and FU2).
Kramer (2003) [ ]Current or lifetime depression/PTSD (according to Q-DIS); SF-36 (energy/fatigue, emotional role, general health, mental health, pain, physical functioning, physical role and social)Whether QoL outcomes over time differed among the disorder groups.Random/fixed effects modelThere was no significant interaction between time and diagnostic group (no depression/PTSD, PTSD, depression and comorbid depression/PTSD) on QoL.
Comparing the adjusted means for all three times among the disorder groups showed significant differences between the groups in most domains. In comparison, those with depression at BL reported reduced QoL over time in several domains compared to the PTSD group and the group without PTSD/depression. In comparison, those with PTSD only showed higher QoL compared to those with depression or comorbid depression/PTSD in several domains.
Kuehner (2009) [ ]Depressive symptoms (MADRS); WHOQOL (overall, physical, psychological, social and environmental)Whether the lag in levels of depressive symptoms predicts future levels of QoL and whether the association differs by group (formerly depressed inpatients vs. community controls).Time-lagged linear modelsHigher depressive symptoms predict future lower QoL (significant for social). The association was not moderated by group status.
Kuehner (2012) [ ]Depression score (according to MADRS, FDD-DSM-IV); WHOQOL-Bref (physical, psychological, social and environment)Whether the lag in depressive symptoms predicted QoL at FU.Hierarchical, time-lagged linear modelsHigher depressive symptoms significantly predicted lower QoL at FU (significant for physical and psychological).
Lenert (2000) [ ]Remission or persistent depression (according to DSM-III criteria, DIS); SF-12 (PCS, MCS)Whether the remission of depression (compared to no remission) is associated with changes in QoL over time.OLS regressionRemission of depression was associated with improved QoL (significant for MCS) at FU1 and FU2.
Mars (2015) [ ]Asymptomatic, mild and high symptoms of depression (according to SCAN); EQ-5D (without anxiety/depression item)Whether depression symptom trajectories over time (asymptomatic, mild symptoms and chronic–high symptoms) are associated with QoL at FU.Latent class growth analysis with distal outcome modelsQoL at FU differed significantly among different depression symptom trajectories, with persons from the the chronic–high depressive symptom class showing lower QoL scores relative to the asymptomatic class.
Moutinho (2019) [ ]Depression at BL (according to DASS cut-off: 9); anxiety at BL (according to DASS anxiety scale cutoff: 7); WHOQOL-Bref at FU (physical, psychological, social and environment)(a) Whether BL depression predicted QoL at FU.
(b) Whether BL anxiety predicted QoL at FU.
(a) and (b) Stepwise linear regression(a) Depression at BL was significantly associated with reduced QoL at FU (significant for psychological functioning, social functioning and environmental).
(b) Anxiety at BL was associated with reduced QoL at FU (significant for physical).
Ormel (1999) [ ]Depression at BL (according to CIDI); “disability” (i.e., reduced QoL according MOS SF 6-item physical functioning scale ≥ 2)Whether depression at BL is associated with the onset of disability (i.e., reduced QoL) during FU.Logistic regression modelsCompared to the non-depressed group, people with depression at BL showed higher odds for the onset of disability (i.e., reduced QoL) during FU (significant for 12-month FU, but not 3-month FU).
Pan (2012) [ ]Depressive symptoms (CES-D); WHOQOL-Bref-TW (overall score, physical, psychological, social and environmental)Whether depressive symptoms were associated with QoL over time.Linear mixed-effects modelsHigher depressive symptoms were associated with lower QoL in MDD patients (significant for overall score, physical, psychological, social and environmental).
Panagioti (2018) [ ]Depressive symptoms (MHI-5); WHOQOL-Bref (physical, psychological, environmental and social)Whether depressive symptoms at BL are associated with changes in QoL over time.Multivariate regression modelsHigher depressive symptoms at BL were associated with a decline in QoL over time (significant for physical and psychological).
Pakpour (2018) [ ]Dental anxiety at BL (MDAS); PedsQL 4.0 general hrqol and oral hrqol scale at FUWhether dental anxiety at BL predicted oral- and general-health-related QoL at FU.Structural equation modelingDental anxiety at BL was no significant direct predictor of generic QoL at FU and was significantly associated with worse oral-health-related QoL at FU.
Pyne (1997) [ ]MD-diagnosis (SCID/SADS) and depressive symptoms (HAM-D); QWBWhether group status over time (community controls, continuously non-depressed patients, incident depression patients and continuously depressed patients) is associated with changes in QoL.Repeated measure analysis (ANOVA)There was no significant interaction term between group status and time, indicating that changes in QoL did not differ between the groups. At both points in time, QoL differed significantly among all groups, except between the incident depression and continuous depression group.
Remmerswaal (2020) [ ]OCD course (SCID), Y-BOCS, BDI, BAI over time; EQ-5D over time(a) Whether OCD symptom severity and QoL over time were associated.
(b) Whether QoL over time differs between OCD course groups (chronic, intermittent and remitting) and general population norms.
(c) Whether OCD symptom severity, anxiety and depressive symptoms over time are associated with changes in QoL over time in patients with OCD.
(a) Pearson’s correlation

(b)–(c) Linear mixed models
(a) QoL over time and OCD symptom severity were significantly correlated.
(b) The QoL of OCD patients was significantly lower compared to general population norms, except the QoL of the intermittent OCD group at FU1, where there was no significant difference compared to the general population. When comparing the OCD course groups, the chronic OCD group had a significantly lower QoL over time compared to the other groups. The remitting group had moderately improved until FU1 and a small QoL improvement between FU1 and FU2 relative to the chronic group.
(c) In those with a remitting OCD, only more severe symptoms of comorbid anxiety and depressive symptoms, but not OCD symptom severity over time, were significantly associated with a lower QoL over time.
Rhebergen (2010) [ ]MD-/dysthymia-/DD diagnosis at BL and subsequent recovery at FU (according to CIDI); comorbid anxiety at BL (CIDI); SF-36 (physical health summary score)Whether QoL trajectories over time differ between:
(a) different depression status groups who achieved remission (MDD, dysthymia and double depression) and a comparison group without mental health disorders.
(b) The different depression status groups.
(c) Whether comorbid anxiety at BL in a sample recovering from depression is associated with changes in QoL.
(a)–(c) Linear mixed models(a) There was a significant interaction between group status and time. More specifically, compared to changes in QoL over time in people without a mental health diagnosis, QoL improved over time in those with MDD and DD, but not dysthymia. All depression diagnosis groups showed a significantly lower QoL compared to the no diagnosis group at all waves.
(b) Considering the depression groups, only the interaction term between dysthymia and time until FU1 was significant. Those with dysthymia had a significantly lower QoL compared to those with MDD at FU1. This difference was not significant at FU2.
(c) Comorbid anxiety disorder at BL in people who recovered from depression over time was not associated with a significant change in QoL over time.
Rubio (2014) [ ]First episode of incident MDD (AUDADIS-IV) at FU; incident GAD, social anxiety disorder, PD, specific phobia (AUDADIS-IV); SF-12 (MCS)Whether incident MDD is associated with changes in QoL over time compared to:
(a) people without history of MDD,
(b) without history of any mental health disorder,
(c) and whether the association differed by gender.
Whether incident anxiety disorders are associated with changes in QoL over time:
(d) compared to no history of the specific anxiety disorder,
(e) compared to no history of any psychiatric disorder,
(f) and whether the association differed by gender.
Linear regression model(a) Incidence of MDD (compared to no MDD) was associated with a significant decrease in QoL until FU.
(b) Incidence of MDD (compared to no mental health disorder) was associated with a significant decrease in QoL until FU.
(c) The association did not vary by gender.
(d) Incidence of all anxiety disorders (with comorbid disorders; ref: no history of anxiety disorder) was associated with a significant decrease in QoL over time.
(e) Incident anxiety disorders were not significantly associated with QoL when only considering “pure” anxiety without any comorbidities (ref: no history of any psychiatric disorder).
(f) The association did not vary by gender.
Rubio (2013) [ ]Remission from MDD, dysthymia (AUDADIS-IV); Remission from GAD, PD, SAD, specific phobia (AUDADIS-IV); SF-12 (MCS)Whether remission from depression (MDD, dysthymia) is associated with:
(a) changes in QoL over time (compared to non-remitted cases),
(b) QoL at FU (compared to people with no history of a specific depressive disorder),
(c) QoL at FU, when only considering depressive disorders without any psychiatric comorbidity (compared to people without any lifetime psychiatric diagnosis).
Whether remission from anxiety disorders are associated with:
(d) changes in QoL over time (compared to non-remitted cases),
(e) QoL at FU (compared to people with no history of a specific anxiety disorder),
(f) QoL at FU, when only considering anxiety disorders without any psychiatric comorbidity (compared to people without any lifetime psychiatric diagnosis).
(a)–(f) Linear regression models(a) Remission from MD and dysthymia was associated with a significant positive change in QoL compared to non-remitted cases.
(b) Remission of MD and dysthymia was associated with significantly lower QoL at FU compared to people without history of a specific diagnosis.
(c) Remission of MD and dysthymia was associated with significantly lower QoL at FU compared to people without any lifetime psychiatric diagnosis.
(d) Remission from SAD and GAD was associated with significant positive changes in QoL compared to non-remitted cases.
(e) Remission of PD, SAD, specific phobia and GAD was associated with significantly lower QoL at FU compared to people without history of a specific diagnosis.
(f) Remission of “pure” PD, SAD, specific phobias and GAD was associated with significantly lower QoL at FU compared to people without any lifetime psychiatric diagnosis.
Rozario (2006) [ ]Depressive symptoms (GDS); SF-12 (MCS and PCS)Whether depressive symptom severity was associated with QoL change profiles over time (no change, declined and improved groups).Multinomial logistic regressionThere was no significant association between depressive symptom severity and QoL change score profiles at FU.
Sareen (2013) [ ]Depression trajectory groups over time (according to AUDADIS-IV); anxiety disorder trajectory groups over time (according to AUDADIS-IV); SF-12 (MCS and PCS)(a) Whether depression trajectory groups (no past year disorder/no suicide attempt at FU, remission without treatment, persistent disorder/comorbidity/suicide attempt/treatment) differed according to QoL at FU.
(b) Whether anxiety disorder trajectory groups (no past year disorder/no suicide attempt at FU, remission without treatment, persistent disorder/comorbidity/suicide attempt/treatment) differed according to QoL at FU.
(a) and (b) Multiple linear regression models(a) QoL at FU differed among the different depression trajectory groups (MCS was significant for all groups: no disorder > remitted disorder > persistent disorder; PCS: no disorder > remitted disorder; remitted disorder < persistent disorder).
(b) QoL at FU differed among the different anxiety trajectory groups (MCS was significant for all groups: no disorder > remitted disorder > persistent disorder; PCS: no disorder > persistent disorder, remitted disorder > persistent disorder).
Shigemoto (2020) [ ]PTSD symptoms (PCL-C); Q-LES-Q (psychosocial and physical)Whether previous PTSD symptoms are associated with QoL at FU.Longitudinal structural equation modelPrevious PTSD symptoms were associated with physical QoL at FU1, but not FU2 or psychosocial QoL at both FUs.
Siqveland (2015) [ ]Depressive symptoms (according to the depression scale from the GHQ-28); PTSD symptoms (PCL-S); WHOQOL-Bref (global and hrqol)(a) Whether depressive symptoms at BL are associated with QoL at FU.
(b) Whether PTSD symptoms at BL are associated with QoL at FU.
(a) and (b) Multiple mixed effects regression analyses(a) Higher depressive symptoms at BL were associated with reduced QoL at FU.
(b) PTSD levels at BL were not significantly associated with reduced QoL at FU.
Spijker (2004) [ ]Depression status (CIDI); Comorbid anxiety (CIDI); SF-36 (social, role emotional)(a) Whether depression status over time (non-depressed, recovered or depressed (including persistent, relapsing course)) is associated with QoL at FU.
Whether comorbid anxiety is associated with QoL at FU
(b) in a group with persistent depression and
(c) in a group recovered from depression.
ANOVA(a) QoL at FU was significantly reduced in depressed samples compared to the non-depressed group, and lower in the persistently depressed compared to the recovered group (significant for: role emotional and social). Among the depressed subgroups, there was no significant difference between a persistent or a relapsing course regarding QoL at FU.
(b) In the persistently depressed group, comorbid anxiety was significantly associated with reduced QoL at FU (significant for role emotional and social).
(c) In those who recovered from depression, comorbid anxiety was significantly associated with reduced QoL (significant for role emotional).
Stegenga (2012) [ ]MDD status according to CIDI (remitted, intermittent and chronic); SF-12 (PCS and MCS)Whether MDD course (remitted, intermittent and chronic) is associated with QoL over time.Random coefficient analysisWhile change in QoL over time did not differ between course groups, QoL at BL (MCS) was lower in those with a chronic course compared to those who remitted from BL.
Stegenga (2012) [ ] MDD (CIDI); anxiety syndromes (panic disorder and others, PHQ); SF-12 (PCS)(a) Whether MDD at BL predicts change in QoL over time.
(b) Whether anxiety syndrome at BL (compared to no psychiatric diagnosis) predict changes in QoL over time.
(c) Whether comorbid anxiety and MDD at BL (compared to no psychiatric diagnosis) predict changes in QoL over time.
(a)–(c) Random coefficient model(a) While changes in QoL over time did not differ significantly between those with MDD at BL and those without any psychiatric diagnosis, QoL at BL was lower in those with depression.
(b) While changes in QoL over time did not differ significantly between those with anxiety syndrome at BL and those without any psychiatric diagnosis, QoL at BL was lower in those with anxiety compared to those without any psychiatric diagnosis.
(c) While changes in QoL over time did not differ significantly between those with comorbid anxiety and MDD at BL and those without any psychiatric diagnosis, QoL at BL was lower in those with comorbid anxiety and MDD compared to those without any psychiatric diagnosis.
Stevens (2020) [ ]Posttraumatic stress symptoms (VETR-PTSD); SF-36 (MCS, PCS, physical functioning, bodily pain, general health, role physical, role emotional, mental health, vitality and social functioning) Whether PTSS at BL is associated with QoL at FU.Generalized estimating equationsHigher BL PTSS was significantly associated with lower QoL (PCS and MCS) at FU. Using a Bonferroni-corrected alpha value, only the domains of mental health, vitality and social functioning at FU were significantly associated with BL PTSS symptoms. The interaction between time and PTSS at BL was not significant, indicating that PTSS had the same effect on QoL outcomes at both FUs.
Tsai (2007) [ ]Increased post-traumatic stress symptoms (DRPST); MOS SF-36 (physical functioning, role physical, pain, general health, vitality, social functioning, role emotional, mental health, PCS and MCS)(a) Whether different PTSS trajectory groups over time (persistent PTSS, recovered, delayed and persistently healthy) differed in QoL at FU.
(b) Whether increased post-traumatic stress symptoms at BL predicted QoL at FU.
(a) ANOVA
(b) Multiple regression models
(a) At FU, those who were persistently healthy had the highest QoL scores (significantly higher compared to the persistent group in all domains; significantly higher than the recovered group for: pain, general health, vitality, mental health and MCS; significantly higher compared to delayed PTSS in all domains). In addition, those with delayed PTSS (significantly lower than the recovered group in all domains except physical functioning) and those with persistent PTSS (significantly lower than recovered group in all domains) had the lowest QoL overall.
(b) Increased PTSS at BL was not significantly associated with QoL at FU.
Vulser (2018) [ ]Depressive symptom levels (CES-D score), depression status (CES-D ≥ 19); SF-12v2 (role emotional and social)Whether depressive symptoms or depression status at BL are associated with QoL at FU.Generalized linear modelsBoth the level of depressive symptoms at BL as well as depression status at BL were associated with QoL at FU (significant for: role emotional and social).
Wang (2000) [ ] Depressive symptoms (SCL-90 subscale); anxiety symptoms (SCL-90 subscale); WHOQOL-Bref (total)(a) Whether depressive symptoms at BL were associated with QoL at FU.
(b) Whether anxiety symptoms at BL were associated with QoL at FU.
(a) and (b) Stepwise regression(a) Higher depressive symptoms at BL were associated with reduced QoL at FU.
(b) Anxiety symptoms BL were not included in the final stepwise regression model.
Wang (2017) [ ]Depressive disorder course groups (CIDI); anxiety disorder course (CIDI); SF-36 (MCS, PCS)(a) Whether QoL at FU differs between three different course groups of depressive disorders (1. no disorder at BL and no suicide attempt until FU; 2. remitted without treatment; 3. persistent disorder/treatment/developed psychiatric co-morbidity/suicide attempt until FU).
(b) Whether QoL at FU differs between three different course groups of anxiety disorders (1. no disorder at BL and no suicide attempt until FU; 2. remitted without treatment; 3. persistent disorder/treatment/developed psychiatric co-morbidity/suicide attempt until FU).
(a) and (b) Multiple linear regression(a) Those with depression at BL that remitted without treatment had lower QoL at FU (significant for MCS and PCS) than those without the disorder and higher QoL at FU (significant for MCS) than those with a persistent disorder.
(b) Those with anxiety at BL that remitted without treatment over time had lower QoL at FU than those without the disorder and higher QoL (MCS, but not PCS) than those with a persistent disorder.
Wu (2015) [ ]Depressive symptoms according to CDI; social anxiety symptoms (SASC); QOLS(a) Whether depressive symptoms at BL are associated with QoL at FU.
(b) Whether social anxiety symptoms at BL are associated with QoL at FU.
(a) and (b) Multivariate stepwise forward regression(a) Higher depressive symptoms at BL were significantly associated with reduced QoL at FU.
(b) Higher social anxiety symptoms at BL were not significantly associated with QoL at FU.

Abbreviations: QoL = quality of life; MD = major depression; FU = follow-up; DSM = Diagnostic and Statistical Manual of Mental Disorders; HDRS = Hamilton Depression Rating Scale; PCS = Physical Component Score; MDS = Mental Component Score; MDD = major depressive disorder; ANOVA = analysis of variance; BL = baseline; MDE = major depressive episode; CIDI = Composite International Diagnostic Interview; SF-36 = Short Form 36; AUDADIS = Alcohol Use Disorders and Associated Disabilities Interview Schedule; SF-12 = Short Form 12; PHQ = Patient Health Questionnaire; SF-12v2: Short Form 12, Version 2; HRSD = Hamilton Rating Scale for Depression; HADS = Hospital Anxiety and Depression Scale; QLDS = Quality of Life in Depression Scale; EQ-VAS = EQ Visual Analogue Scale; DIS = Diagnostic Interview Schedule; BDI = Beck Depression Inventory; SCID = Short Children’s Depression Inventory; MINI = Mini-International Neuropsychiatric Interview; PTSD = post-traumatic stress disorder; hrqol = health-related quality of life, IES-15 = Impact of Event Scale 15; Q-DIS = Quick Version of the Mental Health’s Diagnostic Interview Schedule; MADRS = Montgomery–Åsberg Depression Rating Scale; FDD-DSM-IV = Fragebogen zur Depressionsdiagnostik nach Diagnostic and Statistical Manual of Mental Disorders IV; SCAN = Schedule for Clinical Assessment in Neuropsychiatry; DASS = Depression Anxiety Stress Scales; MOS SF = Medical Outcomes Study Short Form; CES-D = Center for Epidemiological Studies Depression Scale; WHOQOL-Bref-TW = WHOQOL-Bref Taiwan Version; MHI-5 = Mental Health Inventory 5; OCD = obsessive compulsive disorder; Y-BOCS = Yale–Brown Obsessive Compulsive Scale; BAI = Beck Angst Inventar; DD = depressive disorder; PD = psychiatric disorder; SAD = social anxiety disorder; Q-LES-Q = Quality of Life Enjoyment and Satisfaction Questionnaire; GHQ-28 = General Health Questionnaire 28; PCL-S = Post-traumatic Stress Disorder Checklist Scale; VETR-PTSD = Vietnam Era Twin Registry Posttraumatic Stress Disorder; DRPST = Disaster-Related Psychological Screening Test; SCL-90 = Symptomcheckliste bei psychischen Störungen 90; SASC = SpLD Assessment Standards Committee; QOLS = Quality of Life Scale; CDI = Children’s Depression Inventory.

Depression as independent variable and QoL as outcome. One study investigated QoL at several time points during the entire course of an episode of MD .

Buist-Bouwman, Ormel, de Graaf and Vollebergh [ 46 ] analyzed an MD group from a general population setting (NEMESIS) with data on SF-36 domains in the onset, acute and recovery phase of the depressive episode. The onset of MD was associated with a significant drop in several QoL domains and recovery with a significant increase. Pre- and post-morbid QoL levels were not significantly different for most domains, and post-morbid QoL was even higher for the psychological role functioning and psychological health domains. In comparison to a group without MD, pre- and post-morbid QoL levels in the MD group were significantly lower, except for the psychological role functioning domain, where no significant differences were found. Additionally, it should be noted that 40% of the sample had lower post-morbid QoL compared to pre-morbid levels.

Two studies investigated changes in QoL for people experiencing an onset of depression relative to different comparison groups over two points in time.

One study investigated incident MD in a general population sample (NESARC; Rubio, Olfson, Perez-Fuentes, Garcia-Toro, Wang and Blanco [ 14 ]). Here, incident MD (compared to those without a history of MD as well as to a group without any mental disorder) was associated with a significant drop in QoL (SF-12 MCS). Additionally, analyzing two waves, Pyne, Patterson, Kaplan, Ho, Gillin, Golshan and Grant [ 67 ] compared the QoL (Quality of Well-Being scale) between MD patients and community controls. The patient group was further divided into those continuously not receiving an MD diagnosis, those who continuously received the diagnosis and those who only received the diagnosis at FU (onset). The authors found that changes in QoL did not differ between the groups. At both points in time, QoL scores differed significantly between the groups, except for the incident and the continuous depression group [ 67 ].

Six studies investigated different courses of depression over time in people with depression at BL with or without a healthy comparison group as reference.

Two primary care studies analyzed groups with clinical depression at BL with different FU depression statuses (remission, no remission). One study [ 51 ] analyzed changes in generic QoL measures (SF-12, WHOQOL-Bref) and the disease-specific Quality of Life in Depression Scale. In this study, remission was associated with an improvement in all QoL domains, whereas QoL did not change significantly over time for the non-remitted group. Another study [ 60 ] investigated SF-12 MCS and PCS scores and reported a significant increase in MCS over time in the remitting group. MCS scores in the continuously depressed group and PCS scores in both groups improved, albeit not significantly.

Another study [ 47 ] investigated whether chronic MD in a general population sample (NESARC) was associated with domain-specific reduced QoL (SF-12). They found that chronic MD was a significant risk factor for persistently reduced QoL in all domains and for the onset of reduced QoL at FU in all domains except for physical role.

Two population-based studies further differentiated between the depressive disorders. Analyzing MCS scores (NESARC), Rubio, Olfson, Villegas, Perez-Fuentes, Wang and Blanco [ 15 ] reported a significant increase in QoL for those who remitted from MD and from dysthymia relative to those who had a persistent disorder. Rhebergen, Beekman, de Graaf, Nolen, Spijker, Hoogendijk and Penninx [ 69 ] differentiated between people with MD, double depression or dysthymia at BL who remitted until FU relative to a group without a mental health diagnosis (NEMESIS). Physical health (SF-36) was lowest at BL for double depression, dysthymia and then the MD group. Over time, the MD and double depression groups improved significantly in their physical health, while the dysthymia group did not improve significantly. QoL was significantly lower relative to healthy comparisons for all depression groups at all waves. There were no significant differences regarding physical health trajectories over time among the depressive disorder groups.

Stegenga, Kamphuis, King, Nazareth and Geerlings [ 75 ] investigated more than two MD course groups over time (remitted, intermittent and chronic MD) in association with SF-12 MCS and PCS over time in a primary care-recruited sample with BL MD (Predict study). MCS increased over time in all groups, while changes in PCS were small. Compared to those who remitted, MCS at BL was significantly lower for the chronic course group. While the intermittent group also displayed a lower mean MCS at BL, the coefficient was not significant.

Three studies investigated changes in depressive symptom levels as the independent variable and changes in QoL as outcomes in adults.

One study found no significant association between an initial change in depressive symptoms and subsequent change in QoL (EQ-VAS) in older adults recruited in primary care [ 21 ]. The two other studies analyzed changes in depressive symptoms in samples with MD at BL [ 50 , 51 ]. Chung, Tso, Yeung and Li [ 50 ] found that changes in depressive symptom levels was associated with changes in several QoL domains (SF-36: general health, vitality, social functioning, mental health and MCS). Diehr, Derleth, McKenna, Martin, Bushnell, Simon and Patrick [ 51 ] investigated whether quartiles of change in depressive symptoms were associated with changes in QoL (SF-12, QLDS and WHOQOL-Bref). Those without any change in depressive symptoms generally showed no change in QoL. For all QoL domains and scores except for SF-12 PCS, improvement in depressive symptoms over time was associated with a significant increase in QoL, while a reduction in depressive symptoms was associated with a significant reduction in QoL. Those who had the largest reduction in depressive symptoms also had the largest improvement in QoL measures.

Anxiety as an independent variable and QoL as an outcome. Two publications used a general population sample (NESARC) to investigate incident anxiety disorders [ 14 ] and the remission of anxiety disorders [ 15 ] in association with SF-12 MCS. Both studies separated generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder (PD) and social phobia (SP). All incident disorders were associated with a significant reduction in QoL compared to people without a history of the specific disorders. When the analysis was restricted to incident cases without comorbidities, QoL levels were not significantly different compared to people without a history of any psychiatric disorder [ 14 ]. Those who remitted from SAD showed a significant increase in QoL compared to persistent cases. While QoL improved for all remitting anxiety disorders, change scores for PD and SP were not significant [ 15 ].

Another study investigated different courses (intermittent, chronic or remitting) of obsessive compulsive disorder (OCD) and course in QoL (EQ-5D) as well as a comparison group from the general population [ 68 ]. They found that the OCD groups mostly reported a lower QoL compared to the general population. Moreover, the course groups differed regarding their QoL over time, with remitters reporting small to moderate improvements compared to the chronic group.

One study investigated changes in anxiety symptoms in association with changes in all SF-36 domains and both summary scores over time in a sample with MD at BL [ 50 ]. Changes in anxiety symptoms were significantly associated with changes in bodily pain, general health and the mental health domain.

3.4. Overview of Studies on the Association between QoL as Independent Variable and Anxiety/Depression as Outcomes

Additionally, we identified publications operationalizing QoL as the independent variable and anxiety/depression as outcomes with details on all studies reported in Table 3 . Only one study reported on change in QoL over time and change/trajectories in mental health outcomes over time. This study operationalized change in QoL as a predictor of future change in depressive symptoms over time and reported that an initial improvement in EQ-VAS was associated with a future reduction in depressive symptoms in older adults [ 21 ].

Studies on QoL as the independent variable and depression/anxiety as outcome.

First Author (Year)Disorder or Symptoms Analyzed; QoL Domains AnalyzedResearch QuestionMethodsResults
Chou (2011) [ ]Depressive sympt oms (CES-D-20 score); WHOQOL-Bref (total)Whether QoL at BL is associated with depressive symptoms at FU.Multiple regressionLower QoL at BL was associated with higher depressive symptoms at FU.
De Almeida Fleck (2005) [ ]Depression status (remission vs. no complete remission, CIDI and CES-D-20 cutoff >16); QLDS, WHOQOL-Bref (physical, psychological, social and environment), SF-12 (PCS, MCS)Whether QoL at BL is associated with course of depression (complete remission vs. non-complete remission) in a depressed sample.Stepwise multiple logistic regressionDisease-specific QoL measure at BL significantly predicted the remission of depression at FU (significant for QLDS).
Hajek (2015) [ ]Depressive symptoms (GDS); EQ-VASWhether an initial change in QoL is associated with subsequent changes in depressive symptoms. Vector autoregressive modelInitial changes in QoL were associated with a subsequent reduction in depression score (significant for total sample and women).
Hoertel (2017) [ ]MD (according to AUDADIS-IV): SF-12v2 (PCS and MCS)Whether QoL at BL predicted recurrence (vs. remission) or persistence (vs. remission) of MD over time.Structural equation modelLower QoL at BL was a predictor of risk of persistence (PCS and MCS) and recurrence of MDE over time.
Johansen (2007) [ ]PTSD symptoms according to IES-15; WHOQOL-Bref (total)Whether QoL predicted PTSD symptoms at FU.Structural equation modelQoL did not significantly predict PTSD symptoms at FU.
Kuehner (2009) [ ]Depressive symptoms (MADRS); WHOQOL (overall, physical, psychological, social and environmental)Whether the lag of levels of QoL predicts future levels of depressive symptoms and whether the association differs by group (formerly depressed inpatients vs. community controls)Time-lagged linear modelsLower levels of QoL were associated with higher future depressive symptoms (significant for physical, psychological, environmental and overall). The association was not moderated by group status.
Stegenga (2012) [ ]MDD (CIDI); anxiety syndromes (panic disorder and others, PHQ); SF-12 (PCS)(a) Whether “dysfunction” (i.e., reduced QoL) at BL (mildly reduced, moderately reduced or severely reduced; compared to no reduced QoL) predicts MDD onset over time.
(b) Whether “dysfunction” (i.e., reduced QoL) at BL (mildly reduced, moderately reduced or severely reduced; compared to no reduced QoL) predicts anxiety syndrome onset over time.
(c) Whether “dysfunction” (i.e., reduced QoL) at BL (mildly reduced, moderately reduced or severely reduced; compared to no reduced QoL) predicts onset of comorbid anxiety and MDD over time.
(a)–(c) Multinomial logistic regressions(a) Dysfunction (i.e., reduced QoL) at BL was associated with higher odds of onset of MDD over time in the sample of people without a diagnosis at BL (significant for severely reduced QoL).
(b) Dysfunction (i.e., reduced QoL) at BL was associated with higher odds of onset of anxiety syndrome over time in the sample of people without a diagnosis at BL (significant for moderately and severely reduced QoL).
(c) Dysfunction (i.e., reduced QoL) at BL was associated with higher odds of onset of comorbid anxiety and depression over time in the sample of people without a diagnosis at BL (significant for mild, moderately and severely reduced QoL).
Wu (2016) [ ] Elevated social anxiety symptoms (SASC cutoff 9); QOLSWhether QoL is associated with changes in elevated social anxiety symptoms over time.Generalized Estimating EquationHigher QoL was associated with a decreased risk for developing elevated social anxiety symptoms over time.
Wu (2017) [ ] Elevated depressive symptoms (according to CDI ≥19); QOLSWhether QoL at BL is associated with elevated depressive symptoms at FU.Multiple stepwise logistic regressionQoL at BL was not significantly related to depressive symptoms at FU.

Abbreviations: CES-D-20 = Center for Epidemiological Studies Depression Scale 20; BL = baseline; FU = follow-up; QoL = quality of life; CIDI = Composite International Diagnostic Interview; QLDS = Quality of Life in Depression Scale; SF-12 = Short Form 12; PCS = Physical Component Score; MCS = Mental Component Score; GDS = Geriatric Depression Scale; EQ-VAS = EQ Visual Analogue Scale; MD = mental disorder; AUDADIS-IV = Alcohol Use Disorders and Associated Disabilities Interview Schedule; SF-12v2 = Short Form 12 Version 2; PTSD = post-traumatic stress disorder; IES-15 = Impact of Event Scale 15; MADRS = Montgomery–Åsberg Depression Rating Scale; MDD = major depressive disorder; PHQ = Patient Health Questionnaire; SASC = SpLD Assessment Standards Committee; QOLS = Quality of Life Scale; CDI = Children’s Depression Inventory.

3.5. Meta-Analyses on Anxiety, Depression and SF Summary Scores

In total, eight studies on adults were included in a supplementary meta-analyses of several research questions on SF PCS and MCS in association with anxiety and depressive disorders. Forest plots for the analyses are provided in the supplementary materials (Figures S1–S10) .

Differences in SF summary scores at FU among adults with and without depressive disorders at BL. Based on a pooling of four studies [ 45 , 49 , 52 , 54 ], those with depression at BL showed lower MCS scores at FU compared to a group without depression at BL with a large effect size (SMD = −0.96, 95% CI: −1.04 to −0.88, p < 0.001, I 2 = 0.0%). PCS scores at FU were lower for the depression group compared to the non-depression group with a medium effect size (SMD = −0.68, 95% CI: −1.06 to −0.30, p < 0.001, I 2 = 94.6%). Excluding the study rated “poor” in the quality/risk of bias assessment from the pooling did not substantially affect the results (MCS: SMD = −0.96, 95% CI: −1.03 to −0.88, p < 0.001, I 2 = 0.01%; PCS: SMD = −0.63, 95% CI: −1.08 to −0.19, p < 0.01, I 2 = 96.8%).

BL differences in SF summary scores among adults with MD at BL with and without remitting courses over time. Based on a pooling of two studies [ 19 , 84 ] of samples with MD at BL, those with persistent MD at FU had significantly lower MCS at BL (SMD = −0.25, 95% CI: −0.41 to −0.10, p = 0.001, I 2 = 74.95) and PCS scores at BL (SMD = −0.24, 95% CI: −0.39 to −0.09, p = 0.002, I 2 = 73.14) compared to those who achieved remission until FU. Effect sizes were small for both summary scores.

FU differences in SF summary scores among adults with depressive and anxiety disorders at BL with and without remitting courses . Based on the pooling of two studies [ 71 , 81 ] of samples with MD and/or dysthymia, the group where the disorder had persisted/a co-morbid condition was present/had a suicide attempt until FU had significantly lower MCS scores at FU compared to the group where the disorder had remitted without treatment until FU, with a medium effect size for depressive disorders (SMD = −0.59, 95% CI: −0.75 to −0.42, p < 0.001, I 2 = 37.72) and a small effect size for anxiety disorders (SMD = −0.44, 95% CI: −0.58 to −0.30, p < 0.001, I 2 = 58.87). The SMD for PCS scores at FU was negligible in terms of effect size for both disorder groups (depressive disorders: SMD = 0.02, 95% CI: −0.24 to 0.27, p = 0.90, I 2 = 73.65; anxiety disorders: SMD = −0.09, 95% CI: −0.17 to −0.01, p = 0.03, I 2 = 0.01).

4. Discussion

4.1. main results.

This review adds to the present literature by providing an overview of longitudinal observational studies investigating the association between depression, anxiety and QoL in samples without other specific illnesses or specific treatments. Additional meta-analyses investigated group differences according to SF MCS and PCS.

While a concise synthesis of all the identified studies is challenging due to heterogeneity, the following picture emerges from studies investigating change–change associations: before the onset of disorders, QoL is already lower in disorder groups in comparison to healthy comparisons. The onset of the disorders further reduces the QoL. Remission is associated with an increase in QoL, mostly to pre-morbid levels. Additionally, some studies show that remission patterns are relevant for QoL outcomes as well. Moreover, a bi-directional effect was reported, whereby QoL is also predictive of mental health outcomes.

Evidence for a bi-directional association as well as studies showing lower QoL across the entire course of the disorders (before onset, during disorder, after disorder) relative to a healthy comparison group seem to suggest that impairments in QoL may result from a certain pre-disorder vulnerability in these groups. Longitudinal studies using general population data have investigated different hypotheses on (QoL) impairments after remission of anxiety disorders and MD [ 87 , 88 ]. One hypothesis suggests that impairments after the illness episode reflect a pre-disorder vulnerability (vulnerability or trait hypothesis), while the another states that impairments develop during the mental health episode and remain as a residual after recovery (scar hypothesis). Generally, both studies favored the vulnerability hypothesis [ 87 , 88 ]. For subgroups with recurrent anxiety disorders, scarring effects were also found for mental functioning [ 88 ]. Yet, it has to be noted that it was not the aim of our review to gather evidence for these hypotheses using QoL as an indicator, which represents an opportunity for future research.

To be able to investigate possible domain-specific differences across studies, we aimed to conduct a meta-analysis on all studies on the same research question which reported on QoL subdomains (e.g., using WHOQOL and SF). However, as described in the Methods section above, only eight studies reported comparable information on different research questions and could be included in meta-analyses. Due to the limited number of studies included in each meta-analysis, the focus on SF MCS and PCS scores, and most studies reporting on depression, the results of the meta-analyses should be viewed with caution. Keeping this in mind, our results indicate that both mental and physical QoL are significantly impacted by anxiety and depressive disorders and that the course of the disorder is also relevant for QoL outcomes. Not surprisingly, effect sizes for MCS were larger compared to PCS for most research questions. A pooling of two studies on different courses of anxiety and depressive disorders found that effect sizes for MCS at FU were of moderate size for depressive (SMD = −0.59) and of small size for anxiety disorders (SMD = −0.44), while SMDs for PCS at FU were negligible in size.

Overall, effect sizes from meta-analyses ranged from negligible to large, and heterogeneity varied considerably (I 2 between 0% and 95%). Because of the small number of studies, possible influential study-level factors (e.g., setting, operationalization of the variables, length of FU) could not be investigated in further detail by means of a meta-regression, which remains a question for future research.

4.2. Implications for Future Research

Based on the results described and study heterogeneity discussed above, we provide recommendations for future research.

First recommendation: future research should differentiate between individual disorders and focus on anxiety disorders. The majority of the studies investigated depressive disorders or symptoms. On the level of individual disorders, most focused on MD, while two studies additionally reported on dysthymia [ 15 , 69 ]. One of these investigated double depression [ 69 ]. On the level of anxiety disorders, three publications differentiated between individual anxiety disorders within the same study [ 14 , 15 , 63 ]. While it was not possible to conduct a meta-analysis comparing different anxiety disorders in our case, individual studies suggest possible disorder-specific differences when analyzing changes in QoL over time: Rubio, Olfson, Villegas, Perez-Fuentes, Wang and Blanco [ 15 ] suggest that QoL significantly improved for those remitting from GAD and SAD (compared to non-remission). QoL improved for PD and SP as well, but differences in change scores were smaller and did not reach statistical significance. The incidences of all of these disorders were associated with a significant drop in QoL [ 14 ]. In summary, future longitudinal studies should focus on anxiety disorders and generally differentiate between individual disorders to investigate possible disorder-specific differences.

Second recommendation: future research should consider trajectories of disorders/change in symptoms and changes in QoL over time. We would have liked to include a meta-analysis of disorder trajectories and change scores in QoL over time. Because of the small, diverse number of studies on this association in general and the number of assumptions that would have had to have been made for a meta-analysis, we refrained from pooling effects for this research question. In total, 17 studies investigated changes in independent variables associated with changes in outcomes. This approach has several advantages. On the one hand, different disorder or symptom trajectories can be identified. Several studies reported that QoL outcomes differ according to disorder course and the degree of change in symptoms. The focus on the change in characteristics over time in future research could additionally reduce the problem of unobserved time-constant heterogeneity in observational studies when appropriate methods are applied [ 26 ].

Third recommendation: future research should investigate individual QoL domains. Several systematic reviews on cross-sectional studies found that effect sizes differed by QoL domains [ 32 , 89 ]. For example, Olatunji, Cisler and Tolin [ 89 ] reported that health and social functioning were most impaired for anxiety disorders (compared to non-clinical controls). Comparing individuals with diabetes and depressive symptoms to those with diabetes only, Schram, Baan and Pouwer [ 32 ] reported that while SF pain scores were mild to moderately impaired, role and social functioning displayed moderate to severe impairments in those with comorbid depressive symptoms. The other scores were moderately impaired. As described above in detail, a meta-analysis using all subdomains was not feasible in this review. Further research differentiating between QoL domains would thus allow future meta-analyses to investigate whether the observed domain-specific differences reported in previous reviews of cross-sectional data can be observed in longitudinal studies as well.

Fourth recommendation: future research should consider bi-directional effects. While investigating QoL as the outcome measure and anxiety/depression as independent variables seems relatively straightforward, ten studies investigated QoL as the independent variable and anxiety/depression as outcomes. In light of possible bi-directional effects and pre-existing vulnerability suggested by individual studies, future research considering QoL as an independent variable could inform a deeper understanding of this complex association.

4.3. Strengths and Limitations

A strength of this work is the transparent methodological process: the review was prospectively registered with PROSPERO and a study protocol was published [ 34 ]. Two reviewers were included in screening, data extraction and quality assessment processes. There were no limitations regarding the time or location of the publications. Moreover, all versions of the ICD/DSM and validated questionnaires were considered eligible to identify anxiety or depression. Another strength is the thorough literature search that enabled us to identify all relevant studies. Additionally, we did not limit the age range and were therefore able to shed light on studies investigating children/adolescents. Moreover, some studies could be pooled using random-effects meta-analyses, which allows for stronger conclusions regarding effect sizes compared to individual studies. Besides the content analysis, this review emphasizes difficulties in meta-analysis from observational, longitudinal studies. We hope that our work can facilitate discussion on this topic.

The study has some limitations. We did not limit our search to specific research questions, which led to the inclusion of heterogeneous studies. Heterogeneity particularly stemmed from the operationalization of the variables of interest. Due to this, a concise narrative synthesis of all results was not feasible. The positive aspect of this broad focus is that it allowed us to provide an overview of studies and research questions analyzed and to formulate more nuanced recommendations for future research. We have to acknowledge that there is an abundance of QoL assessments used in medicine and health sciences [ 37 ]. The list applied in this work was derived with respect to previous relevant reviews on QoL research. It was not designed to be fully comprehensive or exhaustive. Rather, it provided us with a working definition for this review and helped to enhance the transparency of our selection processes. Additionally, because we included validated QoL measures frequently used in research, we assume that exclusion would particularly have been the case for novel or study-specific measures. Finally, the focus on peer-reviewed literature means that studies in other languages and gray literature were not considered. Nonetheless, this focus on literature published in peer-reviewed journals should ensure a certain scientific quality.

5. Conclusions and Relevance for Clinical Practice

Overall, the results indicate that QoL is lower before the onset of anxiety and depressive disorders, further reduces upon onset of the disorders and generally improves with remission to pre-morbid levels. Moreover, disorder course (e.g., remitted, intermittent, chronic) seems to play an important role; however, only a few studies analyzed this. Changes in anxiety and depressive symptoms were also associated with changes in QoL over time. Meta-analyses found that effect sizes were larger for MCS relative to PCS, highlighting the relevance of differentiation between QoL domains. While our review identified some gaps in the current literature and made recommendations for future research, the following should be noted for clinical practice. On the one hand, an improvement in mental health is associated with better QoL, which emphasizes the relevance of support during the disorders. This is also shown by meta-analyses, which show that cognitive behavioral therapy additionally improves QoL [ 90 , 91 ]. Moreover, the results indicate reduced QoL even before disorder onset, highlighting the relevance of early preventive measures in vulnerable groups. In line with this, studies on school-based prevention programs show a significant reduction in anxiety and depressive symptoms [ 92 , 93 ], and psychosocial prevention programs may additionally improve QoL [ 94 ].

During the COVID-19 pandemic, it is of high relevance to tackle the arising challenges associated with this pandemic. For example, it is important to face the high prevalence rates of both depression and anxiety with appropriate measures.

Acknowledgments

The authors would like to thank Elzbieta Kuzma for her consultation (Albertinen-Haus Centre for Geriatrics and Gerontology, University of Hamburg, Hamburg, Germany; University of Exeter Medical School, Exeter, UK).

Supplementary Materials

The following are available online at https://www.mdpi.com/article/10.3390/ijerph182212022/s1 , Table S1: detailed descriptive information for included studies ( n = 47); Figure S1: forest plot for differences in SF MCS at FU among adults with and without depressive disorders at BL; Figure S2: forest plot for differences in SF PCS at FU among adults with and without depressive disorders at BL; Figure S3: forest plot for differences in SF MCS at FU among adults with and without depressive disorders at BL (sensitivity analysis); Figure S4: forest plot for differences in SF PCS at FU among adults with and without depressive disorders at BL (sensitivity analysis); Figure S5: forest plot for BL differences in SF MCS among adults with MD at BL with and without remitting courses over time; Figure S6: forest plot for BL differences in SF PCS among adults with MD at BL with and without remitting courses over time; Figure S7: forest plot for FU differences in SF MCS among adults with depressive disorders at BL with and without remitting courses; Figure S8: forest plot for FU differences in SF PCS among adults with depressive disorders at BL with and without remitting courses; Figure S9: forest plot for FU differences in SF MCS among adults with anxiety disorders at BL with and without remitting courses; Figure S10: forest plot for FU differences in SF PCS among adults with anxiety disorders at BL with and without remitting courses.

Author Contributions

J.K.H.: conceptualization of research question; development of search strategy; study screening and selection; risk of bias/quality assessment; study synthesis; writing—original draft, review and editing; H.-H.K.: conceptualization of research question; writing—review and editing; E.Q.: study screening and selection; risk of bias/quality assessment; writing—review and editing; A.H.: conceptualization of research question; development of search strategy; study screening and selection (third party); study synthesis; writing—review and editing. All authors have read and agreed to the published version of the manuscript.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Institutional Review Board Statement

Data availability statement, conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Home — Essay Samples — Nursing & Health — Psychiatry & Mental Health — Anxiety

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Essays About Anxiety

Anxiety essay topic examples, argumentative essays.

Argumentative essays on anxiety require you to take a stance on a specific aspect of anxiety and provide evidence to support your viewpoint. Consider these topic examples:

  • 1. Argue for the importance of mental health education in schools, emphasizing the role it plays in reducing anxiety among students.
  • 2. Debate whether the increased use of technology and social media contributes to rising levels of anxiety among young adults, considering the pros and cons of digital connectivity.

Example Introduction Paragraph for an Argumentative Anxiety Essay: Anxiety is a prevalent mental health concern that affects individuals of all ages. In this argumentative essay, we will explore the significance of introducing comprehensive mental health education in schools and its potential to alleviate anxiety among students.

Example Conclusion Paragraph for an Argumentative Anxiety Essay: In conclusion, the argument for incorporating mental health education in schools underscores the need to address anxiety and related issues at an early stage. As we advocate for change, we are reminded of the positive impact such initiatives can have on the well-being of future generations.

Compare and Contrast Essays

Compare and contrast essays on anxiety involve analyzing the similarities and differences between various aspects of anxiety, treatment approaches, or the impact of anxiety on different demographic groups. Consider these topics:

  • 1. Compare and contrast the experiences and coping mechanisms of individuals with generalized anxiety disorder (GAD) and social anxiety disorder (SAD), highlighting their unique challenges and commonalities.
  • 2. Analyze the differences and similarities in the prevalence and impact of anxiety among different age groups, such as adolescents and older adults, considering the contributing factors and treatment options.

Example Introduction Paragraph for a Compare and Contrast Anxiety Essay: Anxiety manifests in various forms, affecting individuals differently. In this compare and contrast essay, we will examine the experiences and coping strategies of individuals with generalized anxiety disorder (GAD) and social anxiety disorder (SAD), shedding light on the distinctions and shared aspects of their conditions.

Example Conclusion Paragraph for a Compare and Contrast Anxiety Essay: In conclusion, the comparison and contrast of GAD and SAD provide valuable insights into the diverse landscape of anxiety disorders. As we deepen our understanding, we can better tailor support and interventions for those grappling with these challenges.

Descriptive Essays

Descriptive essays on anxiety allow you to provide a detailed account of anxiety-related experiences, the impact of anxiety on daily life, or the portrayal of anxiety in literature and media. Here are some topic ideas:

  • 1. Describe a personal experience of overcoming a major anxiety-related obstacle or fear, highlighting the emotions and strategies involved in the process.
  • 2. Analyze the portrayal of anxiety and mental health in a specific novel, movie, or television series, discussing its accuracy and the messages it conveys to the audience.

Example Introduction Paragraph for a Descriptive Anxiety Essay: Anxiety can be a formidable adversary, but it is also a source of resilience and personal growth. In this descriptive essay, I will recount a deeply personal journey of overcoming a significant anxiety-related challenge, shedding light on the emotions and strategies that guided me along the way.

Example Conclusion Paragraph for a Descriptive Anxiety Essay: In conclusion, my personal narrative of conquering anxiety illustrates the transformative power of resilience and determination. As we share our stories, we inspire others to confront their fears and embrace the path to recovery.

Persuasive Essays

Persuasive essays on anxiety involve advocating for specific actions, policies, or changes related to anxiety awareness, treatment accessibility, or destigmatization. Consider these persuasive topics:

  • 1. Persuade your audience of the importance of increasing mental health resources on college campuses, emphasizing the positive impact on students' well-being and academic performance.
  • 2. Advocate for the destigmatization of anxiety and other mental health conditions in society, highlighting the role of media, education, and public discourse in reducing stereotypes and discrimination.

Example Introduction Paragraph for a Persuasive Anxiety Essay: Anxiety affects millions of individuals, yet stigma and limited resources often hinder access to necessary support. In this persuasive essay, I will make a compelling case for the expansion of mental health services on college campuses, emphasizing the benefits to students' overall well-being and academic success.

Example Conclusion Paragraph for a Persuasive Anxiety Essay: In conclusion, the persuasive argument for increased mental health resources on college campuses highlights the urgent need to prioritize students' mental well-being. As we advocate for these changes, we contribute to a more inclusive and supportive educational environment.

Narrative Essays

Narrative essays on anxiety allow you to share personal stories, experiences, or perspectives related to anxiety, your journey to understanding and managing it, or the impact of anxiety on your life. Explore these narrative essay topics:

  • 1. Narrate a personal experience of a panic attack, describing the physical and emotional sensations, the circumstances, and the steps taken to cope and recover.
  • 2. Share a story of your journey toward self-acceptance and resilience in the face of anxiety, emphasizing the strategies and support systems that have helped you navigate this mental health challenge.

Example Introduction Paragraph for a Narrative Anxiety Essay: Anxiety is a deeply personal experience that can profoundly impact one's life. In this narrative essay, I will take you through a vivid account of a panic attack I experienced, offering insights into the physical and emotional aspects of this anxiety-related event.

Example Conclusion Paragraph for a Narrative Anxiety Essay: In conclusion, the narrative of my panic attack experience underscores the importance of self-awareness and coping strategies in managing anxiety. As we share our stories, we foster understanding and support for those facing similar challenges.

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Anxiety is a psychological and physiological response characterized by feelings of apprehension, fear, and unease. It is a natural human reaction to perceived threats or stressors, triggering a heightened state of arousal and activating the body's fight-or-flight response.

Excessive worrying: Individuals with anxiety often experience persistent and intrusive thoughts, excessive worrying, and an inability to control their anxious thoughts. Physical symptoms: Anxiety can manifest physically, leading to symptoms such as increased heart rate, rapid breathing, sweating, trembling, muscle tension, headaches, and gastrointestinal disturbances. Restlessness and irritability: Anxiety can cause a sense of restlessness and irritability, making it difficult for individuals to relax or concentrate on tasks. Sleep disruptions: Anxiety has the potential to interfere with sleep patterns, resulting in challenges when trying to initiate sleep, maintain it, or achieve a restorative sleep. Consequently, this can exacerbate feelings of fatigue and weariness. Avoidance behaviors: People with anxiety may engage in avoidance behaviors, such as avoiding certain situations or places that trigger their anxiety. This can restrict their daily activities and limit their quality of life.

Genetic predisposition: Research suggests that individuals with a family history of anxiety disorders may have a higher likelihood of developing anxiety themselves. Certain genetic variations and inherited traits can increase susceptibility to anxiety. Brain chemistry: Imbalances in neurotransmitters, such as serotonin, dopamine, and gamma-aminobutyric acid (GABA), are thought to play a role in anxiety disorders. These chemical imbalances can affect the regulation of mood, emotions, and stress responses. Environmental factors: Traumatic life events, such as abuse, loss, or significant life changes, can trigger or exacerbate anxiety. Chronic stress, work pressure, and relationship difficulties can also contribute to the development of anxiety. Personality traits: Certain personality traits, such as being prone to perfectionism, having a negative outlook, or being highly self-critical, may increase the risk of developing anxiety disorders. Medical conditions: Certain medical conditions, such as thyroid disorders, cardiovascular issues, and respiratory problems, can be associated with anxiety symptoms.

Generalized Anxiety Disorder (GAD): GAD is marked by excessive and uncontrollable worry about various aspects of life, including work, health, and everyday situations. Individuals with GAD often experience physical symptoms like restlessness, fatigue, muscle tension, and difficulty concentrating. Panic Disorder: Panic disorder involves recurrent and unexpected panic attacks, which are intense episodes of fear accompanied by physical symptoms like rapid heart rate, shortness of breath, chest pain, and dizziness. People with panic disorder often worry about future panic attacks and may develop agoraphobia, avoiding places or situations that they fear might trigger an attack. Social Anxiety Disorder (SAD): SAD is characterized by an intense fear of social situations and a persistent worry about being embarrassed, judged, or humiliated. People with SAD may experience extreme self-consciousness, avoidance of social interactions, and physical symptoms like blushing, trembling, or sweating. Specific Phobias: Common examples include phobias of heights, spiders, flying, or enclosed spaces. Exposure to the feared object or situation can trigger severe anxiety symptoms. Obsessive-Compulsive Disorder (OCD): OCD is characterized by intrusive and unwanted thoughts (obsessions) that lead to repetitive behaviors or mental acts (compulsions) aimed at reducing anxiety. Common obsessions include fears of contamination, doubts, and a need for symmetry, while common compulsions include excessive cleaning, checking, and arranging.

The treatment of anxiety typically involves a multi-faceted approach aimed at addressing the individual's specific needs. One common form of treatment is psychotherapy, which involves talking with a trained therapist to explore the underlying causes of anxiety and develop coping strategies. Cognitive-behavioral therapy (CBT) is often employed to challenge negative thought patterns and behaviors associated with anxiety. In some cases, anti-anxiety medications, such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines, may be prescribed by a healthcare professional. These medications work to alleviate the intensity of anxiety symptoms and promote a sense of calm. Additionally, lifestyle modifications can play a significant role in anxiety management. Regular exercise, stress-reduction techniques like meditation or yoga, and maintaining a balanced diet can contribute to overall well-being and help alleviate anxiety symptoms.

1. Anxiety disorders are highly prevalent mental health conditions that affect a substantial number of individuals worldwide, impacting approximately 284 million people globally. 2. Research indicates that women have a higher likelihood of being diagnosed with anxiety disorders compared to men. Studies reveal that women are twice as likely to experience anxiety, with this gender difference emerging during adolescence and persisting into adulthood. 3. Anxiety disorders often coexist with other mental health issues. Extensive research has demonstrated a strong correlation between anxiety disorders and comorbidities such as depression, substance abuse, and eating disorders. These co-occurring conditions can significantly impact an individual's well-being and require comprehensive and integrated approaches to treatment.

Anxiety is an important topic to explore in an essay due to its widespread impact on individuals and society as a whole. Understanding and addressing anxiety is crucial for several reasons. Firstly, anxiety disorders are highly prevalent, affecting a significant portion of the population globally. This prevalence highlights the need for increased awareness, accurate information, and effective strategies for prevention and treatment. Secondly, anxiety can have profound effects on individuals' mental, emotional, and physical well-being. It can impair daily functioning, hinder relationships, and limit personal growth. By delving into this topic, one can examine the various factors contributing to anxiety, its symptoms, and the potential consequences on individuals' lives. Additionally, exploring anxiety can shed light on the complex interplay between biological, psychological, and social factors that contribute to its development and maintenance. This understanding can inform the development of targeted interventions and support systems for individuals experiencing anxiety.

1. Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), 327-335. 2. Kessler, R. C., et al. (2005). Lifetime prevalence and age-of-onset distributions of anxiety disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602. 3. National Institute of Mental Health. (2018). Anxiety disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders/ 4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. 5. Craske, M. G., et al. (2017). Anxiety disorders. Nature Reviews Disease Primers, 3(1), 17024. 6. Hofmann, S. G., et al. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440. 7. Roy-Byrne, P. P., et al. (2010). Treating generalized anxiety disorder with second-generation antidepressants: A systematic review and meta-analysis. Journal of Clinical Psychiatry, 71(3), 306-317. 8. Etkin, A., et al. (2015). A cognitive-emotional biomarker for predicting remission with antidepressant medications: A report from the iSPOT-D trial. JAMA Psychiatry, 72(1), 14-22. 9. Heimberg, R. G., et al. (2014). Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial. JAMA, 293(23), 2884-2893. 10. Hofmann, S. G., et al. (2013). Efficacy of cognitive behavioral therapy for social anxiety disorder: A meta-analysis. Psychological Medicine, 43(05), 897-910.

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A major aim of this course was to shed some light on the aetiology of depression and anxiety. At the end of it you should have some idea of the complexity of this enterprise. We have focused on one of the best-studied and hence best-understood contributors to psychopathology – stress. This has biological, social and psychological significance, and its operation can be studied and understood at all these levels.

The clear message you should take away is that interaction between these levels is enormously important in aetiology. Biological factors, such as dysregulation of the HPA axis and its consequences, possible abnormalities in brain neurotransmitter systems, the effects of stress on the developing brain at different ages, and the kinds of genes that an individual carries, appear to play an important part in the development and maintenance of emotional disorders such as depression and anxiety. However, these biological factors cannot be divorced from factors that are thought of as psychosocial, such as abuse in childhood, or stressful events and how we perceive them. This is very evident from the most recent developments in genetics, which show how, via epigenetic processes, experiences are translated into the activity (or expression) of genes, which then modify the workings of the brain in ways that affect mood.

Research into epigenetic influences on mental health and ill-health is burgeoning and is likely to make a very significant contribution to our understanding of aetiology in the years to come. If so, it should also help clarify how existing treatments, both pharmacological and psychotherapeutic, for emotional disorders work, or suggest new approaches that would work more effectively.

The HPA axis is overactive in those with depression and anxiety, suggesting a role for chronic stress. Elevated levels of glucocorticoids such as cortisol and corticosterone, resulting from chronic stress, have toxic effects in some areas of the brain and promote neurogenesis in others.

The monoamine hypothesis of mood disorders has been influential in trying to explain the causes of depression. However the picture is now more complex and the view of a simple chemical imbalance as a cause of depression is outdated.

Hypotheses such as the neurotrophic hypothesis and the network hypothesis have been developed to try to account for the complex effects of antidepressant treatments on the brain.

The life-cycle model of stress links brain development with stress effects over the lifetime.

The cognitive approach concentrates on particular ways of thinking and how these cause and sustain depression.

Genetic and other vulnerabilities (also called predispositions or diatheses) can interact with environmental factors, which include psychosocial stressors such as stressful life events and early life stress (including child abuse) to cause emotional disorders such as depression.

Epigenetic processes add another layer of complexity to the interaction between genes and environment. There is increasingly evidence of the importance of epigenetic processes in the aetiology of mood disorders.

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10 New Thesis Statement about Depression & Anxiety | How to Write One?

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Did you know according to the National Institute of Mental Health; it is estimated that approximately 8.4% of adults are patients of major depression in the US? Well, depression is a common illness globally that affects a lot of people. Yet, the reasons for this psychological sickness vary from person to person and numerous studies are being conducted to discover more about depression.

Therefore, college and university students are currently assigned to write research papers, dissertations, essays, and a thesis about depression. However, writing essays on such topics aims to increase the awareness of physical and mental well-being among youth and help them find solutions.

However, a lot of students find it pretty challenging to write a thesis statement about depression and seek someone to write my essay . No worries! In this article, you will learn about what is a good thesis statement about mental health and some effective methods and approaches to write a killer headline and compose an astonishing essay about depression.

5 Thesis Statement About Depression:

  • “The complexity of depression, which includes biological, psychological, and environmental components, emphasizes the need for individualized treatment plans that consider each person’s particular requirements.”
  • “Depression in the workplace not only affects an individual’s productivity but also carries economic implications, emphasizing the importance of fostering a mental health-friendly work environment.”
  • “Alternative, holistic approaches to mental health care have the potential to be more successful as the link between creative expressions, such as art therapy, and depression management becomes more commonly recognized.”
  • “It is critical to enhance geriatric mental health treatment and reduce the stigma associated with mental illness in older people since depression in senior populations is typically underdiagnosed and mistreated.”
  • “The link between early childhood adversity and the risk of developing depression later in life accentuates the importance of early intervention and support systems for children exposed to adverse experiences.”

5 Thesis Statements about Anxiety & Depression :

  • “Depression and anxiety Co-occurring disorders are a major concern in mental health, necessitating integrated treatment options that meet the unique challenges that co-occurring diseases provide.”
  • “The utilization of technology-driven therapies, such as smartphone apps and telehealth services, is a realistic approach of addressing persons suffering from anxiety and depression, while also increasing access to mental health care.”
  • “The examination of the gut-brain connection and its potential role in anxiety and depression showcases a burgeoning area of research that could lead to novel treatments emphasizing nutrition and gut health.”
  • “Adolescents who experience both anxiety and depression face a serious issue that calls for comprehensive school-based mental health programs and preventative measures to promote young people’s mental health.”
  • “Exploring the impact of sociocultural factors and the role of community support systems in the experience of anxiety and depression provides insights into the development of culturally sensitive mental health interventions.”

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Follow 7 Proven Methods to Compose Thesis Statement about Depression

A thesis is the overview of the concepts and ideas that you will write in your research paper or in the essay. Yet, a thesis statement about anxiety focuses more on the stress and depression topics for the paper you’re working on, which can be written by following the tips given below.

Nonetheless, you can compose an outline by covering the points mentioned below:

1. Pick a good study topic and perform a basic reading. Look for some intriguing statistics and try to come up with creative ways to approach your subject. Examine a few articles for deficiencies in understanding.

2. Make a list of your references and jot down when you come across a noteworthy quotation. You can cite them in your paper as references. Organize all of the information you’ve acquired in one location.

3. In one phrase, state the purpose of your essay. Consider what you want to happen when other people read your article.

4. Examine your notes and construct a list of all the key things you wish to emphasize. Make use of brainstorming strategies and jot down any ideas that come to mind.

5. Review and revise the arguments and write a thesis statement for a research paper or essay about depression.

6. Organize your essay by organizing the list of points. Arrange the points in a logical sequence. Analyze all elements to ensure that they are all relevant to your goal.

7. Reread all of your statements and arrange your outline in a standard manner, such as a bulleted list.

Final Words

So, what is an ideal way to write a thesis statement about depression for your research paper or essay? We hope you have a thorough idea of the essay you’re writing before picking a thesis statement about mental well-being. That will assist you in developing the greatest thesis for our essay.

But don’t get too worked up over your thesis statement for a research paper on mental disorders. Our professional subject experts have produced a list of thesis statements about mental health and depression themes for research paper writing, so you’ve got your job cut out for you. For your essay assignments or assignments, we will also offer appropriate thesis statements.

If you’re still confused about which statement to use, contact us right away. We have a staff of highly qualified and seasoned writers who can assist you with your essay or research work and guarantee that you receive the highest possible score.

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Essay on Anxiety And Depression

Students are often asked to write an essay on Anxiety And Depression in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Anxiety And Depression

Anxiety and depression: an overview.

Anxiety and depression are mental health issues. Both can make a person feel sad or worried. Anxiety can make you feel scared or nervous. Depression can make you feel very sad for a long time. Both can make it hard to do everyday things.

Causes of Anxiety and Depression

Signs and symptoms.

Signs of anxiety and depression can be different for everyone. Some people might not want to do things they usually enjoy. They might feel tired all the time, have trouble sleeping, or eat too much or too little.

Getting Help

If you think you have anxiety or depression, it’s important to talk to someone you trust about it. This could be a parent, teacher, or friend. They can help you find a doctor or counselor who can help.

Treatment and Recovery

250 words essay on anxiety and depression, understanding anxiety and depression.

Anxiety and depression are mental health issues that affect many people. Anxiety makes you feel worried or scared. Depression makes you feel sad and lose interest in things you once enjoyed.

These conditions can be caused by many things. It could be due to a tough situation at home or school, like bullying. Sometimes, it might be because of chemical changes in the brain. It’s important to remember that it’s not anyone’s fault if they have these conditions.

People with anxiety might feel nervous, have a hard time sleeping, or find it difficult to focus. Those with depression might feel tired all the time, have trouble sleeping, or not want to eat. They might also feel sad or hopeless.

If you or someone you know is dealing with these feelings, it’s important to get help. This could be talking to a trusted adult, like a parent or teacher. They can help find a doctor or counselor who knows how to deal with these issues.

Anxiety and depression are serious, but help is available. It’s okay to ask for help, and it’s important to take care of your mental health. Remember, you’re not alone, and there are people who want to help.

500 Words Essay on Anxiety And Depression

What is anxiety and depression, why do people get anxiety and depression.

There are many reasons why someone might feel anxious or depressed. Sometimes, it’s because of something that happened in their life, like moving to a new school or losing a loved one. Other times, it might be because of changes in the brain. It’s important to remember that it’s not the person’s fault. Just like you can’t control if you get a cold, you can’t control if you have anxiety or depression.

Signs of Anxiety and Depression

Anxiety and depression can show up in different ways. Someone with anxiety might have a hard time sleeping or feel their heart beating really fast. They might worry a lot about things that could go wrong. A person with depression might feel tired all the time or have a hard time getting out of bed. They might not want to hang out with friends or do things they usually like.

How Are Anxiety and Depression Treated?

How can we support people with anxiety and depression.

In conclusion, anxiety and depression are serious but common mental health issues. They can make people feel scared, worried, or sad for long periods. But with the right help and support, people with anxiety and depression can feel better. If you or someone you know is struggling, it’s important to reach out to a mental health professional.

Apart from these, you can look at all the essays by clicking here .

Happy studying!

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depression anxiety essay

Anxiety and Depression Among College Students Essay

  • To find inspiration for your paper and overcome writer’s block
  • As a source of information (ensure proper referencing)
  • As a template for you assignment

Introduction

Methods section.

Education is expected to have appositive importance on the student’s life by enhancing their capability to think and improving their competency. However, it often acts as a source of stress that affects students’ mental health adversely. This causation of academic stress often emanates from the need to have high grades, the requirement to change attitude for success, and even pressures put by various school assignments.

These pressures introduced by education can make the student undergo a series of anxiety, depression, and stress trying to conform to the forces. The causes of academic stress are well-researched but there is still no explanation why the rate of strain increases despite some measures being implemented to curb student stress. This research explores this niche by using 100 participants who study at my college.

Nowadays there are many reasons that cause stress among growing number of students who might not know they are going through the condition most of the time. Hence, undiscovered discouragement or uneasiness can cause understudies to feel that they are continually passing up unique open doors. It prompts substance misuse; self-destruction is the second most typical reason for death among undergrads. The main hypothesis of this article is that college and university students have higher depression rates.

Problem Statement

This proposal undercovers how the problem of anxiety and depression is progressing if not addressed. With such countless youngsters experiencing undiscovered tension, it may be challenging for them to appreciate school. Understudies’ emotional well-being is risked when pressure and trouble go unnoticed, which can prompt social and educational issues (Nelson & Liebel, 2018). Educators might battle to perceive uneasiness since these circumstances manifest themselves contrastingly in different people.

Anxiety and depression are complicated disorders with numerous elements that impact people differently. Teachers and staff must be well trained to deal with these unforeseen events. Understudies coming to college come from various financial foundations, which can prompt an assortment of psychological wellness chances (Li et al., 2021). Additionally, current works will be evaluated to differentiate the risk factors associated with stress among university undergraduates worldwide.

There are various reasons which might cause the onset of anxiety and depression. It can be absence of rest, terrible dietary patterns, and lack of activity add to the gloom in undergrads (Ghrouz et al., 2019). Scholarly pressure, which incorporates monetary worries, strain to track down a decent profession after graduation, and bombed connections, is sufficient to drive a few understudies to exit school or more awful.

Numerous parts of school life add to despondency risk factors. For example, understudies today are owing debtors while having fewer work prospects than prior. Discouraged kids are bound to foster the problems like substance misuse (Lattie et al., 2019). For adaptation to close-to-home trouble, discouraged understudies are more inclined than their non-discouraged companions to knock back the firewater, drink pot, and participate in unsafe sexual practices.

Hypothesis on the Topic

The central hypothesis for this study is that college students have a higher rate of anxiety and depression. The study will integrate various methodologies to prove the hypothesis of nullifying it. High rates of anxiety and depression can lead to substance misuse, behavioral challenges, and suicide (Lipson et al., 2018). Anxiety is one of the most critical indicators of academic success, it shows how students’ attitudes change, reflecting on their overall performance.

Participants

The study will use college students who are joining and those already in college. The research period is planned to last six months; college students are between the ages of 18 and 21 and life is changing rapidly at this age (Spillebout et al., 2019). This demography will come from the college where I study. The participants will be chosen randomly, the total number will be 100, both female and male, and from all races.

Apparatus/ Materials/ Instruments

Some of the materials to be used in the study will include pencils, papers, and tests. Paper and pencils are typical supplies that students are familiar with, so using them will not cause additional stress. It will be used during the interview with the students and throughout the study will be in effect (Huang et al., 2018). These have been applied in various studies before, and, hence, they will be instrumental in this study.

The study will follow a step-wise procedure to get the required results. First, the students’ pre-depression testing results would be researched and recorded. Second, the students would undergo standardized testing in the same groups. Scholarly accomplishment is impacted by past intellectual performance and standardized testing (Chang et al., 2020). Third, the students’ levels of depression and anxiety would be monitored along with their test results.

The study will use a descriptive, cross-sectional design with categorical and continuous data. The sample demographic characteristics were described using descriptive statistics. Pearson’s proportion of skewness values and common mistakes of skewness was utilized to test the ordinariness of the persistent factors. The distinctions in mean scores between sociodemographic variables and stress will be examined using Tests (Lipson et al., 2018). The independent variable will be essential because it will provide the basis of measurement.

The 100 participants had different anxiety levels, as seen from the Test taken and the various evaluations. Forty-five of the participants had high levels, 23 had medium levels, while the remaining 32 had low levels (Lipson et al., 2018). The correlation and ANOVA, which had a degree of era margin of 0.05, were allowed (Lipson et al., 2018). This finding aligns intending to have clear and comprehensive outcomes.

Significance of the Study

If the results would be not significant, it means that students are not subjected to more pressure on average. If the study results in significant outcomes, this would mean that there is much that needs to be done to reduce student’s anxiety. The idea that scholarly accomplishment is indispensable to progress is built up in higher instructive conditions (Nelson & Liebel, 2018). Many colleges devote money to tutoring, extra instruction, and other support services to help students succeed.

APA Ethical Guidelines

The study will have to follow the APA ethical guidelines because it involves experimenting with humans. Some of the policies include having consent from the participant, debriefing the participant on the study’s nature, and getting IRB permission (Nelson & Liebel, 2018). Ethical guidelines should comply with proficient, institutional, and government rules. They habitually administer understudies whom they likewise instruct to give some examples of obligations.

Limitations

The study also had some limitations, making it hard to get the desired outcomes. It was not easy to detect the population-level connections, but not causality. This case hardened the aspect of confounding and getting the relevant random assignment needed for the study had to access (Nelson & Liebel, 2018). For the right individuals for the investigation to be identified, the sampling was not easy.

This study would be essential as it will create a platform for future studies. The result that was gotten shows that many college students are undergoing the problem of anxiety and depression without knowing that it is happening. Educators will have an awareness on what aspects of academics they need to modify to ensure their students are not experiencing mental health challenges. Hence, it makes it possible for future researchers to conduct studies to provide possible solutions.

Chang, J., Yuan, Y., & Wang, D. (2020). Mental health status and its influencing factors among college students during the epidemic of COVID-19. Journal of Southern Medical University , 40(2), 171-176.

Ghrouz, A. K., Noohu, M. M., Manzar, D., Warren Spence, D., BaHammam, A. S., & Pandi-Perumal, S. R. (2019). Physical activity and sleep quality in relation to mental health among college students. Sleep and Breathing Journal , 23(2), 627-634.

Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., & Wang, J. (2018). Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychiatric Research , 107, 1-10.

Lattie, E. G., Adkins, E. C., Winquist, N., Stiles-Shields, C., Wafford, Q. E., & Graham, A. K. (2019). Digital mental health interventions for depression, anxiety, and enhancement of psychological well-being among college students: A systematic review. Journal of Medical Internet Research , 21(7), e12869.

Li, Y., Zhao, J., Ma, Z., McReynolds, L. S., Lin, D., Chen, Z.,… & Liu, X. (2021). Mental health among college students during the COVID-19 pandemic in China: A 2-wave longitudinal survey. Journal of Affective Disorders , 281, 597-604.

Lipson, S. K., Kern, A., Eisenberg, D., & Breland-Noble, A. M. (2018). Mental health disparities among college students of color. Journal of Adolescent Health , 63(3), 348-356.

Nelson, J. M., & Liebel, S. W. (2018). Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant, sex, and subtype differences. Journal of American College Health , 66(2), 123-132.

Spillebout, A., Dechelotte, P., Ladner, J., & Tavolacci, M. P. (2019). Mental health among university students with eating disorders and irritable bowel syndrome in France. Journal of Affective Disorders , 67(5), 295-301.

  • Anxiety and Depression: The Case Study
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  • Defense Mechanisms and Brain Structure
  • Coping with Stress and Physical Health Problems
  • Quality of Life With Schizophrenia
  • Schizophrenia: The Etiology Analysis
  • Schizophrenia as a Chronic Mental Disorder
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  • Chicago (N-B)

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434 Depression Essay Titles & Research Topics: Argumentative, Controversial, and More

Depression is undeniably one of the most prevalent mental health conditions globally, affecting approximately 5% of adults worldwide. It often manifests as intense feelings of hopelessness, sadness, and a loss of interest in previously enjoyable activities. Many also experience physical symptoms like fatigue, sleep disturbances, and appetite changes. Recognizing and addressing this mental disorder is extremely important to save lives and treat the condition.

In this article, we’ll discuss how to write an essay about depression and introduce depression essay topics and research titles for students that may be inspirational.

  • 🔝 Top Depression Essay Titles
  • ✅ Essay Prompts
  • 💡 Research Topics
  • 🔎 Essay Titles
  • 💭 Speech Topics
  • 📝 Essay Structure

🔗 References

🔝 top 12 research titles about depression.

  • How is depression treated?
  • Depression: Risk factors.
  • The symptoms of depression.
  • What types of depression exist?
  • Depression in young people.
  • Differences between anxiety and depression.
  • The parents’ role in depression therapy.
  • Drugs as the root cause of depression.
  • Dangerous consequences of untreated depression.
  • Effect of long-term depression.
  • Different stages of depression.
  • Treatment for depression.

The picture provides a list of topics for a research paper about depression.

✅ Prompts for Essay about Depression

Struggling to find inspiration for your essay? Look no further! We’ve put together some valuable essay prompts on depression just for you!

Prompt for Personal Essay about Depression

Sharing your own experience with depression in a paper can be a good idea. Others may feel more motivated to overcome their situation after reading your story. You can also share valuable advice by discussing things or methods that have personally helped you deal with the condition.

For example, in your essay about depression, you can:

  • Tell about the time you felt anxious, hopeless, or depressed;
  • Express your opinion on depression based on the experiences from your life;
  • Suggest a way of dealing with the initial symptoms of depression ;
  • Share your ideas on how to protect mental health at a young age.

How to Overcome Depression: Essay Prompt

Sadness is a common human emotion, but depression encompasses more than just sadness. As reported by the National Institute of Mental Health, around 21 million adults in the United States, roughly 8.4% of the total adult population , faced at least one significant episode of depression in 2020. When crafting your essay about overcoming depression, consider exploring the following aspects:

  • Depression in young people and adolescents;
  • The main causes of depression;
  • The symptoms of depression;
  • Ways to treat depression;
  • Help from a psychologist (cognitive behavioral therapy or interpersonal therapy ).

Postpartum Depression: Essay Prompt

The birth of a child often evokes a spectrum of powerful emotions, spanning from exhilaration and happiness to apprehension and unease. It can also trigger the onset of depression. Following childbirth, many new mothers experience postpartum “baby blues,” marked by shifts in mood, bouts of tears, anxiety, and sleep disturbances. To shed light on the subject of postpartum depression, explore the following questions:

  • What factors may increase the risk of postpartum depression?
  • Is postpartum depression predictable?
  • How to prevent postpartum depression?
  • What are the symptoms of postpartum depression?
  • What kinds of postpartum depression treatments exist?

Prompt for Essay about Teenage Depression

Teenage depression is a mental health condition characterized by sadness and diminishing interest in daily activities. It can significantly impact a teenager’s thoughts, emotions, and behavior, often requiring long-term treatment and support.

By discussing the primary symptoms of teenage depression in your paper, you can raise awareness of the issue and encourage those in need to seek assistance. You can pay attention to the following aspects:

  • Emotional changes (feelings of sadness, anger, hopelessness, guilt, etc.);
  • Behavioral changes (loss of energy and appetite , less attention to personal hygiene, self-harm, etc.);
  • New addictions (drugs, alcohol, computer games, etc.).

💡 Research Topics about Depression

  • The role of genetics in depression development.
  • The effectiveness of different psychotherapeutic interventions for depression.
  • Anti-depression non-pharmacological and medication treatment.
  • The impact of childhood trauma on the onset of depression later in life.
  • Exploring the efficacy of antidepressant medication in different populations.
  • The impact of exercise on depression symptoms and treatment outcomes.
  • Mild depression: pharmacotherapy and psychotherapy.
  • The relationship between sleep disturbances and depression.
  • The role of gut microbiota in depression and potential implications for treatment.
  • Investigating the impact of social media on depression rates in adolescents.
  • Depression, dementia, and delirium in older people .
  • The efficacy of cognitive-behavioral therapy in preventing depression relapse.
  • The influence of hormonal changes on depression risk.
  • Assessing the effectiveness of self-help and digital interventions for depression.
  • Herbal and complementary therapies for depression.
  • The relationship between personality traits and vulnerability to depression.
  • Investigating the long-term consequences of untreated depression on physical health.
  • Exploring the link between chronic pain and depression.
  • Depression in the elderly male.
  • The impact of childhood experiences on depression outcomes in adulthood.
  • The use of ketamine and other novel treatments for depression.
  • The effect of stigma on depression diagnosis and treatment.
  • The conducted family assessment: cases of depression.
  • The role of social support in depression recovery.
  • The effectiveness of online support groups for individuals with depression.
  • Depression and cognitive decline in adults.
  • Depression: PICOT question component exploration .
  • Exploring the impact of nutrition and dietary patterns on depression symptoms.
  • Investigating the efficacy of art-based therapies in depression treatment.
  • The role of neuroplasticity in the development and treatment of depression.
  • Depression among HIV-positive women.
  • The influence of gender on depression prevalence and symptomatology.
  • Investigating the impact of workplace factors on depression rates and outcomes.
  • The efficacy of family-based interventions in reducing depression symptoms in teenagers.
  • Frontline nurses’ burnout, anxiety, depression, and fear statuses.
  • The role of early-life stress and adversity in depression vulnerability.
  • The impact of various environmental factors on depression rates.
  • Exploring the link between depression and cardiovascular health.
  • Depression detection in adults in nursing practice.
  • Virtual reality as a therapeutic tool for depression treatment.
  • Investigating the impact of childhood bullying on depression outcomes.
  • The benefits of animal-assisted interventions in depression management.
  • Depression and physical exercise.
  • The relationship between depression and suicidal behavior.
  • The influence of cultural factors on depression symptom expression.
  • Investigating the role of epigenetics in depression susceptibility.
  • Depression associated with cognitive dysfunction.
  • Exploring the impact of adverse trauma on the course of depression.
  • The efficacy of acceptance and commitment therapy in treating depression.
  • The relationship between depression and substance use disorders .
  • Depression and anxiety among college students.
  • Investigating the effectiveness of group therapy for depression.
  • Depression and chronic medical conditions.

Psychology Research Topics on Depression

  • The influence of early attachment experiences on the development of depression.
  • The impact of negative cognitive biases on depression symptomatology.
  • Depression treatment plan for a queer patient .
  • Examining the relationship between perfectionism and depression.
  • The role of self-esteem in depression vulnerability and recovery.
  • Exploring the link between maladaptive thinking styles (e.g., rumination, catastrophizing) and depression.
  • Investigating the impact of social support on depression outcomes and resilience.
  • Identifying depression in young adults at an early stage.
  • The influence of parenting styles on the risk of depression in children and adolescents.
  • The role of self-criticism and self-compassion in depression treatment.
  • Exploring the relationship between identity development and depression in emerging adulthood.
  • The role of learned helplessness in understanding depression and its treatment.
  • Depression in the elderly.
  • Examining the connection between self-efficacy beliefs and depression symptoms.
  • The influence of social comparison processes on depression and body image dissatisfaction.
  • Exploring the impact of trauma-related disorders on depression.
  • The role of resilience factors in buffering against the development of depression.
  • Investigating the relationship between personality traits and depression.
  • Depression and workplace violence .
  • The impact of cultural factors on depression prevalence and symptom presentation.
  • Investigating the effects of chronic stress on depression risk.
  • The role of coping strategies in depression management and recovery.
  • The correlation between discrimination/prejudice and depression/anxiety.
  • Exploring the influence of gender norms and societal expectations on depression rates.
  • The impact of adverse workplace conditions on employee depression.
  • Investigating the effectiveness of narrative therapy in treating depression.
  • Cognitive behavior and depression in adolescents .
  • Childhood emotional neglect and adult depression.
  • The influence of perceived social support on treatment outcomes in depression.
  • The effects of childhood bullying on the development of depression.
  • The impact of intergenerational transmission of depression within families.
  • Depression in children: symptoms and treatments.
  • Investigating the link between body dissatisfaction and depression in adolescence.
  • The influence of adverse life events and chronic stressors on depression risk.
  • The effects of peer victimization on the development of depression in adolescence.
  • Counselling clients with depression and addiction.
  • The role of experiential avoidance in depression and its treatment.
  • The impact of social media use and online interactions on depression rates.
  • Depression management in adolescent.
  • Exploring the relationship between emotional intelligence and depression symptomatology.
  • Investigating the influence of cultural values and norms on depression stigma and help-seeking behavior.
  • The effects of childhood maltreatment on neurobiological markers of depression.
  • Psychological and emotional conditions of suicide and depression.
  • Exploring the relationship between body dissatisfaction and depression.
  • The influence of self-worth contingencies on depression vulnerability and treatment response.
  • The impact of social isolation and loneliness on depression rates.
  • Psychology of depression among college students.
  • The effects of perfectionistic self-presentation on depression in college students.
  • The role of mindfulness skills in depression prevention and relapse prevention.
  • Investigating the influence of adverse neighborhood conditions on depression risk.
  • Personality psychology and depression.
  • The impact of attachment insecurity on depression symptomatology.

Postpartum Depression Research Topics

  • Identifying risk factors for postpartum depression.
  • Exploring the role of hormonal changes in postpartum depression.
  • “Baby blues” or postpartum depression and evidence-based care .
  • The impact of social support on postpartum depression.
  • The effectiveness of screening tools for early detection of postpartum depression.
  • The relationship between postpartum depression and maternal-infant bonding .
  • Postpartum depression educational program results.
  • Identifying effective interventions for preventing and treating postpartum depression.
  • Examining the impact of cultural factors on postpartum depression rates.
  • Investigating the role of sleep disturbances in postpartum depression.
  • Depression and postpartum depression relationship.
  • Exploring the impact of a traumatic birth experience on postpartum depression.
  • Assessing the impact of breastfeeding difficulties on postpartum depression.
  • Understanding the role of genetic factors in postpartum depression.
  • Postpartum depression: consequences.
  • Investigating the impact of previous psychiatric history on postpartum depression risk.
  • The potential benefits of exercise on postpartum depression symptoms.
  • The efficacy of psychotherapeutic interventions for postpartum depression.
  • Postpartum depression in the twenty-first century.
  • The influence of partner support on postpartum depression outcomes.
  • Examining the relationship between postpartum depression and maternal self-esteem.
  • The impact of postpartum depression on infant development and well-being.
  • Maternal mood symptoms in pregnancy and postpartum depression.
  • The effectiveness of group therapy for postpartum depression management.
  • Identifying the role of inflammation and immune dysregulation in postpartum depression.
  • Investigating the impact of childcare stress on postpartum depression.
  • Postpartum depression among low-income US mothers.
  • The role of postnatal anxiety symptoms in postpartum depression.
  • The impact of postpartum depression on the marital relationship.
  • The influence of postpartum depression on parenting practices and parental stress.
  • Postpartum depression: symptoms, role of cultural factors, and ways to support.
  • Investigating the efficacy of pharmacological treatments for postpartum depression.
  • The impact of postpartum depression on breastfeeding initiation and continuation.
  • The relationship between postpartum depression and post-traumatic stress disorder.
  • Postpartum depression and its identification.
  • The impact of postpartum depression on cognitive functioning and decision-making.
  • Investigating the influence of cultural norms and expectations on postpartum depression rates.
  • The impact of maternal guilt and shame on postpartum depression symptoms.
  • Beck’s postpartum depression theory: purpose, concepts, and significance .
  • Understanding the role of attachment styles in postpartum depression vulnerability.
  • Investigating the effectiveness of online support groups for women with postpartum depression.
  • The impact of socioeconomic factors on postpartum depression prevalence.
  • Perinatal depression: research study and design.
  • The efficacy of mindfulness-based interventions for postpartum depression.
  • Investigating the influence of birth spacing on postpartum depression risk.
  • The role of trauma history in postpartum depression development.
  • The link between the birth experience and postnatal depression.
  • How does postpartum depression affect the mother-infant interaction and bonding ?
  • The effectiveness of home visiting programs in preventing and managing postpartum depression.
  • Assessing the influence of work-related stress on postpartum depression.
  • The relationship between postpartum depression and pregnancy-related complications.
  • The role of personality traits in postpartum depression vulnerability.

🔎 Depression Essay Titles

Depression essay topics: cause & effect.

  • The effects of childhood trauma on the development of depression in adults.
  • The impact of social media usage on the prevalence of depression in adolescents.
  • “Predictors of Postpartum Depression” by Katon et al.
  • The effects of environmental factors on depression rates.
  • The relationship between academic pressure and depression among college students.
  • The relationship between financial stress and depression.
  • The best solution to predict depression because of bullying.
  • How does long-term unemployment affect mental health ?
  • The effects of unemployment on mental health, particularly the risk of depression.
  • The impact of genetics and family history of depression on an individual’s likelihood of developing depression.
  • The relationship between depression and substance abuse.
  • Child abuse and depression.
  • The role of gender in the manifestation and treatment of depression.
  • The effects of chronic stress on the development of depression.
  • The link between substance abuse and depression.
  • Depression among students at Elon University.
  • The influence of early attachment styles on an individual’s vulnerability to depression.
  • The effects of sleep disturbances on the severity of depression.
  • Chronic illness and the risk of developing depression.
  • Depression: symptoms and treatment.
  • Adverse childhood experiences and the likelihood of experiencing depression in adulthood.
  • The relationship between chronic illness and depression.
  • The role of negative thinking patterns in the development of depression.
  • Effects of depression among adolescents.
  • The effects of poor body image and low self-esteem on the prevalence of depression.
  • The influence of social support systems on preventing symptoms of depression.
  • The effects of child neglect on adult depression rates.
  • Depression caused by hormonal imbalance.
  • The link between perfectionism and the risk of developing depression.
  • The effects of a lack of sleep on depression symptoms.
  • The effects of childhood abuse and neglect on the risk of depression.
  • Social aspects of depression and anxiety.
  • The impact of bullying on the likelihood of experiencing depression.
  • The role of serotonin and neurotransmitter imbalances in the development of depression.
  • The impact of a poor diet on depression rates.
  • Depression and anxiety run in the family .
  • The effects of childhood poverty and socioeconomic status on depression rates in adults.
  • The impact of divorce on depression rates.
  • The relationship between traumatic life events and the risk of developing depression.
  • The influence of personality traits on susceptibility to depression.
  • The impact of workplace stress on depression rates.
  • Depression in older adults: causes and treatment.
  • The impact of parental depression on children’s mental health outcomes.
  • The effects of social isolation on the prevalence and severity of depression.
  • The role of cultural factors in the manifestation and treatment of depression.
  • The relationship between childhood bullying victimization and future depressive symptoms.
  • The impact of early intervention and prevention programs on reducing the risk of postpartum depression.
  • Treating mood disorders and depression.
  • How do hormonal changes during pregnancy contribute to the development of depression?
  • The effects of sleep deprivation on the onset and severity of postpartum depression.
  • The impact of social media on depression rates among teenagers.
  • The role of genetics in the development of depression.
  • The impact of bullying on adolescent depression rates.
  • Mental illness, depression, and wellness issues.
  • The effects of a sedentary lifestyle on depression symptoms.
  • The correlation between academic pressure and depression in students.
  • The relationship between perfectionism and depression.
  • The correlation between trauma and depression in military veterans.
  • Anxiety and depression during childhood and adolescence.
  • The impact of racial discrimination on depression rates among minorities.
  • The relationship between chronic pain and depression.
  • The impact of social comparison on depression rates among young adults.
  • The effects of childhood abuse on adult depression rates.

Depression Argumentative Essay Topics

  • The role of social media in contributing to depression among teenagers.
  • The effectiveness of antidepressant medication: an ongoing debate.
  • Depression treatment: therapy or medications?
  • Should depression screening be mandatory in schools and colleges?
  • Is there a genetic predisposition to depression?
  • The stigma surrounding depression: addressing misconceptions and promoting understanding.
  • Implementation of depression screening in primary care .
  • Is psychotherapy more effective than medication in treating depression?
  • Is teenage depression overdiagnosed or underdiagnosed: a critical analysis.
  • The connection between depression and substance abuse: untangling the relationship.
  • Humanistic therapy of depression .
  • Should ECT (electroconvulsive therapy) be a treatment option for severe depression?
  • Where is depression more prevalent: in urban or rural communities? Analyzing the disparities.
  • Is depression a result of chemical imbalance in the brain? Debunking the myth.
  • Depression: a serious mental and behavioral problem.
  • Should depression medication be prescribed for children and adolescents?
  • The effectiveness of mindfulness-based interventions in managing depression.
  • Should depression in the elderly be considered a normal part of aging?
  • Is depression hereditary? Investigating the role of genetics in depression risk.
  • Different types of training in managing the symptoms of depression.
  • The effectiveness of online therapy platforms in treating depression.
  • Should psychedelic therapy be explored as an alternative treatment for depression?
  • The connection between depression and cardiovascular health: Is there a link?
  • The effectiveness of cognitive-behavioral therapy in preventing depression relapse.
  • Depression as a bad a clinical condition.
  • Should mind-body interventions (e.g., yoga, meditation) be integrated into depression treatment?
  • Should emotional support animals be prescribed for individuals with depression?
  • The effectiveness of peer support groups in decreasing depression symptoms.
  • The use of antidepressants: are they overprescribed or necessary for treating depression?
  • Adult depression and anxiety as a complex problem.
  • The effectiveness of therapy versus medication in treating depression.
  • The stigma surrounding depression and mental illness: how can we reduce it?
  • The debate over the legalization of psychedelic drugs for treating depression.
  • The relationship between creativity and depression: does one cause the other?
  • Cognitive-behavioral therapy for generalized anxiety disorder and depression.
  • The role of childhood trauma in shaping adult depression: Is it always a causal factor?
  • The debate over the medicalization of sadness and grief as forms of depression.
  • Alternative therapies, such as acupuncture or meditation, are effective in treating depression.
  • Depression as a widespread mental condition.

Controversial Topics about Depression

  • The existence of “chemical imbalance” in depression: fact or fiction?
  • The over-reliance on medication in treating depression: are alternatives neglected?
  • Is depression overdiagnosed and overmedicated in Western society?
  • Measurement of an individual’s level of depression.
  • The role of Big Pharma in shaping the narrative and treatment of depression.
  • Should antidepressant advertisements be banned?
  • The inadequacy of current diagnostic criteria for depression: rethinking the DSM-5.
  • Is depression a biological illness or a product of societal factors?
  • Literature review on depression .
  • The overemphasis on biological factors in depression treatment: ignoring environmental factors.
  • Is depression a normal reaction to an abnormal society?
  • The influence of cultural norms on the perception and treatment of depression.
  • Should children and adolescents be routinely prescribed antidepressants?
  • The role of family in depression treatment.
  • The connection between depression and creative genius: does depression enhance artistic abilities?
  • The ethics of using placebo treatment for depression studies.
  • The impact of social and economic inequalities on depression rates.
  • Is depression primarily a mental health issue or a social justice issue?
  • Depression disassembling and treating.
  • Should depression screening be mandatory in the workplace?
  • The influence of gender bias in the diagnosis and treatment of depression.
  • The controversial role of religion and spirituality in managing depression.
  • Is depression a result of individual weakness or societal factors?
  • Abnormal psychology: anxiety and depression case .
  • The link between depression and obesity: examining the bidirectional relationship.
  • The connection between depression and academic performance: causation or correlation?
  • Should depression medication be available over the counter?
  • The impact of internet and social media use on depression rates: harmful or beneficial?
  • Interacting in the workplace: depression.
  • Is depression a modern epidemic or simply better diagnosed and identified?
  • The ethical considerations of using animals in depression research.
  • The effectiveness of psychedelic therapies for treatment-resistant depression.
  • Is depression a disability? The debate on workplace accommodations.
  • Polysubstance abuse among adolescent males with depression.
  • The link between depression and intimate partner violence : exploring the relationship.
  • The controversy surrounding “happy” pills and the pursuit of happiness.
  • Is depression a choice? Examining the role of personal responsibility.

Good Titles for Depression Essays

  • The poetic depictions of depression: exploring its representation in literature.
  • The melancholic symphony: the influence of depression on classical music.
  • Moderate depression symptoms and treatment.
  • Depression in modern music: analyzing its themes and expressions.
  • Cultural perspectives on depression: a comparative analysis of attitudes in different countries.
  • Contrasting cultural views on depression in Eastern and Western societies.
  • Diagnosing depression in the older population.
  • The influence of social media on attitudes and perceptions of depression in global contexts.
  • Countries with progressive approaches to mental health awareness.
  • From taboo to acceptance: the evolution of attitudes towards depression.
  • Depression screening tool in acute settings.
  • The Bell Jar : analyzing Sylvia Plath’s iconic tale of depression .
  • The art of despair: examining Frida Kahlo’s self-portraits as a window into depression.
  • The Catcher in the Rye : Holden Caulfield’s battle with adolescent depression.
  • Music as therapy: how jazz artists turned depression into art.
  • Depression screening tool for a primary care center.
  • The Nordic paradox: high depression rates in Scandinavian countries despite high-quality healthcare.
  • The Stoic East: how Eastern philosophies approach and manage depression.
  • From solitude to solidarity: collective approaches to depression in collectivist cultures.
  • The portrayal of depression in popular culture: a critical analysis of movies and TV shows.
  • The depression screening training in primary care.
  • The impact of social media influencers on depression rates among young adults.
  • The role of music in coping with depression: can specific genres or songs help alleviate depressive symptoms?
  • The representation of depression in literature: a comparative analysis of classic and contemporary works.
  • The use of art as a form of self-expression and therapy for individuals with depression.
  • Depression management guidelines implementation.
  • The role of religion in coping with depression: Christian and Buddhist practices.
  • The representation of depression in the video game Hellblade: Senua’s Sacrifice .
  • The role of nature in coping with depression: can spending time outdoors help alleviate depressive symptoms?
  • The effectiveness of dance/movement therapy in treating depression among older adults.
  • The National Institute for Health: depression management.
  • The portrayal of depression in stand-up comedy: a study of comedians like Maria Bamford and Chris Gethard.
  • The role of spirituality in coping with depression: Islamic and Hindu practices .
  • The portrayal of depression in animated movies : an analysis of Inside Out and The Lion King .
  • The representation of depression by fashion designers like Alexander McQueen and Rick Owens.
  • Depression screening in primary care .
  • The portrayal of depression in documentaries: an analysis of films like The Bridge and Happy Valley .
  • The effectiveness of wilderness therapy in treating depression among adolescents.
  • The connection between creativity and depression: how art can help heal.
  • The role of Buddhist and Taoist practices in coping with depression.
  • Mild depression treatment research funding sources.
  • The portrayal of depression in podcasts: an analysis of the show The Hilarious World of Depression .
  • The effectiveness of drama therapy in treating depression among children and adolescents.
  • The representation of depression in the works of Vincent van Gogh and Edvard Munch.
  • Depression in young people: articles review.
  • The impact of social media on political polarization and its relationship with depression.
  • The role of humor in coping with depression: a study of comedians like Ellen DeGeneres.
  • The portrayal of depression in webcomics: an analysis of the comics Hyperbole and a Half .
  • The effect of social media on mental health stigma and its relationship with depression.
  • Depression and the impact of human services workers.
  • The masked faces: hiding depression in highly individualistic societies.

💭 Depression Speech Topics

Informative speech topics about depression.

  • Different types of depression and their symptoms.
  • The causes of depression: biological, psychological, and environmental factors.
  • How depression and physical issues are connected.
  • The prevalence of depression in different age groups and demographics.
  • The link between depression and anxiety disorders.
  • Physical health: The effects of untreated depression.
  • The role of genetics in predisposing individuals to depression.
  • What you need to know about depression.
  • How necessary is early intervention in treating depression?
  • The effectiveness of medication in treating depression.
  • The role of exercise in managing depressive symptoms.
  • Depression in later life: overview.
  • The relationship between substance abuse and depression.
  • The impact of trauma on depression rates and treatment.
  • The effectiveness of mindfulness meditation in managing depressive symptoms.
  • Enzymes conversion and metabolites in major depression.
  • The benefits and drawbacks of electroconvulsive therapy for severe depression.
  • The effect of gender and cultural norms on depression rates and treatment.
  • The effectiveness of alternative therapies for depression, such as acupuncture and herbal remedies.
  • The importance of self-care in managing depression.
  • Symptoms of anxiety, depression, and peritraumatic dissociation.
  • The role of support systems in managing depression.
  • The effectiveness of cognitive-behavioral therapy in treating depression.
  • The benefits and drawbacks of online therapy for depression.
  • The role of spirituality in managing depression.
  • Depression among minority groups.
  • The benefits and drawbacks of residential treatment for severe depression.
  • What is the relationship between childhood trauma and adult depression?
  • How effective is transcranial magnetic stimulation (TMS) for treatment-resistant depression?
  • The benefits and drawbacks of art therapy for depression.
  • Mood disorder: depression and bipolar.
  • The impact of social media on depression rates.
  • The effectiveness of dialectical behavior therapy (DBT) in treating depression.
  • Depression in older people.
  • The impact of seasonal changes on depression rates and treatment options.
  • The impact of depression on daily life and relationships, and strategies for coping with the condition.
  • The stigma around depression and the importance of seeking help.

Persuasive Speech Topics about Depression

  • How important is it to recognize the signs and symptoms of depression ?
  • How do you support a loved one who is struggling with depression?
  • The importance of mental health education in schools to prevent and manage depression.
  • Social media: the rise of depression and anxiety .
  • Is there a need to increase funding for mental health research to develop better treatments for depression?
  • Addressing depression in minority communities: overcoming barriers and disparities.
  • The benefits of including alternative therapies, such as yoga and meditation, in depression treatment plans.
  • Challenging media portrayals of depression: promoting accurate representations.
  • Two sides of depression disease.
  • How social media affects mental health: the need for responsible use to prevent depression.
  • The importance of early intervention: addressing depression in schools and colleges.
  • The benefits of seeking professional help for depression.
  • There is a need for better access to mental health care, including therapy and medication, for those suffering from depression.
  • Depression in adolescents and suitable interventions.
  • How do you manage depression while in college or university?
  • The role of family and friends in supporting loved ones with depression and encouraging them to seek help.
  • The benefits of mindfulness and meditation for depression.
  • The link between sleep and depression, and how to improve sleep habits.
  • How do you manage depression while working a high-stress job?
  • Approaches to treating depression.
  • How do you manage depression during pregnancy and postpartum?
  • The importance of prioritizing employee mental health and providing resources for managing depression in the workplace.
  • How should you manage depression while caring for a loved one with a chronic illness?
  • How to manage depression while dealing with infertility or pregnancy loss.
  • Andrew Solomon: why we can’t talk about depression.
  • Destigmatizing depression: promoting mental health awareness and understanding.
  • Raising funds for depression research: investing in mental health advances.
  • The power of peer support: establishing peer-led programs for depression.
  • Accessible mental health services: ensuring treatment for all affected by depression.
  • Evidence-based screening for depression in acute care.
  • The benefits of journaling for mental health: putting your thoughts on paper to heal.
  • The power of positivity: changing your mindset to fight depression .
  • The healing power of gratitude in fighting depression.
  • The connection between diet and depression: eating well can improve your mood.
  • Teen depression and suicide in Soto’s The Afterlife .
  • The benefits of therapy for depression: finding professional help to heal.
  • The importance of setting realistic expectations when living with depression.

📝 How to Write about Depression: Essay Structure

We’ve prepared some tips and examples to help you structure your essay and communicate your ideas.

Essay about Depression: Introduction

An introduction is the first paragraph of an essay. It plays a crucial role in engaging the reader, offering the context, and presenting the central theme.

A good introduction typically consists of 3 components:

  • Hook. The hook captures readers’ attention and encourages them to continue reading.
  • Background information. Background information provides context for the essay.
  • Thesis statement. A thesis statement expresses the essay’s primary idea or central argument.

Hook : Depression is a widespread mental illness affecting millions worldwide.

Background information : Depression affects your emotions, thoughts, and behavior. If you suffer from depression, engaging in everyday tasks might become arduous, and life may appear devoid of purpose or joy.

Depression Essay Thesis Statement

A good thesis statement serves as an essay’s road map. It expresses the author’s point of view on the issue in 1 or 2 sentences and presents the main argument.

Thesis statement : The stigma surrounding depression and other mental health conditions can discourage people from seeking help, only worsening their symptoms.

Essays on Depression: Body Paragraphs

The main body of the essay is where you present your arguments. An essay paragraph includes the following:

  • a topic sentence,
  • evidence to back up your claim,
  • explanation of why the point is essential to the argument;
  • a link to the next paragraph.

Topic sentence : Depression is a complex disorder that requires a personalized treatment approach, comprising both medication and therapy.

Evidence : Medication can be prescribed by a healthcare provider or a psychiatrist to relieve the symptoms. Additionally, practical strategies for managing depression encompass building a support system, setting achievable goals, and practicing self-care.

Depression Essay: Conclusion

The conclusion is the last part of your essay. It helps you leave a favorable impression on the reader.

The perfect conclusion includes 3 elements:

  • Rephrased thesis statement.
  • Summary of the main points.
  • Final opinion on the topic.

Rephrased thesis: In conclusion, overcoming depression is challenging because it involves a complex interplay of biological, psychological, and environmental factors that affect an individual’s mental well-being.

Summary: Untreated depression heightens the risk of engaging in harmful behaviors such as substance abuse and can also result in negative thought patterns, diminished self-esteem, and distorted perceptions of reality.

We hope you’ve found our article helpful and learned some new information. If so, feel free to share it with your friends. You can also try our free online topic generator !

  • Pain, anxiety, and depression – Harvard Health | Harvard Health Publishing
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725 Research Proposal Topics & Title Ideas in Education, Psychology, Business, & More

414 proposal essay topics for projects, research, & proposal arguments.

Anxiety and depression raise the risk of dangerous blood clots, study finds

Recent research has drawn a link between anxiety, depression and an increased risk of deep vein thrombosis.

An artist's rendering of a cross-sectioned artery. Red blood cells flow through the artery, but get stuck at a large clot.

Having anxiety or depression may increase the risk of potentially life-threatening blood clots, known as deep vein thrombosis (DVT).

With DVT, a blood clot forms in a deep vein, usually in the legs. DVT can cause damage by limiting blood flow to the site of the clot and increasing pressure in veins. A larger danger arises if some or all of that clot breaks loose and then travels to the lungs , where it can block blood flow, causing shortness of breath, chest pain and even death.

Within the last decade, scientists have uncovered links between people's mental health and their risk of these blood clots. However, conflicting study results and complicating factors — such as some study subjects' medication use and histories of high blood pressure — have made it difficult to determine exactly how the two are connected. 

Now, a study published July 4 in the American Journal of Hematology has examined not only how much anxiety or depression can raise a person's risk of DVT but also why.

Related: Rare clotting effect of early COVID shots finally explained

"My research comes from my patients," Dr. Rachel Rosovsky , lead study author and director of thrombosis research in the Division of Hematology at Massachusetts General Hospital, told Live Science. "When I realized the association between long-term anxiety and depression and blood clots, I started to think about whether those conditions could affect a patient's risk of developing a clot."

To investigate the link, the researchers looked retrospectively at data from almost 119,000 people. The data included measurements of stress-related brain activity obtained using positron emission tomography (PET). PET scans reveal the activity levels and energy use of different parts of the brain. 

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The researchers compared the activity of the amygdala — a brain region that processes and responds to potential threats — to that of the ventromedial prefrontal cortex, which helps regulate the amygdala and thus control emotional responses. In that way, the researchers got a snapshot of stress-related neural activity, or SNA. 

The data also included measures of high-sensitivity C-reactive protein, a marker of inflammation , and heart rate variability, a measure of adaptability . The higher your heart rate variability, the better your body can cope with stressful situations.

Of the overall group, about 106,450 had a diagnosis of anxiety, while 108,790 had depression; there's overlap in these groups as many participants had both conditions. 

Over an average follow-up time of 3.6 years, about 1,780 study participants experienced DVT. Those with a history of anxiety or depression were 53% and 48% more likely to experience DVT, respectively, compared with those with no history of either condition. Similar trends were seen among people with both conditions.

Related: 6 distinct forms of depression identified by AI in brain study

An illustration showing how red blood cells get caught in a blood vessel.

Furthermore, of 1,520 people who got PET scans, those with anxiety or depression showed higher SNA than those without either condition. People with higher-than-normal levels of this activity were 30% more likely to experience DVT than those with normal levels.

"We first showed that anxiety and depression were significantly associated with increased SNA," Rosovsky said. Then, the team found that SNA was associated with increased leukopoietic activity , meaning the creation of white blood cells — a driver of inflammation. 

This had previously been shown to "promote clotting through many different mechanisms," she said. And now, the team has connected the dots from anxiety and depression to SNA and on to DVT risk. 

Three potential mechanisms connect anxiety and depression to DVT: higher SNA, higher inflammation and reduced heart rate variability. It appears that the more stress a person experiences, the higher their risk of DVT, the researchers concluded.

This "intriguing study" sheds light on how SNA influences the production of blood in the body, said Kamran Mirza , a professor of hematopathology at the University of Michigan who was not involved in the study. It reveals a "potential connection between mental health and increased clotting risk that warrants further investigation," Mirza told Live Science.

Notably, the researchers were limited to data that had already been collected. Prospective studies that follow people over time would enable scientists to track changes in stress and inflammation and see how they relate to DVT. The team plans to examine how treating anxiety or depression might affect DVT rates, and they also want to see if somehow reducing SNA could reduce risk.

— An astronaut got a blood clot in space. Here's how doctors on Earth fixed it .

— Can chronic stress cause or worsen cancer? Here's what the evidence shows .

— How anxiety affects the body: 5 physical symptoms, according to science

"If you have depression or anxiety, be aware that those are potential risk factors for blood clots," Rosovsky said. "But also think about whether you have other risk factors and what you can do about those to reduce your risk."

This article is for informational purposes only and is not meant to offer medical advice.

Ever wonder why some people build muscle more easily than others or why freckles come out in the sun ? Send us your questions about how the human body works to [email protected] with the subject line "Health Desk Q," and you may see your question answered on the website!

Michael Schubert is a veteran science and medicine communicator. He writes across all areas of the life sciences and medicine but specializes in the study of the very small — from the genes that make our bodies work to the chemicals that could support life on other planets. Mick holds graduate degrees in medical biochemistry and molecular biology. When he's not writing or editing, he is co-director of the Digital Communications Fellowship in Pathology; a professor of professional practice in academic writing at ThinkSpace Education; an inclusion and accessibility consultant; and (most importantly) dog-walker and ball-thrower extraordinaire.

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depression anxiety essay

Examining psychological flexibility in unaccompanied refugee minors: A network analysis

  • Freymann, Johannes
  • Morroni, Dafne
  • Kleinbub, Johann Roland
  • Karekla, Maria

Refugees, particularly unaccompanied refugee minors (URM), often report poor mental health. Psychological Flexibility (PF), derived from Acceptance and Commitment Therapy (ACT), appears to positively impact mental health in various populations, including adolescents and refugees. This study aimed to examine the structure of the PF model and the connections among its core processes, as well as the structure and connections between mental health constructs (i.e., post-traumatic stress, depression, anxiety, stress, quality of life) and PF in URM. 100 URM aged 13–18 years living in shelters in the Republic of Cyprus completed four self-reports, assessing depression, anxiety, and stress (DASS-21), PF (Psy-Flex), PTSD (CRIES-13), and HRQL (KIDSCREEN-10). Network Analysis was used to examine the structure and connections of the constructs. Most core PF processes showed positive connections amongst each other, with the strongest edge between committed action and values. Together with self as context, these core processes exhibited the highest expected influence. The strongest positive connections in the mental health network were found among stress, anxiety, and depression. Stress had the highest expected influence, whereas PF had the lowest. A post hoc Johnson-Neyman analysis suggested a buffering effect of PF on the impact of PTSD on anxiety and stress. Proposed areas of focus for clinicians working with URM include incorporating strategies that address stress symptoms and facilitate individuals in pursuing value-based behavior. It is equally important to encourage critical reflection on values and the conceptualized self in the context of culture.

  • Psychological flexibility;
  • Mental health;
  • Adolescents;
  • Unaccompanied refugee minors;
  • Network analysis

IMAGES

  1. ≫ Levels of Anxiety and Depression, Especially Among Adolescents and

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  2. Anxiety Disorder and Ways to Deal With It Personal Essay on Samploon.com

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  3. Depression and Anxiety Essay Example

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  4. Found an essay about overcoming depression I wrote when I was 12. How

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  5. Stress, Depression and Anxiety in Women Free Essay Example

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  6. 📌 Essay Sample on How Social Media Has Increased Depression and Anxiety

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COMMENTS

  1. Anxiety Disorders and Depression Essay (Critical Writing)

    Anxiety disorders are normally brained reactions to stress as they alert a person of impending danger. Most people feel sad and low due to disappointments. Feelings normally overwhelm a person leading to depression, especially during sad moments such as losing a loved one or divorce. When people are depressed, they engage in reckless behaviors ...

  2. Depression Essay Examples with Introduction Body and Conclusion

    2 pages / 702 words. Introduction Depression is an insidious condition that affects millions of people worldwide. It is a complex mental health disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in daily activities. This narrative essay aims to delve into the personal...

  3. Anxiety, Depression and Quality of Life—A Systematic Review of Evidence

    1. Introduction. The World Health Organization [] estimates that 264 million people worldwide were suffering from an anxiety disorder and 322 million from a depressive disorder in 2015, corresponding to prevalence rates of 3.6% and 4.4%.While their prevalence varies slightly by age and gender [], they are among the most common mental disorders in the general population [2,3,4,5,6].

  4. The Critical Relationship Between Anxiety and Depression

    Across all psychiatric disorders, comorbidity is the rule (), which is definitely the case for anxiety and depressive disorders, as well as their symptoms.With respect to major depression, a worldwide survey reported that 45.7% of individuals with lifetime major depressive disorder had a lifetime history of one or more anxiety disorder ().These disorders also commonly coexist during the same ...

  5. 327 Depression Essay Titles & Examples

    Depression is a disorder characterized by prolonged periods of sadness and loss of interest in life. The symptoms include irritability, insomnia, anxiety, and trouble concentrating. This disorder can produce physical problems, self-esteem issues, and general stress in a person's life. Difficult life events and trauma are typical causes of ...

  6. I Beat Anxiety & Depression

    called "I BEAT ANXIETY DEPRESSION, now what?". It is a very engaged group of warriors who are ready to heal and share their journey and their story for ongoing healing and support! Evidence-based Tips & Strategies from our Member Experts. Unseen Trauma: Recognizing and Understanding Childbirth-Related PTSD.

  7. Depression And Anxiety

    Depression And Anxiety - Free Essay Examples and Topic Ideas. Depression is a serious mental illness that is characterized by a persistent feeling of sadness or hopelessness, loss of interest in activities, changes in appetite and sleeping patterns, fatigue, difficulty concentrating, and sometimes thoughts of self-harm or suicide.

  8. 217 Anxiety Essay Topics to Research

    Anxiety is the emotion that causes severe physical changes, can negatively affect social contacts, and even lead to depression. Here we've gathered top research questions about anxiety disorder as a mental health issue, as well as anxiety essay examples.

  9. ≡Essays on Anxiety: Top 10 Examples by GradesFixer

    Social anxiety is also known as social phobia. Social anxiety disorder is the most common anxiety disorder, affecting over 10 million Americans. This disorder can develop as early in childhood, mid-teens, or even in adulthood. Social anxiety can be inherit usually through family history.

  10. Essay on Depression And Anxiety

    250 Words Essay on Depression And Anxiety What is Depression and Anxiety? Depression and anxiety are types of mental health problems. Depression makes people feel sad, tired, and lose interest in things they once loved. Anxiety often makes people worry too much about different things. It's like a fear or dread that doesn't go away.

  11. Understanding depression and anxiety: Conclusion

    Conclusion. A major aim of this course was to shed some light on the aetiology of depression and anxiety. At the end of it you should have some idea of the complexity of this enterprise. We have focused on one of the best-studied and hence best-understood contributors to psychopathology - stress. This has biological, social and psychological ...

  12. Anxiety and Depression Disorders Free Essay Example

    Anxiety is the feeling and behavior of worryness and fear strong enough to interfere with a person's daily life. Depression is a disorder that is both very serious and very common. It negatively affects individuals, causing them to feel extreme sadness and loss of interest in doing something once before enjoyed.

  13. 10 New Thesis Statement about Depression & Anxiety

    3. In one phrase, state the purpose of your essay. Consider what you want to happen when other people read your article. 4. Examine your notes and construct a list of all the key things you wish to emphasize. Make use of brainstorming strategies and jot down any ideas that come to mind. 5. Review and revise the arguments and write a thesis ...

  14. Essay on Anxiety And Depression

    Treatment for anxiety and depression can include talking to a therapist or taking medicine. It can take time to feel better, but many people do. Remember, it's okay to ask for help. 250 Words Essay on Anxiety And Depression Understanding Anxiety and Depression. Anxiety and depression are mental health issues that affect many people.

  15. Depression and Anxiety

    Depression and Anxiety welcomes original research and review articles covering neurobiology (genetics and neuroimaging), epidemiology, experimental psychopathology, and treatment (psychotherapeutic and pharmacologic) aspects of mood and anxiety disorders and related phenomena in humans. Articles Most Recent; Research Article ...

  16. My Depression in My Life

    The Loneliness and Anxiety: In some ways I consider this step one of when my depression spikes because it always seems to come first. But I don't consider it step one in levels of horribleness. Like I said above I really think that both ways my depression hits me are pretty awful and I couldn't say which is worse.

  17. Anxiety and Depression Among College Students Essay

    The central hypothesis for this study is that college students have a higher rate of anxiety and depression. The study will integrate various methodologies to prove the hypothesis of nullifying it. High rates of anxiety and depression can lead to substance misuse, behavioral challenges, and suicide (Lipson et al., 2018).

  18. 434 Depression Essay Titles & Research Topics: Argumentative

    30. Our Experts. can deliver a custom essay. for a mere 11.00 9.35/page --- qualified. specialists online Learn more. Depression is undeniably one of the most prevalent mental health conditions globally, affecting approximately 5% of adults worldwide. It often manifests as intense feelings of hopelessness, sadness, and a loss of interest in ...

  19. Conclusion depression

    Conclusion depression. Depression is one of the most common conditions in primary care, but is often unrecognized, undiagnosed, and untreated. Depression has a high rate of morbidity and mortality when left untreated. Most patients suffering from depression do not complain of feeling depressed, but rather anhedonia or vague unexplained symptoms.

  20. Depression In College Essay

    Depression In College Essay; Depression In College Essay. 2266 Words 10 Pages ... "1 out of every 4 college students suffers from some form of mental illness," (Kerr) whether it be depression, anxiety, eating disorder or any of the like our kids are suffering and they need our help. Mental illness on the college campus is becoming an epidemic.

  21. Depression and Anxiety Essay example

    Bipolar Disorder used to be known as "manic depression", because the person experiences depression, normal mood and mania, which is basically the opposite of depression. Symptoms for Bipolar Disorder include feeling great, having a lot of energy, having racing thoughts, little need for sleep, taking fast, having difficulty focusing on tasks ...

  22. Position Paper

    Being socially engaged to people may reduce stress, anxiety, and depression, improve self-worth, bring solace and joy, avoid loneliness, and even lengthen one's life. On the other hand, having few close friends puts your mental and emotional wellbeing at danger.

  23. Anxiety and depression raise the risk of dangerous blood clots, study

    Having anxiety or depression may increase the risk of potentially life-threatening blood clots, known as deep vein thrombosis (DVT). With DVT, a blood clot forms in a deep vein, usually in the ...

  24. Examining psychological flexibility in unaccompanied refugee ...

    The strongest positive connections in the mental health network were found among stress, anxiety, and depression. Stress had the highest expected influence, whereas PF had the lowest. A post hoc Johnson-Neyman analysis suggested a buffering effect of PF on the impact of PTSD on anxiety and stress.