Severe anxiety and depression: what to know

Anxiety may bring constant worry, physical tension, panic, irritability or difficulty settling. Depression may bring low mood, loss of interest, fatigue, hopelessness, appetite change, poor concentration or withdrawal. Together they can disturb sleep, work, relationships and self-care. Daytime sleepiness or fatigue can follow poor sleep, while sleeping more does not always restore energy. These symptoms are real and treatable, but their severity cannot be judged from one symptom alone.

Contact a primary-care clinician or mental-health professional and describe changes in mood, worry, sleep, appetite, concentration and daily functioning. Ask someone you trust to help with the appointment or practical tasks if reaching out feels difficult. Keep a simple routine for medication, meals, fluids, personal care and sleep; reduce alcohol and avoid making major decisions while overwhelmed. Treatment may include talking therapy, clinician-guided medicine, practical support, or a combination. Do not stop prescribed medicine abruptly without advice.

Seek urgent help now if you are thinking about suicide or self-harm, have a plan or access to means, cannot keep yourself safe, feel detached from reality, or are unable to care for basic needs. Contact local emergency services or go to the nearest emergency department, and stay with a trusted person while help is arranged. New severe agitation, confusion or several nights without sleep also needs prompt assessment.

Ask how anxiety and depression are being assessed, whether sleep or physical health may contribute, which treatment choices suit you, and how safety will be reviewed. Share any thoughts of self-harm plainly, even if they feel fleeting, and mention alcohol, other substances and current medicines.