People living with depression or bipolar disorder are also likely to have significant problems with anxiety, both diagnosed and undiagnosed, according to an online survey conducted by the Depression and Bipolar Support Alliance (DBSA). The nation's largest patient- run organization focusing on two of the most prevalent mental illnesses conducted the survey to mark National Anxiety and Depression Awareness Week, May 6-12. The survey of nearly 800 people with depression or bipolar disorder reveals telling indicators that reinforce a strong relationship between anxiety and mood disorders, a fact not unknown to mental health researchers and clinicians, but nevertheless important for people living with these common conditions to fully understand. According to the National Institute of Mental Health (NIMH), approximately 24 million Americans live with a diagnosed mood disorder while 40 million American adults are diagnosed with an anxiety disorder. Most people deal with anxiety on some level from time to time, but anxiety disorders are characterized by prolonged periods (at least six months) of exaggerated worry and fearfulness that keep people from doing things most others take for granted. Common anxiety disorders include generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD) and social phobias. Eighty-seven percent of survey respondents said they either had a diagnosed anxiety disorder or an undiagnosed problem with anxiety. Those findings echo the Bipolar Genetics Initiative study conducted by NIMH in 2006 that found more than 90 percent of people with panic disorder also had some form of depression or bipolar disorder. Respondents with both depressive and anxiety diagnoses cited generalized anxiety disorder (68%), panic disorder (57%) and PTSD (30%) as the most common anxiety conditions. Since some people are diagnosed with more than one anxiety disorder, the survey allowed for multiple answers. Seventy-three percent of respondents reported that their anxiety and mood disorders were related, with 43 percent saying their anxiety worsened their depressive illness and 30 percent reporting the opposite. "For people living with our illnesses it's important to manage stress and anxiety," said DBSA president Sue Bergeson. "Whether we have a diagnosed anxiety disorder or not, it's imperative that we develop and adhere to wellness plans and strategies that minimize stress so that we are living full, happy and productive lives with the goal of full and sustained recovery." When asked about potential triggers that worsened their anxiety, survey respondents most commonly cited disrupted sleep patterns (57%), stressful social situations (51%) and being in crowded areas (43%). Other anxiety inducing situations included workplace pressures, familial problems and special occasions, such as holidays and birthdays. While less than half of respondents (43%) expressed confidence that their medications and/or treatment plans were effective in helping manage anxiety, they were quick to acknowledge that medication was the most important thing they did to treat their conditions. Nearly three quarters (72%) of respondents said taking medication was the best way to alleviate their symptoms. Other helpful activities cited included sleep or rest (56%) and talk therapy (40%). The findings from the survey reinforce much of the research done on the relationship between anxiety and mood disorders. Monitoring sleep patterns and being aware of the types of social situations that induce stress and anxiety are good ways of managing the illnesses, Bergeson suggested. "We can't view or treat these illnesses separately; we need to take a holistic approach so that we are addressing anything and everything that impedes recovery," she added. "Medication and therapy may be only part of the equation; many people are relying on peer-led support groups, mood trackers, journaling and other types of techniques and strategies to achieve wellness." For more information on mood and anxiety disorders, visit