Many people with anxiety also suffer from clinical depression. For some people the misery of anxiety is the cause of their depression, but for others the depression comes first, and anxiety is a secondary effect of the depression.

Depression is not just a case of feeling low, or of needing to cheer yourself up. Clinical depression is an illness. Here is a list of symptoms ((you are unlikely to experience all of them):

• depressed mood most of the day, nearly every day
• tiredness. No energy
• feeling guilty, feeling worthless, blaming yourself
• taking no pleasure or interest in your usual activities
• problems with memory or concentration
• changes in appetite and sleeping pattern
• withdrawal from people and social activities
• restlessness
• irritability and anger
• feeling pessimistic and hopeless
• thinking about death, or contemplating suicide.

Mild depression can be treated through self-help – exercise is particularly helpful. More severe depression will need help from your doctor, in the form of anti-depressant tablets or visits to a counselor.

If you have depression, whatever has caused it, you will have to decide whether to work on the depression before you turn your attention to your Anxiety. The key is to examine your motivation and your energy levels. Depression saps both, and without them self-help can be very difficult.

This decision is complicated by the fact that you are bound to feel a bit daunted at the start of a self-help program – the journey seems so long, and the ultimate goal of recovery so very unobtainable.

I suggest that you don’t think at all about the ultimate goal at the moment. Just think about the next step. It will be a small step, because that’s how self-help works – small, steady, well-planned steps. If you think you have the energy and motivation for this, then self-help for your Anxiety is worth trying. If you can’t face even the smallest step, then turn your attention to your depression before you tackle your Anxiety.