By Susan Warren, LCSW

Depression and anxiety are often thought of as opposites, and they can be, however, they also co-exist in this odd state of dis-harmony. Sometimes we characterize depression as sadness and anxiety as worry or fear. Social anxiety disorder and major depressive disorder often occur together and are two of the most common mental health disorders.1


Our mindset determines our perceptions and our bias’, think of this as a pair of sunglasses we put on before entering the world: only sometimes are we aware of the sunglasses. Social anxiety is associated with greater levels of self-blame for stressful events, attempts to reduce discomfort in social situations through safe behaviors (think of social withdrawal and limited self-disclosure), and minimized rejection opportunities.2 Researchers hypothesize for some, the negative detriments of social anxiety disorder can exacerbate the effects of depression. Essentially social anxiety and depression are reciprocal, deceivingly communal, and ultimately feed off one another, leaving us in a belief point: maybe everyone just hates us? The issue is, that our brain does not take all of this into account. We don’t know when we are impacted by the blue-hue of our social anxiety/depression sunglasses.


Potentially one of the more disheartening ‘which came first- the anxious chicken or the depressed egg’? The relieving news for the chicken and the egg, is that right now it doesn’t truly matter which came first, because at the end of the day, neither the chicken or the egg is comfortable in this existence. You’re probably thinking “okay Susan- how does one get out of this cycle??” The short answer: through working to create a new cycle.


First, acknowledge that awareness is the (potentially painful) thing needed to be different.  Along with a mental health care practice such as sleeping well, eating well, hydrating appropriately, remaining connected to our communities, meeting with professionals as needed, we also practice mindful self-compassion.3 Self-compassion sometimes is referred to as loving-kindness.  Researchers in Australia studied the effects of self-compassion on shame within relationships, something that anxiety and depression can impact. Findings demonstrate reduced strength in shame due to anxiety and depression and that self-compassion can be an effective emotion regulation strategy. It takes time and effort to care for ourselves, we live busy lives.


Lao Tzu is quoted with “If you are depressed you are living in the past. If you are anxious you are living in the future. If you are at peace you are living in the present.” Mindfulness is beneficial in the treatment of anxiety and depression. There is evidence that shorter practices (~5 minutes) is just as significant, if not more beneficial for those beginning a mindfulness practice.4 I included a short loving-kindness meditation if you’d like to practice, if not maybe save this post to reference another time. 
 How does one untie a knotted rope? Through patiently and persistently working what works. If you find yourself at a place of needing extra support or wanting to explore these themes further, please reach out!


Cardinal Counseling is here for you! You can call us at (501) 408- 3431 or e-mail

Loving Kindness Meditation

Sit comfortably on a cushion or a chair with your back straight. (If sitting is physically difficult, feel free to lie down instead.) Take note of being present in your body and your environment. Breathe. Take your time. Notice how your body accommodates each breath.
Turn your focus to the heart. It can help to place your hand over your heart.

Call to mind a person (or pet) of past or present who has steady love and unconditional acceptance of you. Imagine they are right near you, happy for your presence and grateful for you just as you are.

Relax into this feeling of connection.

Allow thoughts to arise and evaporate, similar to your breathing, and come back to the heart.
Now put this lovingkindness and warmth that you are receiving into words. If helpful, you can imagine that these kind thoughts are what the person (or animal) you’ve called to mind wants for you and picture that they are wishing them with you.

Here’s one example: (you will repeat these a few times, eventually I stop listing them.)

May I be happy and safe.

May I be healthy in body and in mind.

May I always have enough.
May my heart know peace.
Repeat the wishes at least three times, out loud or in your mind.

Next, bring to mind someone who means a lot to you, someone in whose presence you can relax and be fully appreciated for who you are. Feel the goodness of this heart connection, feel your mutual gratitude. Offer this person well wishes.

May I be happy and safe.

May I be healthy in body and in mind.

May I always have enough.

May my heart know peace.

Repeat the wishes at least three times, out loud or in your mind.

Next, bring to mind someone you’ve met casually, someone you recognize but don’t really know. A school crossing guard, the person who manages the produce department at your grocery store, a neighbor you see taking out their trash. As you think of them, wish them well.

May they be happy and …

(The next step is traditional, but if you do not want to, or it’s challenging for you, you can skip it. It’s recommended to start with a low-level conflict person and work up to someone who has caused direct harm or malice.)

Now, imagine someone you experience conflict with, maybe someone difficult to be kind towards. Observe what occurs in your body and thoughts. As you evoke them in your mind’s eye, try to let go of your antipathy.

May I be happy and …

Finally, think of your community, include as many people and possibly even animals as you can in your wishes. Happy or sad, loved or neglected, in good health or in poor health, in all stages of life. Without making a particular effort to envision them separately, simply maintain awareness of the presence of all of these beings who share your planet and send them your wishes with a sincere and tender heart.

May we be happy and …

Now return to awareness of being present in your space, connected to all of these beings through your wishes. Maintaining this sense of presence to your best ability, simply sit.

As you end this time with yourself, gently bring your awareness back to your physical surroundings- looking at the four corners in the room you’re in, wiggling your fingers and toes, and slowly stretching your body.

1. Wong J, Morrison AS, Heimberg RG, Goldin PR, Gross JJ. Implicit associations in social anxiety disorder: the effects of comorbid depression. J Anxiety Disord. 2014 Aug;28(6):537-46. doi: 10.1016/j.janxdis.2014.05.008. Epub 2014 Jun 14. PMID: 24983794; PMCID: PMC4134987.

2. Goodman, F. R., Birg, J. A., Daniel, K. E., & Kashdan, T. B. (2023). Stress generation in social anxiety and depression: A two-study community assessment. Journal of Affective Disorders, 329, 285-292.

3. Callow, T. J., Moffitt, R. L., & Neumann, D. L. (2021). External shame and its association with depression and anxiety: The moderating role of self-compassion. Australian Psychologist, 56(1), 70-80.

4. Maddock, A., & Blair, C. (2023). How do mindfulness-based programmes improve anxiety, depression and psychological distress? A systematic review. Current Psychology, 42(12), 10200-10222.