For me it is all a mixed bag in recent years. I never used to get anxiety but since five years ago I started getting it bad. For me the anxiety for sure causes paranoia and I get that sense of impending doom. I can't really say if the depression causes it or not. It is worse when I am severely depressed. Thank god the anxiety has been under control with klonopin for the last six months and I have not had any. I still get the depression but with just mild anxiety. That sense of impending doom and paranoia I am well familiar with but it seems to just come out of no where. It is not based on reality at all.