All together, coexisting like two dark entities of the same coin: anxiety and depression. Living under the absolute dominance of these two conditions completely limits the quality of life. Thus, from the field of mental health, this reality is well known, since nearly 60% of people with depression also suffer from an anxiety disorder.
It is not a trivial matter the clinical symptoms associated with this type of psychological disorder can become chronic in many cases. Whether due to not seeking specialized help or not having a valid and adequate diagnosis, it is common to find many patients who reach that extreme where suicidal ideation appears.
Irritability, discomfort, anhedonia, feelings of guilt, negative feelings, hopelessness… The daily life of a person gripped by anxiety and depression gradually becomes a scenario of quicksand where they sink deeper with every moment.
These are very complex situations that require the best assistance and the best therapeutic approaches to respond to a situation that is undoubtedly seen with increasing frequency.
In many of these cases, we are dealing with a mixed anxiety-depressive disorder. This is a clinical reality in which various symptoms and characteristics converge, which professionals must identify as soon as possible.
“Our greatest glory is not in never falling, but in rising every time we fall.”
-Confucius-
Anxiety and depression in mixed anxiety-depressive disorder
The link between anxiety and depression is well-known in the psychological and psychiatric fields. Experts in the field, such as David Barlow, director of the Center for Mood Disorders at Boston University, tell us that even from a neurobiological point of view they seem to share the same processes.
Studies, such as the one carried out at Emory University (Atlanta, United States), are revealing. Both realities would have their origin in our brain’s amygdala. That is to say, this structure in which our “fear center” is located is sometimes too reactive. This means, for example, that any event or stimulus is experienced disproportionately, accompanied by very intense negative emotions.
With depression, our reality is frozen. Suspended in a state of feeling helpless and hopeless at the same time. However, this excessive fear causes us to continue to anticipate ideas and to see tomorrow with great anxiety, anguish, and despair.
On the other hand, the reason why we come to develop these conditions or the reason why we are more susceptible to suffering from them would be, for many experts, a predisposition (genetic) factor, which would be added to the context that may surround us and our lack of tools when facing various circumstances.
What are the symptoms of mixed anxiety-depressive disorder?
The first question that may come to mind is: if I suffer from anxiety and depression, do I then suffer from some kind of psychological disorder? Well, in light of this question, we must understand that we are all susceptible to experiencing these realities at certain times.
The problem arises when these states become persistent and appear together. The clinical manifestations must coexist permanently (more than one month) and to the same degree. In addition, the following characteristics must also appear:
- Concentration problems and memory lapses.
- Constant worry.
- Fatalistic thoughts, pessimism, and hopelessness.
- Sleep disturbances.
- Anhedonia (lack of motivation, vitality, energy, and spirit…)
- Irritability and constant bad mood.
- Feelings of worthlessness, guilt, low self-esteem…
- Hypervigilance. A feeling of always being on alert, with the feeling that something is going to happen…
- Gastrointestinal problems.
On the other hand, the most striking thing about this condition is the extreme to which many patients can reach: lack of hygiene, social isolation, inability to go to work… Epidemiological data tell us that only 50% of those who suffer from this disorder are diagnosed in primary care (either because they do not go to or because they are not referred to specialized professionals).
How is mixed anxiety-depressive disorder treated?
The therapeutic approach depends on many variables, but if there is one that is important, it is the personal reality of each patient. There will be those who present mild symptoms and therefore benefit from a psychological approach. In other cases, in those where the situation is more serious, the psychological intervention will be complemented with pharmacological intervention.
In any case, patients should benefit from a multidisciplinary approach, which does not exclude, for example, social, care, and even psychoeducational aspects. A person with a mixed anxiety-depressive disorder needs as much support as possible. These would therefore be the most common strategies:
- Cognitive-behavioral therapy (aimed at cognitive restructuring, reducing hypervigilance, fear, and anxiety).
- Relaxation techniques.
- Mindfulness.
- Pharmacological treatment (antidepressants and anxiolytics).
- Psychoeducation: the patient is taught the reality of his or her situation, letting him or her know what depression is, what anxiety is, and what strategies he or she can use to treat and prevent it.
Finally, there is only one aspect to be mentioned. We must bear in mind that many people suffer from anxiety and depression. However, the fact that these appear with the same intensity, giving rise to mixed anxiety-depressive disorder, is something more particular that is sadly not always identified adequately. Therefore, we should not hesitate to seek specialized help to always have the best response, attention, and guidance.
All sources cited were thoroughly reviewed by our team to ensure their quality, reliability, timeliness, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
- Bobes García, J. (2001). Anxiety disorders and depressive disorders in primary care. Barcelona, etc.: Masson.
- Echeburúa, E.; Salaberría, K.; de Corral, P.; Cenea, R. & Barasategui, T. (2000). Treatment of mixed anxiety and depression disorder: results of an experimental study. Behavior Analysis and Modification, vol.26, 108.
- Vallejo Ruiloba, Julio (1999) Affective disorders: anxiety and depression. Masson