Living With Anxiety And Depression (Mixed Anxiety-depressive Disorder)

All together, coexisting as two dark entities of the same coin: anxiety and depression. Living under the absolute control of these two conditions completely limits the quality of life. Thus, from the field of mental health this reality is well known, since about 60% of people with depression also suffer from an anxiety disorder.

It is not a trivial issue, it is more, the clinical symptoms associated with this type of psychological disorder can become chronic in many cases. Either by not seeking specialized help or by not having a valid and adequate diagnosis, it is common that we find many patients who reach that extreme where suicidal ideation appears.

Irritability, discomfort, anhedonia, a feeling of guilt, negative feelings, hopelessness … The day-to-day life of that person gripped by anxiety and depression is gradually becoming a scene of quicksand where they sink deeper at every moment.

They are very complex situations that require the best assistance, the best therapeutic approaches to respond to a fact that is undoubtedly seen more and more frequently.

Thus, in many of these cases what we have before us is a mixed anxiety-depressive disorder. It is a clinical reality in which various symptoms converge, various characteristics that professionals must identify as soon as possible.

Anxiety and depression in mixed anxiety-depressive disorder

The link between anxiety and depression is well known in the psychological and psychiatric field. Furthermore, experts on the subject, such as David Barlow, director of the Center for Mood Disorders at Boston University, indicates 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 amygdala. In other words, 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 in which we feel helpless and hopeless in turn. However, this inordinate fear in turn causes us to not stop anticipating ideas, to see tomorrow with great anxiety, anguish and despair.

On the other hand, the reason why we develop these conditions or the reason why we are more sensitive to suffering from them would be,  for many experts, a predispositional factor (genetic), 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 the following: if I suffer from anxiety and depression, then do I suffer from some kind of psychological disorder? Well, before this question we must understand that we are all susceptible to experiencing these realities at certain times.

The problem is when these states become persistent and appear together. The clinical manifestations must coexist permanently (more than a month) and to the same degree. In addition, it is necessary that these characteristics appear in turn:

• Concentration problems and memory lapses.
• Constant worry.
• Fatalistic thoughts, pessimism and hopelessness.
• Sleep disturbances
• Anhedonia (lack of motivation, vital drive, energy and spirits …)
• Irritability and constant bad mood.
• Feelings of worthlessness, guilt, low self – esteem ...
• Hypervigilance. Sensation of being always alert, with the feeling that something is going to happen …

• Gastrointestinal disorders.

On the other hand, the most striking thing about this condition is the extreme to which many patients can go : lack of hygiene, social isolation, inability to go to work … Epidemiological data tell us that only 50% of those who suffer from this disorder reach be diagnosed in primary care (either because they do not attend 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 an important one, 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, those where the situation is more serious, the psychological intervention will be complemented with a pharmacological intervention.

Be that as it may, it is best for patients to benefit from a multidisciplinary approach, where they do not exclude, for example, social, care and even psychoeducational aspects. The person with 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, anxiety).
• Relaxation techniques.
• Mindfulness.
• Pharmacological treatment (antidepressants and anxiolytics).
• Psychoeducation: the patient is taught the reality of his situation, letting him know what depression is, what anxiety is and what strategies he can use to treat and prevent it.

Finally, there is only one aspect that can be emphasized. We must bear in mind that many people suffer from anxiety and depression. However, that these appear in the same intensity, shaping the mixed anxiety-depressive disorder, is something more particular that sadly is not always adequately identified. Therefore, let us not hesitate to seek specialized help to always have the best response, attention and guidance.