Anxiety disorders are the most prevalent in the general population. After them would be depressive disorders. Traditionally, psychologists have observed that both types of disorders have many elements in common, and it is common for a prolonged anxiety situation to end up generating depressive symptoms and vice versa.

But in a large number of people, characteristics of both depression and anxiety appear simultaneously, and can be classified as cases of mixed anxiety-depressive disorder .

Depression and Anxiety: What They Have in Common

The link between depressive and anxiety problems is a circumstance that is well known to psychological and psychiatric research. In clinical practice, rarely occurs in a pure form , and it is very frequent that depressed subjects end up developing anxiety problems. That is why in research it has been frequent to try to find out in which concrete aspects they are similar and in which ones they diverge.

One of the main elements in common between anxiety and depression is that in both there is a high level of negative affect. In other words, both disorders share the fact that both present a high level of emotional pain, irritability, discomfort and feelings of guilt and low mood.

Another common point is that in both cases people are suffering due to the consideration that they are not, will be or would be capable of facing life or its concrete circumstances, suffering from a deep feeling of defenselessness and presenting low self-esteem.

However, in addition to the high negative effect in depression we would also find a low positive effect, which would not be the case in anxiety. It is what produces anhedonia and lack of energy and vitality. This circumstance does not appear in pure anxiety.

Something specific about anxiety that doesn’t occur in depression (with the exception of some subtypes like the one with psychotic symptoms) is hyperactivity. People with anxiety notice a powerful increase in arousal , a “surge” of energy from the anticipation of possible harm, which they cannot give a practical way out. This does not occur in depression, where a person’s energy level tends to decrease.

These are some of the elements in which depression and anxiety are similar or different . But what happens when both types of problem appear at the same time? What is mixed anxiety-disorder?

Mixed anxiety and depression: what is it?

Mixed anxiety-depressive disorder is a type of disorder characterized by the combined presence of symptoms of both depression and anxiety , with neither having a greater impact than the other.

Typical symptoms of this disorder include depressed mood and/or anhedonia that appear along with distress, difficulty concentrating, tension and excessive, irrational worry . These symptoms should last for at least two weeks or a month and should not be due to painful experiences or the presence of other disorders.

In addition, vegetative symptoms such as tremors, intestinal discomfort or tachycardia should occur at some point.These are symptoms that are consistent with a very high level of negative affect, with the hyperactivity of anxiety disorders and the low positive effect of depressants also appearing in part.

The diagnosis of mixed anxiety disorder

Anxiety disorders are the most prevalent in the general population. After them would be depressive disorders.
Traditionally, psychologists have observed that both types of disorders have many elements in common, and it is common for a prolonged anxiety situation to end up generating depressive symptoms and vice versa.

But in a large number of people, characteristics of both depression and anxiety appear simultaneously, and can be classified as cases of mixed anxiety-depressive disorder .

Depression and Anxiety: What They Have in Common

The link between depressive and anxiety problems is a circumstance that is well known to psychological and psychiatric research.
In clinical practice, rarely occurs in a pure form , and it is very frequent that depressed subjects end up developing anxiety problems.
That is why in research it has been frequent to try to find out in which concrete aspects they are similar and in which ones they diverge.

One of the main elements in common between anxiety and depression is that in both there is a high level of negative affect.
In other words, both disorders share the fact that both present a high level of emotional pain, irritability, discomfort and feelings of guilt and low mood.

Another common point is that in both cases people are suffering due to the consideration that they are not, will be or would be capable of facing life or its concrete circumstances, suffering from a deep feeling of defenselessness and presenting low self-esteem.

However, in addition to the high negative effect in depression we would also find a low positive effect, which would not be the case in anxiety. It is what produces anhedonia and lack of energy and vitality.
This circumstance does not appear in pure anxiety.

Something specific about anxiety that doesn’t occur in depression (with the exception of some subtypes like the one with psychotic symptoms) is hyperactivity. People with anxiety notice a powerful increase in arousal , a “surge” of energy from the anticipation of possible harm, which they cannot give a practical way out.
This does not occur in depression, where a person’s energy level tends to decrease.

These are some of the elements in which depression and anxiety are similar or different . But what happens when both types of problem appear at the same time? What is mixed anxiety-disorder?

Mixed anxiety and depression: what is it?

Mixed anxiety-depressive disorder is a type of disorder characterized by the combined presence of symptoms of both depression and anxiety , with neither having a greater impact than the other.

Typical symptoms of this disorder include depressed mood and/or anhedonia that appear along with distress, difficulty concentrating, tension and excessive, irrational worry .

Psychoeducation is generally used , through which patients are explained the characteristics of their problem, it can be very useful for them to understand what is happening to them and that they are not the only ones suffering from it. Subsequently, both anxious and depressive symptoms are treated, using exposure to avoided situations, breathing and relaxation training, and self-instruction techniques.

In problems of a depressive nature, action is taken involving the subjects in positive and rewarding activities and cognitive restructuring is used to move on to acquire new thinking patterns that are more adaptive than those used up to now. It has also been observed that group therapy greatly helps to improve symptoms and to identify maladaptive thought patterns and change them for others.

At the pharmacological level, the application of SSRIs has been shown to be useful in controlling symptoms by inhibiting the reuptake of serotonin in a specific way and successfully combating both depressive and anxious symptoms.

Bibliographic references:

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
  • Echeburúa, E.; Salaberría, K.; de Corral, P.; Cenea, R. & Barasategui, T. (2000). Treatment of mixed anxiety and depression disorder: results of an experimental investigation. Análisis y modificación de conducta, vol.26, 108. Departamento de Personalidad, Evaluación y Tratamientos Psicológicos. Faculty of Psychology. University of the Basque Country.
  • World Health Organization (1992). Tenth Edition. Madrid: WHO.
  • Santos, J.L. ; García, L.I. ; Calderón, M.A. ; Sanz, L.J.; de los Ríos, P.; Izquierdo, S.; Román, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. Manual CEDE de Preparación PIR, 02. CEDE. Madrid.