Mixed anxiety–depressive disorder

Mental health disorder

Mixed anxiety–depressive disorder (MADD) is a mental health condition characterized by the simultaneous presence of both anxiety and depression symptoms, without one set of symptoms clearly predominating over the other. This disorder is recognized in the International Classification of Diseases (ICD-10) but not in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Symptoms

Individuals with mixed anxiety–depressive disorder experience a combination of symptoms from both anxiety and depressive disorders. Common symptoms include:

• Persistent feelings of sadness or hopelessness
• Excessive worry or fear
• Fatigue or low energy
• Difficulty concentrating
• Irritability
• Sleep disturbances, such as insomnia or hypersomnia
• Changes in appetite
• Physical symptoms such as headaches or stomachaches

Diagnosis

The diagnosis of mixed anxiety–depressive disorder is made when a person exhibits symptoms of both anxiety and depression, but does not meet the full criteria for either an anxiety disorder or a depressive disorder alone. The symptoms must cause significant distress or impairment in social, occupational, or other important areas of functioning.

Causes

The exact cause of mixed anxiety–depressive disorder is not fully understood, but it is believed to result from a combination of genetic, biological, environmental, and psychological factors. Stressful life events, such as trauma or loss, can trigger or exacerbate symptoms.

Treatment

Treatment for mixed anxiety–depressive disorder typically involves a combination of psychotherapy and pharmacotherapy.

Psychotherapy

Cognitive behavioral therapy (CBT) is commonly used to help individuals identify and change negative thought patterns and behaviors. Other therapeutic approaches may include interpersonal therapy and mindfulness-based therapy.

Pharmacotherapy

Medications such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) may be prescribed to help manage symptoms. The choice of medication depends on the individual's specific symptoms and medical history.

Prognosis

The prognosis for individuals with mixed anxiety–depressive disorder varies. With appropriate treatment, many people experience significant improvement in their symptoms. However, some individuals may have a chronic course and require long-term management.

Related pages

• Anxiety disorder
• Major depressive disorder
• Bipolar disorder
• Generalized anxiety disorder

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