Depressive anxiety

Sometimes anxiety and depression coexist and this type of bond can manifest itself in different ways and courses. It often happens that a person who initially suffers from anxiety develops, at a later time, mood disorders up to real forms of depression.

In other cases, the opposite happens: partially treated forms of depression can result in an anxiety syndrome.

When anxiety and depression occur at the same time, different terms are used to describe this mixed situation, including depressive anxiety, depressive anxiety syndrome or even anxious depression.

What is anxiety

Even before pathological anxiety, there is physiological anxiety, which allows us to react to situations of imminent danger. Instead, we speak of generalized anxiety disorder when the subject lives in a tendentially constant anxious state that leads to disproportionate and incongruous concerns in different areas of the patient’s life. Those who suffer from generalized anxiety disorder tend to be constantly on alert, to worry excessively about everything, highlighting over time a significant reduction in quality of life. Compared to other psychiatric conditions such as social phobia or panic attacks, which are often attributable to specific and circumscribed concerns, in generalized anxiety the concerns do not concern a specific theme, but are extended to the different areas of the patient’s life.

Typical symptoms are:

• restlessness or constant psychic tension
• feeling of emptying and chronic fatigue
• fatigue in concentration resulting in reduced memory
• easy nervousness and irritability
• chronic muscle tension that can concentrate in the limbs, neck muscles, back and generate pain
• difficulty falling asleep and maintaining sleep, or restless and non-restorative sleep.

In addition, physical symptoms such as gastrointestinal disorders, sweating, muscle tension, headaches etc. are also generally present.

What is depression

Depression can manifest itself in different forms (such as bipolar depression or dysthymia, a mild chronic depressive form), in which biological, psychological and social factors intervene differently.

In general, depressive disorder is not the consequence of a specific event, but derives from its interaction with an individual vulnerability. Depression should not be confused with the sadness or demoralization that we all experience in occasional and short-lived situations, as can happen with other moods such as anxiety, happiness or fear. Depression is a real disease in which the way we perceive ourselves and the world around us changes. Depressed subjects lose the pleasure of existence, lose interest and vital drive, have mood on the ground all day, every day, do not know how to move forward and have thoughts of death. The general malaise is accompanied by many other disorders: ranging from loss of appetite and therefore weight, without having put yourself on a diet, to its significant increase; from insomnia to hypersomnia; from agitation to physical and mental slowdown. Years (on average two) can pass between the first symptoms and the diagnosis and therefore the beginning of the therapies.

What is depressive anxiety

When anxiety and depression overlap and coexist, there is a picture of depressive anxiety or anxious depression, which requires careful psychological and / or psychiatric evaluation to be framed and therefore identify an optimal treatment. Those who suffer from it can feel sad, apathetic and without vital drive and at the same time be anxious, always tense and restless.

There are various theories about the association between anxiety and depression. In most cases, as statistics suggest, initially anxious patients may also develop depressive symptoms over time. In these cases, depressed mood could be a consequence of anxiety.

Rarely, however, the opposite can also happen, that is, that a depressed patient can develop a form of anxiety. Generally in these cases these are patients on therapy in which anxious symptoms may remain.

There are also those who argue that anxiety and depression are simply two independent and coexisting disorders. According to this theory, depressed patients and anxious patients have different characteristics regarding personality, prognosis, social adaptation and ability to respond to treatment.

As for the possible causes, both biological and environmental factors would be involved. Possible risk factors include traumatic episodes, states of poverty, genetic predisposition for mental illness and lack of social relationship.

Symptoms of depressive anxiety

Anxious-depressive syndrome is characterized by a combination of anxious and depressive symptoms. As already mentioned, the main ones are difficulty concentrating, a sense of “empty head”, feeling of fatigue or low energy, hypervigilance, worry, ease of crying, tendency to negative predictions for the future, hopelessness, low self-esteem or feelings of self-loathing.

These symptoms are also accompanied by more or less relevant physical disorders, including gastrointestinal disorders, musculoskeletal pain, dry mouth, tachycardia, tremors, dizziness and sleep disorders.

This symptomatology causes considerable discomfort, with the risk of compromising in a more or less significant way social, family, work life, etc. The lack of desire to carry out any activity, sadness and low self-esteem, in fact, make it difficult not only to carry out professional activities, but can also put a strain on relationships with others and in the youngest performance at school. This condition can also cause further consequences, such as substance abuse.

How to deal with depressive anxiety

Recognizing an anxious depressive syndrome is not always easy, especially when the manifestations are apparently mild, but no less disabling if not treated adequately. This is what typically happens in so-called “below threshold disorders” or in cases of depression characterized by mainly physical symptoms (alterations in sleep and appetite, dizziness, musculoskeletal pain, stomach ache, headache, etc.).

To be able to bring these mixed forms to light, it is important that the family doctor sees their presence and refers the patient to a specialist to identify the most suitable treatment.

Anxious depression can only be cured through proper diagnosis and therapy. The first step to getting out of anxious depression is therefore to recognize that you have a problem and ask for help.

How to cure depressive anxiety

When a person is depressed and / or anxious, a simple effort of will is not enough to feel better and avoid the reproduction of a negative attitude. The individual patient, with its nuances, must be framed carefully, and then personalize the treatment. The tools available include psychotherapy, cognitive behavioural therapy, psychosocial interventions as well as a wide range of drugs that act at different levels.

The choice of therapy depends on the severity of the anxiety depressive syndrome. In the subthreshold and mild forms, the psychological approach and behavioral interventions are often effective and sufficient, while in the most severe forms it is also necessary to intervene with drugs, choosing the right molecule for each patient.

Benzodiazepines are very useful anxiolytic drugs to counteract sudden anxiety attacks, but they do not represent the long-term therapy of choice for disorders characterized by chronic anxiety. Antidepressant drugs are the most suitable treatment for mood disorders, but they are also often used to treat various anxiety states such as obsessive compulsive disorder, panic disorder, phobias and, more recently, generalized anxiety disorder, a pathology often associated with depression.

Once a drug therapy has been started, however, it must always be taken into account that, sometimes, it can take even a few weeks to have effects. A fundamental prerequisite for a good response to therapy is however that the patient follows it constantly and undergoes periodic checks.

During therapy, it is also important to review the patient’s lifestyle if you want to achieve 360-degree results on his health. In particular, regular physical activity, a healthy and balanced diet, and possibly the practice of relaxation techniques, yoga or meditation to reduce stress, are all measures that can help improve the mood and well-being of the patient. Among the useful tips also learn not to overload mind and body on too many fronts, as in the typical case of women who are at the same time workers, mothers of families and wives.

To alleviate some symptoms, always on the recommendation of the doctor, natural remedies that promote sleep or rest, such as preparations based on valerian, passionflower or melatonin, can also be used. Equally important are social relationships, trying instead to avoid bad habits such as alcohol and drugs that can complicate an already serious and difficult picture.