Coping with Mixed Anxiety Depressive Disorder

Mixed Anxiety Depressive Disorder (MADD) may result from a genetic predisposition or environmental and psychological factors, writes Dr Vihan Sanyal

Can someone feel restless and sad at the same time? Have they been feeling this way for over a month? Can a person feel this way without any particular trigger or reason? The answer is a yes and it hints towards a condition called Mixed Anxiety Depressive Disorder (MADD). This condition though differs from a diagnosis of anxiety disorder and depression. Even clinicians at times tend to lean more towards a singular diagnosis of either anxiety or depression and not MADD. Here’s a look at some of the features of MADD.

When a person has both symptoms of anxiety and depression in almost equal proportions and when neither of the disorders is predominant in nature, he/she is diagnosed with MADD. The symptoms should not be severe enough to warrant a separate diagnosis of either anxiety or depression. In addition, the person must also have some physical symptoms of panic or gastric disturbances. These physical symptoms are known as autonomic features of the condition. Autonomic features are caused by a hyperactive nervous system.

The symptoms are chronic in nature, last for a minimum of four weeks and must have four of the following symptoms: sleep disturbance, irritability, trouble concentrating, being forgetful, crying for little or no reason, worrying, expecting the worst to happen, feeling hopeless, feeling worthless, pessimistic. Anxiety and depression often go hand-in-hand. People who have anxiety have a higher chance of depression. On the other hand, more than 50% of people who have depression also have symptoms of anxiety. The slightest things can trigger anxiety and depression. The symptoms of anxiety and depression are not a result of other medical conditions, from drug use or side effects of other medications. The reason for Anxiety-Depressive Disorder is not known. It may result from a genetic predisposition or environmental and psychological factors. For example, a person who has a relative with anxiety or depression is more likely to suffer from this condition. If they have recently gone through a major life-altering situation (financial crisis, difficult relationship, loss of job, loss of a loved one) or if they have been a victim of physical or sexual abuse, then they can experience symptoms of anxiety and depression. Other contributing factors include lacking the support of friends and family members, having been a victim of childhood bullying and trauma, being in a toxic relationship, having low confidence, distorted self-image, suffering from chronic illness.

Anxiety and depression are the two most common mental health disorders globally. It is a co-occurring condition, however, mild anxiety mixed with mild to moderate depression is not as common as cases of high anxiety and depression or moderate to high depression with symptoms of anxiety. In most cases, early interventions of counselling and therapy can help a person manage the symptoms of MADD. Most people are effectively able to manage the symptoms without it spiralling into full-blown anxiety or a depressive disorder.

Testing

Both anxiety and depression have mild, moderate and severe stages. There are psychometric tests available for anxiety and depression. It is best to consult a mental health professional and get the tests administered and checked by them rather than attempting a test online.

Treatment

Counselling & psychotherapy: Talk therapy, CBT, REBT, Hypnotherapy are some options and modalities which continue to help people with MADD. Mild to moderate cases of anxiety and depression can effectively be treated and managed with counselling and psychotherapy alone.

Medication: There are many anti-depressant medicines that also help control symptoms of anxiety. Not all treatments are long term. Do speak with a mental health professional who can assess the condition and suggest the best course of treatment.

Yoga & meditation: Yoga, meditation, mindfulness and breathing techniques are all excellent ways of de-stressing and relaxing. They also help in increasing neurochemicals like serotonin and dopamine which are like natural anti-depressants.

(The author is a psychotherapist.)