The depressive and anxiety disorders they have many parameters in common, so much so that a prolonged anxiety situation may end up leading to a depressive disorder.
However, there have been multiple cases in which they present symptoms of both disorders, thus developing what is called mixed anxiety-depressive disorder.
Mixed anxiety-depressive disorder concurs with the presence of both types of symptoms, both depression and anxiety, without one having more repercussions than the other, without one being more serious than the other or appearing at the same time..
Cognitive triad: negative vision of himself, the world and the future. People feel that they are not, nor will they be able to cope with life events, suffering from what is called "learned helplessness" and low self-esteem..
To determine that this symptomatology has sufficient characteristics to be considered a disorder, a significant deterioration in the social, work or other areas of the life of the person suffering from it.
The duration of the symptoms must be at least 2 weeks or a month, not related to another disorder, substance use or a painful life event.
TO psychophysiological level Symptoms such as tremors, tachycardia, palpitations, dry mouth, epigastric discomfort, etc. may occur, which are probably present intermittently during its course.
These vegetative symptoms are usually the reason why the person goes to the doctor. In these cases, action in primary care centers and specifically the sensitivity of the doctor to detect such disorders and initiate the corresponding procedures and procedures is very important..
An early detection and correct treatment of the disorder can prevent its chronification.
Aspects in common between depressive and anxiety disorders: negative affect, emotional pain, irritability, malaise, feelings of guilt, and low mood.
Differential aspects: in depression the subject, apart from having a negative affect, will show a low positive affect, a fact that does not occur in patients with anxiety.
On the other hand, people with high levels of anxiety experience a rise in arousal (or physiological activation) due to concerns about possible dangers in the present, the future and repetitions of the past, a factor that is not present in depressive disorders characterized by a total state of anhedonia.
Unlike the benchmark anxiety and depression disorders, the mixed anxiety depressive disorder tends to have lower levels of anxiety than generalized anxiety, has less severity of depressive symptoms than patients diagnosed with depression and less psychophysiological activation than in panic disorders, as well as a higher frequency of appearance of the symptoms specified above.
The coexistence of both disorders on a regular basis is very common. Some researchers confirm that its prevalence in primary care is very high, being around 10% in the general population. and in affected population of up to 50%.
In current diagnostic manuals such as the DSM (Diagnostic and Statistical Manual of Mental Disorders) it is not listed as a single disorder but rather is usually presented as a derivation of depressive disorder including characteristics of anxiety disorders. However, in the ICD-10 and ICD-11 if it is collected as a differentiated disorder.
According to scientific evidence and literature in this regard, there are several types of causes that can develop the presence of this disorder in the person:
Possible causes
Emotional factors
Labor and social factors: The demands of today's society, work stress, mobcing, and a long etcetera, can be decisive in the development of this type of disorder.
Several studies have been carried out in reference to the treatments with the best results for mixed disorder, concluding as a result that the application of the cognitive behavioral therapy is the most appropriate in these cases, applying to the symptoms of both disorders separately.
The group therapy it has also been shown to be effective.
First we must investigate the previous psychiatric history. If there are previous diagnoses of depression or anxiety, consider maintenance or relapse treatment of the disorder in question.
On the other hand, we must consider the possibility of other disorders in the absence of previous diagnoses before decreeing the mixed anxiety-depressive disorder. If it presents characteristics of both disorders separately, make a double diagnosis and, if this is not possible, we must prioritize depressive disorder.
Cognitive behavioral therapy consists of evaluating and treating the disorder by analyzing both the behaviors that the subject emits and addressing them through different techniques as well as the erroneous and limiting beliefs product of a mainly negative thought towards oneself, the future and the world.
Treatment scheme
Treatment should be tailored to the severity, duration of symptoms, and previous experience with other similar disorders. As we mentioned previously, treatments such as cognitive behavioral therapy have proven their effectiveness as well as others such as introspection psychotherapy, group therapy, or brief therapy techniques (for ruminations).
The pharmacological treatment of choice in case of not having results with psychological therapy, will be with anxiolytics, antidepressants or both.
If it is not treated in time, it can become chronic. As we have indicated previously, if an approach is carried out through cognitive behavioral therapy, it can be stopped in time and a psychopharmacological intervention may not be necessary..
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