The mean number of anxious depression criteria met was 4.7 (SD = 2.1). Only 4.2% (n = 14) of the 332 patients did not meet any anxious depression criterion, and 27.1% (n = 93) met at least one criterion. The combined absolute value of the percentages is very low (0.0%, based on a sample of two patients). This lack of agreement provides strong evidence that anxious depression symptoms are diverse and are likely to vary according to age, sex, ethnicity, and culture. Gender was found to be a significant factor in both frequency and severity of depression, but this finding needs further study. Similarly, race/ethnicity and culture were significant factors in both frequency and severity.
Iontophoresis with the use of isoelectronic or transcranial magnetic stimulation has been found to be effective in controlling several types of anxiety disorders, including obsessive-compulsive and post-traumatic stress disorders. While this technology does not presently treat an anxious depression symptom, it is promising for patients with mild to moderate degrees of depression who are not responding adequately to standard treatments. The treatment is based on the idea that certain areas of the brain, called "neuro circuits" respond more strongly to stimulation than other areas. These areas include the periaqueductal grey matter, basal ganglia, and cerebellum. Treatments using this technology has resulted in improvements in many of these areas.
Neurofeedback therapy has been found to be effective in treating several types of anxiety disorders and anxious depression. The theory behind neurofeedback is that anxious depression is characterized by increased excitability of brain circuits. The increased excitability results in a diminished ability for the brain to effectively coordinate behavior. Neurofeedback provides feedback to the brain and helps to reduce the effect of excitability.
Because anxious depression is often accompanied by co-occurring clinical symptoms, it can complicate the process of obtaining a correct diagnosis. Although co-occurring disorders are common, doctors must be careful to ruled out the possibility that the patient's clinical symptoms are related to a psychiatric illness without a clear anxiety or depression diagnosis. This is important because some co-occurring illnesses have been found to improve when treated.
A family study of anxious depression showed that close relatives, particularly parents, were more likely to suffer from the disorder than non-familial relatives. There is also a strong genetic component to the disorder. Family studies that controlled for family history showed that patients' anxious depression was significantly different from non-familial patients. Psychological family studies that controlled for family history of disorders were also significant in helping to provide a scientific rationale for the disorder.
In addition, anxiety disorders and anxious depression share many symptoms and frequently co-occur with other psychological disorders. Many psychiatrists use a checklist that assesses several possible psychological illnesses including generalized anxiety disorder (GAD), social phobia, and specific phobias. The American psychiatric association has issued a list of psychological disorders that include panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and specific phobias. According to the APA, patients who suffer GAD also experience depression, whereas patients with GAD and specific phobias may not suffer from depression. Other conditions that may co-occur with anxious depression include substance abuse, insomnia, and eating disorders.
Physicians do not always obtain conclusive evidence to support the clinical diagnoses of anxiety and depression. In many cases, medical records are incomplete or unreliable. Because the presence of other illnesses complicates the diagnosis of anxious depression, patients are advised to disclose all other health conditions even if they seem unrelated. Similarly, patients should inform their physicians if they engage in substance abuse or obesity, if they are under any stress, or if they have been involved in any traumatic event.
Another problem with obtaining conclusive evidence to support a clinical diagnosis of anxious depression is the absence of a specific psychological test that might confirm or disprove the diagnosis. Some anxiety disorder patients may suffer from other mental disorders that are manifested by negative emotions. These patients may present different signs and symptoms but might not meet the criteria for an anxiety disorder. Sometimes this can be overlooked as these conditions are often unrelated and thus would not be reflected on standard diagnostic tools. This is the reason why patients should be evaluated carefully for any signs or symptoms that might suggest the presence of anxious depression or other psychological disorders and should be treated accordingly. In addition, in order to avoid a misdiagnosis of depression, it is advisable to discuss any concerns you have with your physician before taking any medications, seeing a specialist, or undergoing therapy.
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