Many people struggling with depression also struggle with anxiety, which creates a more complex condition known as major depressive disorder with anxious distress. This subtype is also known as anxious depression and is one of the most common forms of major depressive disorder (MDD), affecting between 40-60% of individuals diagnosed with depression.
Major depressive disorder (MDD) is a serious mood disorder that affects how a person feels, thinks, and interacts with the world. It’s characterized by a persistent sense of despair and a loss of interest in once-enjoyable activities.
MDD is one of the most widespread mental health conditions, affecting almost 300 million people worldwide and ranking among the leading causes of disability. As research continues to evolve, experts are uncovering the ways MDD presents in different people, including a subtype known as major depressive disorder with anxious distress. This type of MDD involves increased levels of anxiety and adds on even more emotional and cognitive challenges.
MDD with anxious distress differs from non-anxious depression in several ways. Studies show that those with this subtype face a higher risk of severe symptoms and poorer outcomes. Differences include:
Major depressive disorder with anxious distress includes both core symptoms of depression and increased anxiety-related symptoms. The combination of these symptoms can result in greater emotional turmoil and difficulty coping with stress.
Per the DSM-5-TR, MDD is diagnosed when a person experiences at least five symptoms over a two-week period, with at least one being depressed mood or loss of interest or pleasure. These symptoms include:
These symptoms cannot be due to substance use or another medical condition and must interfere with work, relationships, or daily responsibilities.
The anxious distress specifier is applied when an individual experiences at least two of the following symptoms on most days during a major depressive episode:
The severity of anxious distress is categorized based on the number of symptoms present:
While effective treatment options are available, they may require longer adjustment periods or a combination of approaches to achieve the best results. Psychotherapy, medications, and transcranial magnetic stimulation (TMS) are among the most common treatments for MDD with anxious distress.
Cognitive-Behavioral Therapy (CBT) is a go-to therapy for many people struggling with MDD with anxious distress. It helps individuals identify and challenge irrational thoughts, change negative self-perceptions, and develop healthier coping skills for depression and anxiety.
By addressing distorted thinking patterns and managing anxiety triggers, CBT can reduce symptoms over time. Research has shown that those undergoing CBT experience a significant decrease in depression, anxiety, and stress levels.
Medications can also be used to treat MDD with anxious distress as they help regulate mood and reduce excessive worry. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are first-line treatments used for MDD and anxiety disorders.
SSRI and SNRI medications increase serotonin and/or norepinephrine levels in the brain. Pregabalin, though mainly used for nerve pain and epilepsy, has also shown effectiveness in treating anxiety-related symptoms.
For those who do not respond to first-line medications, second-line medications may be considered:
Since treatment response can vary, medication selection is usually individualized, and adjustments may be required to find the most effective regimen with the fewest side effects.
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, FDA-approved treatment for depression that uses magnetic pulses to stimulate specific areas of the brain that are involved in mood regulation. Unlike medication that affects the entire body, rTMS directly targets the prefrontal cortex, which is often underactive in those with MDD.
rTMS is especially beneficial for those who have not responded well to antidepressants or therapy. It doesn’t require anesthesia, has minimal side effects, and allows patients to go about their day immediately after a treatment session. Sessions are usually done a few times per week for several weeks with results gradually improving over time.
Research shows that rTMS can also provide relief for individuals with MDD and anxious distress. A study found that patients undergoing rTMS experience an average reduction of 50% or greater in both Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scores.
At Cura Behavioral Health, we specialize in evidence-based care that’s customized to your unique needs. Whether you’re struggling with anxiety, depression, or both, our team is here to help you explore your treatment options and develop a plan that works for you. Reach out today to learn more about our mental health services.
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
Join our newsletter to stay up to date on features and releases.
By subscribing you agree to with our Privacy Policy and provide consent to receive updates from our company.
Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
