Database of diseases - Practical psychiatry and psychogeriatry

Almost all depressed patients experience more or less anxiety .
. He can wake up with them in the early hours of the morning and accompany him until he falls asleep. However, these can also be the waves of this intrusive and paralyzing feeling. It is thought that anxiety and depression are related states almost inseparably. Many psychiatrists treat him in depressions as so-called "Axial symptom". It seems that this connection is very strict indeed. Depression can generate anxiety and this can induce the appearance of depression. The appearance of the person in fear is characteristic, we all know him. If not from our personal experiences, we often encounter a manifestation of fear in films, theater plays, and in art. Such a person is usually shaken, sweaty, in a clear internal tension.


The most common fears are concerns about: Loss of control over their behavior and the possibility of compromising. Loss of job or prestige due to mental failure. Fainting in a public place. Madness. The patient has the feeling that something bad is happening with his mental health, with reason. He has the feeling that he will go crazy in a moment. Death. Some misfortune that will affect him or his loved ones. Possibility to commit suicide.

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 Differentiation between anxiety disorders and depression      .
Differentiation between anxiety disorders and depression already established during the first examination is based on the assessment of the patient's psychopathology picture, his premorbial personality, psychiatric history, as well as on the accurate determination of the personal and social problems preceding the onset of the disorder. Anxiety manifests itself in vegetative stimulation in people with avoidant personality subjected to strong and long-lasting stress. In depression, the dominant symptoms may be dysphoria, guilt and despair in patients facing frustration, loss and grief. .

  
In clinical practice, however, the picture of both disorders is not so easy to separate: Most patients with endogenous depression also suffer from anxiety. About 1/4 of all patients with major depression are anxious. About 1 10 patients suffering from short depressive episodes also have symptoms of anxiety.

    

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Today, depression and anxiety disorders are thought to coexist around one third of patients seeking help for one of these disorders.
 
More than half of the patients suffering from anxiety in the form of cardiac complaints also had depression and anxiety. In practice, family physicians, the coexistence of depression and anxiety disorders becomes even more apparent: data collected from their practice indicate that over three-quarters of panic disorder patients also show some of the depressive symptoms, and quite often they are intensified to a large extent.

   

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. Doctor of Medicine Janusz Krzyżowski
Psychiatrist
Private office tel. 22 833 18 68
00-774Warszawa, Dolna 4 lok. 15

  

    

 

Very often, mixed anxiety-depressive states are encountered

. As part of the practice of doctors of other specialties, very often mixed anxiety-depressive states are also observed: eg gastroenterologists come into contact with the irritable bowel syndrome, whose aetiology draws attention to the somatization of anxiety and depression, whereasin dermatology, many often occurring disorders affecting the aesthetics of appearance, such as eczema, psoriasis and rosacea, cause the appearance of anxiety, shame and depressive reaction associated with an unsightly appearance.

Emergency ambulance doctors also come in contact with the associated anxiety-depressive states that often make differential diagnosis difficult. For the anxious depressive patient in question, ambulance is often called to life-threatening condition: with a preliminary diagnosis of retrosternal pain.
 

In women, the coexistence of various mental disorders is much more common. Not only depression is twice as common in women, but also two to four times more often: anxiety, phobias and panic attacks. Mixed anxiety-depressive disorders typically coexist with many mental disorders associated with the menstrual cycle in women. Premenstrual syndrome, postpartum depression and menopausal depression are syndromes in which there is often agitation and anxiety, helplessness characteristic of depression and many nagging somatic symptoms associated with anxiety.
  
Patients who suffer from panic attacks also have symptoms of depression. One of the possibilities to explain such a frequent coexistence of anxiety-depressive states is the fact that chronic anxiety favors the appearance of discouragement, which in turn predisposes to the occurrence of reactive depression. Another way to explain this phenomenon is to assume that both anxiety and depression are manifestations of a common pathological mechanism.
 
The coexistence of anxiety and depression may finally be coincidental coincidence, because both these disorders are quite common in the population. In everyday medical practice, depression and anxiety coexist in different time configurations: depressive symptoms may occur in the course of ongoing anxiety disorder, major depression may be accompanied by symptoms of increased anxiety or generalized anxiety, or panic attacks may lead to secondary depression. Genetic research and family history show significant connections between the occurrence of anxiety and depression.

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Studies of twins have a significant link between the occurrence of anxiety and depression, which seems to support the hypothesis of a greater bioavailability shared by both disorders. The phenomena described may constitute additional evidence of a common biochemical mechanism underlying anxiety and depression. Also, polysomnographic data can make a significant contribution to understanding the nature of coexisting anxiety-depressive disorders.

In the course of anxiety-depressive disorder, early wake-up is characteristic. For depression, REM phase disorders are characteristic, while joining the anxiety component causes intermittent sleep patterns, with numerous episodes of nocturnal wake, and later with difficult falling asleep, this is clearly visible especially during the first half of the night. These disorders are much more common in women. .

They are often mistaken for a small degree of disorder, with a mild course and good prognosis. The connection between anxiety and depression is not yet fully clear, and a thorough understanding of the interrelationships of the associated anxiety-depressive states requires further observation and research.

 

Doctor of Medicine Janusz Krzyżowski
Psychiatrist
Private office tel. 22 833 18 68
00-774Warszawa, Dolna 4 lok. 15 .