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Mixed Anxiety Depressive Disorder

7 Major Causes of Mixed Anxiety Depressive Disorder

Writen By: Sadia Mirza
Reviewed By: Huma Khan
Publish Date: February 27, 2024

Ever felt like you’re carrying around a big cloud of worry and sadness, but you’re not sure why? That feeling where it’s like you have two unwanted guests in your mind, causing chaos? Well, that’s what we call “Mixed Anxiety Depressive Disorder”.

Research says that about 284 million people suffer from anxiety disorders and 264 million people suffer from depression worldwide. Both anxiety and depression are prevalent issues around the world and also occur together in the form of Mixed Anxiety Depressive Disorder.

In this blog post, we’re going to break down everything you need to know about Mixed Anxiety-Depressive Disorder. We’ll talk about what it is, the signs to look out for, and why it happens in the first place. Plus, we’ll dive into some tips and tricks to help you manage it better.

So, grab a comfy seat, and let’s dive in! And hey, stick around till the end because we’ve got some great self-help book recommendations that might just change your life.

What is Mixed Anxiety Depressive Disorder?

So, you might want to know what exactly Mixed Anxiety Depressive Disorder, or MADD, actually is. But before we dive into that, let’s talk about anxiety and depression first.

Anxiety is indicated by excessive worry and overthinking about future events or situations. Sometimes, anxiety is a normal reaction to stress and can even help motivate us, but when it becomes excessive and starts to interfere with daily life, it can turn into an anxiety disorder.

Depression, on the other hand, is like feeling really down all the time. It’s more than just having a bad day; it’s a deep sadness that sticks around and makes it hard to do regular stuff.

Now, back to MADD. It’s basically when you’ve got both anxiety and depression hanging out at the same time, kind of like having two not-so-great roommates crashing on your mental couch. They’re both there, but neither one takes over completely. Some people call it “Anxious Depression.

Now, you might not find MADD in all the big fancy books that talk about mental health (like the DSM-5), as there has been much debate regarding whether it should be considered a separate diagnosis or if it is merely a component of anxiety and depression.

But get this – research has shown that a whopping 85% of people dealing with depression also have anxiety symptoms. And the reverse is true too—up to 90% of people with anxiety also feel symptoms of depression.

It’s pretty common stuff, especially among teens and adults in the US. So, if you’re feeling like anxiety and depression are teaming up on you, you’re definitely not alone.

Symptoms Of Mixed Anxiety Depressive Disorder 

The symptoms of MADD are a mixture of both anxiety and depression symptoms.

Symptoms of anxiety include:

  • Intense and uncontrollable feelings of worry and fear.
  • Anger and irritability
  • Rapid heart rate
  • Stomach pain,
  • Irritable bowels,
  • Nausea,
  • Muscle tension
  • Lack of focus
  • Panic attacks 

Symptoms of depression include:

  • Persistent feelings of sadness.
  • Hopelessness.
  • Loss of interest in activities once enjoyed.
  • Difficulty sleeping or oversleeping.
  • Lack of motivation and confidence
  • Difficulty concentrating
  • Insufficient desire for sex
  • Low self-esteem, feeling worthless or guilty.
  • Significant weight loss or weight gain (when not dieting) or change in appetite.
  • Recurrent thoughts of death or suicide.

What Causes Mixed Anxiety Depressive Disorder?

There are several factors that are known to be the cause of Mixed anxiety depressive disorder. Let’s discuss these factors. 

1. Genetics

People who have a family history of depression, anxiety, and other mental health conditions are more likely to develop Mixed Anxiety Depressive Disorder (MADD). This is attributed, in part, to genetics playing a role in the development of both depression and anxiety. Research supports the influence of genetics as a contributing factor for both depression and anxiety. Studies have identified specific genes linked to an increased risk of these disorders.

2. Brain Chemistry

When there is an imbalance in brain chemicals such as serotonin and norepinephrine, it also results in anxiety and depression as they lower the mood and increase stress levels. Research shows that changes in the endocrine system and brain chemicals such as serotonin lead to many mental health disorders, like depression and anxiety disorders, mood disorders, autism, schizophrenia, and attention deficit hyperactivity disorder (ADHD). 

3. Stressful Life Events

Life can get pretty tough sometimes, right? Well, when really stressful things happen, like going through a traumatic experience or dealing with a big change in life like a breakup, losing a job, or facing money problems, it can trigger mixed anxiety depressive disorder. 

For example, a survey was done on college students. It found that having a lot of pressure from school and feeling uncertain about future job opportunities made them feel anxious and depressed. So, stressful events like these can really mess with your mental health and bring on mixed anxiety and depression symptoms.

4. Substance Abuse

Sometimes, when we’re feeling anxious or down, we might turn to drugs or alcohol to try and feel better. But the truth is that relying on these substances can actually make things worse in the long run. Research has shown that things like smoking cigarettes can be linked to feelings of depression and anxiety, making it even tougher to deal with. So, things like smoking nicotine, drinking alcohol, or using other drugs might seem like they help at first, but they can mess with our mental health significantly.

5. Medical Conditions

Some medical conditions, such as thyroid problems, anemia, diabetes, or chronic pain, can increase the risk of developing MADD, making an individual more irritable and frustrated.

A research study analyzed and found the symptoms of depression and anxiety in adolescents with type 1 diabetes which shows that diabetes can be the cause of anxiety and depression. 

6. Personality Structure 

Personality structure can be a contributing factor to both anxiety and depression. Personality traits like perfectionism, low self-esteem, and difficulty expressing emotions can also increase the risk of anxiety and depression. People who have an avoidant personality, like avoiding social situations, can exacerbate loneliness and negative emotions, leading to anxiety and depression. 


Some medications can cause anxiety and depression.

  • Stimulants: Medications that are used for ADHD, like Adderall and Ritalin, can sometimes cause jitteriness, insomnia, and racing thoughts, which can lead to anxiety symptoms.
  • Blood pressure medications: these medications can cause fatigue and tiredness, which might lead to depression.
  • Hormonal medications: Birth control pills, thyroid medications, and medications for other hormonal imbalances can sometimes affect mood and can lead to anxiety and depression.
  • Pain medications: Opioids and other pain medications can have mood-altering side effects, especially at high doses.

We read above all the factors that cause anxiety and depression. Now it’s time to talk about how anxiety and depression impact an individual’s life.

Impact Of Mixed Anxiety Depressive Disorder

MADD can have a significant impact on all aspects of life. It includes:

  • People who are experiencing MADD may have difficulty maintaining healthy relationships due to their anxiety and depression symptoms, such as being irritable, withdrawn, or having difficulty trusting others. It may cause conflicts and emotional unavailability in relationships. 
  • MADD impacts work and school life, as people with MADD may have difficulty concentrating, meeting deadlines, and completing tasks. 
  • People who have MADD may avoid social gatherings due to anxiety and fear of negative evaluation. They may also have difficulty making friends or keeping up with existing friendships.
  • MADD can also worsen physical health problems and make it more difficult to cope with chronic illnesses. People with MADD may engage in unhealthy behaviors such as smoking or drinking alcohol to cope with it and this can hurt their health too.

If you are going through a mixed anxiety-depressive disorder, then there are treatments available for it. Below, we are going to discuss the different treatment options for mixed anxiety depressive disorder so read with us. 

Treatment Of Mixed Anxiety Depressive Disorder

Are you going through anxiety and depression at the same time? Don’t worry, as there are many treatment options available for mixed anxiety depressive disorder that you can use to manage this disorder.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy helps you identify and change negative thought patterns and behaviors that are the reason for mixed anxiety and depressive disorder. CBT is one of the most effective treatment options for depression and anxiety.

Interpersonal Therapy (IPT)

The role of interpersonal therapy is that it focuses on improving relationships with others. IPT is based on the belief that our relationships with others have a significant impact on our mental health. Difficulties in our relationships can contribute to symptoms of depression, anxiety, and other mental health conditions. So, it focuses on solving interpersonal problems that may be causing stress. 

Mindfulness-Based Cognitive Therapy (MBCT)

MBCT helps and teaches you how to be more present at the moment and less reactive to your feelings and thoughts. When we are in the present moment, we become less judgmental of our thoughts and emotions. This helps in managing both anxiety and depression.

Behavioral Activation Therapy

Behavioral activation therapy is a powerful therapy for treating mixed anxiety and depressive disorder. In this therapy, individuals are gradually guided to increase their engagement in valued and enjoyable activities to relieve symptoms like social withdrawal, isolation, and a lack of interest in activities. 

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy helps in accepting anxiety, depression, sadness, and other emotions as part of life, so there is no need to fight these feelings, but by accepting them, it will be easier to let go of the distress related to anxiety and depression. 


Antidepressants and anti-anxiety medicines can help treat anxiety and depression by increasing chemicals in the brain that play a role in regulating mood. There are many antidepressants and anti-anxiety medicines available, such as fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil, Pexeva), and sertraline (Zoloft).

According to the research, Agomelatine has been shown to effectively reduce symptoms of both anxiety and depression. 

If you are going through mixed anxiety-depressive disorder, then you should seek professional therapy, as anxiety and depression in combination make it difficult to treat on your own. 

Tips For Managing Mixed Anxiety Depressive Disorder

There are certain lifestyle factors that you can adopt to manage mixed anxiety and depressive disorders. 

Physical Activity

  • Exercise can help you deal with anxiety and depression. Try to exercise for at least 30 minutes most days of the week. 
  • Spend some time in nature, along with deep breathing, as it can help improve your mood and elevate stress.
  • Consider doing yoga or Tai Chi, as these practices, when combined with physical movements, can be helpful for mixed anxiety depressive disorder.

Healthy Habits

  • Take quality sleep of at least 7-8 hours each night. Also, avoid screen time before bed.
  • Eat a balanced and healthy diet that supports your gut health and mental health.
  • Avoid substance abuse and caffeine, as these can worsen anxiety and interfere with sleep.

Mindfulness and Relaxation Techniques

  • Practice meditation, as mindfulness meditation can help focus on the present moment and reduce negative thoughts.
  • Do relaxation techniques such as progressive muscle relaxation, guided imagery, or listen to calming music.

Social Support

  • Spend time with your loved ones, supportive friends, and family who can listen to you without judgment and offer help.
  • Join a support group for Mixed Anxiety Depressive Disorder, as it can provide invaluable support and a sense of belonging. Sharing experiences and receiving encouragement from others who understand your struggles can offer hope and reassurance.
  • Consider talking to a therapist, as they can help you learn coping mechanisms and create a proper treatment plan.

Self-Help Books

Self-help books can also aid with treating anxious depression. Let’s find out some impactful self-help books that can assist us in dealing with anxiety and depression.

1. The Anxiety, Worry, and Depression Workbook

This book is by Jennifer L. Abel. It consists of 65 exercises, worksheets, and tips to let go of anxiety and depression and cope with them.

2. Eat to Beat Depression and Anxiety: Nourish Your Way to Better Mental Health in Six Weeks

This book is written by Drew Ramsey. Eat to Beat Depression gives us information and suggestions on which type of nutrition we can take to beat depression and anxiety, as our gut has a great impact on our mental health. 

3. You’re Not Alone: The Only Book You’ll Ever Need to Overcome Anxiety and Depression

Zachary David wrote this book. From this book, you will get the right tools to overcome feelings of anxiety and depression. It also teaches you techniques to promote calm and happiness.


In this blog post, we shed light on the comorbidity of anxiety and depression, also known as ‘Mixed anxiety depressive disorder’. 

Anxiety and depression are the most prevalent mental disorders worldwide and when they occur together, they need proper professional treatment to overcome. 

Mixed anxiety depressive disorder is a complex and challenging condition as it is a combination of both anxiety and depression, which makes it a unique and often misunderstood disorder.

If you doubt that you are going through anxiety, depression, or mixed anxiety depressive disorder, then you should seek help from a professional therapist, as they can give you proper strategies to overcome and deal with it.


Is MADD serious?

Yes, MADD is a serious health condition, as it is a combination of depression and anxiety that can cause significant stress and impact daily life. It can also increase the risk of suicide. 

What is the cause of mixed anxiety depressive disorder?

Mixed anxiety depressive disorder can be caused by family history, brain chemistry, certain traumatic and stressful life events, medical conditions, and substance abuse. It is not caused by a single condition but many factors are involved in causing it.

What is Type 3 mixed anxiety and depression?

Type 3 mixed anxiety and depression is a mixture of symptoms of both anxiety and depression. In this condition, one type may predominate over the other at any point but both symptoms are present regularly.

Is MADD curable?

Yes, MADD is a treatable condition. Its treatment involves a combination of psychotherapy, such as CBT, Mindfulness therapy and Interpersonal therapy. Plus, medications can also be helpful to treat it.