Why Mixed Anxiety-Depressive Disorder and Addiction Often Go Hand-in-Hand

Addiction and mental health disorders, like mixed anxiety-depressive disorder, often co-occur. Approximately 20 percent of Americans with these mental health disorders also struggle with substance use disorder, compared to around 2 percent of the general population.

There are a number of factors that contribute to this increased risk of comorbid substance use disorders and mixed anxiety-depressive disorder.

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What is Anxiety-Depressive Disorder?

Mixed anxiety and depressive disorder (MADD) is usually characterized by symptoms of anxiety and depression of equal intensity. According to experts, the symptoms alone do not meet the requirements for a singular diagnosis of either an anxiety disorder or a depressive disorder.

The World Health Organization (WHO) advises that a person can struggle with anxiety depressive disorder but they could actually be experiencing anxiety and depression. It’s important to speak to a medical specialist who can advise which of these diagnoses is more applicable in your case.

Mixed anxiety- depressive disorder can be quite disruptive, impairing a person’s day-to-day life.

In addition to a reduction in quality of life, a doctor will look for other specific criteria to make a diagnosis, including:

  • Significant changes to mood (sadness, anxiety, or irritability) for four weeks or longer
  • Difficulty concentrating, insomnia, feeling tearful and hopeless, and lacking energy
  • Social impairment, meaning that you may want to withdraw from socializing

The doctor may also check that symptoms are not a side effect of medication before making a diagnosis and going on to advise you about treatment options.

What Causes Mixed Anxiety-Depressive Disorders?

Experts say that there are a number of risk factors for MADD that are genetic, environmental, and trauma-related.

The risk factors for mixed anxiety-depressive disorders are genetic, environmental, and trauma-related.

Specifically, these risk factors may include:

  • Significant stress
  • Chronic illness
  • A lack of social support
  • Money worries
  • Gender (women are more likely to develop MADD than men)
  • Childhood trauma
  • A family history of mental health disorders, including addiction

What is Substance Use Disorder?

Substance use disorder (SUD) is a mental health disorder that affects a person’s ability to control their substance use, despite the negative consequences. There are various levels of SUD, from mild to moderate and severe.

Substance use disorder (SUD) is a mental health disorder that affects a person’s ability to control their substance use, despite the negative consequences.

The symptoms of SUD include:

  • Excessive alcohol or drug use
  • Social isolation
  • Preferring drinking or using to the activities you used to enjoy
  • Difficulty stopping substance use
  • Changes to physical appearance, such as weight loss/gain, and poor personal hygiene
  • Continuing to use/drink despite missing school or work, or familial obligations
  • Thinking that you don’t have a problem
  • Legal and financial issues

Why Do Mixed Anxiety-Depressive Disorders Co-occur with Addiction?

According to the National Institute on Mental Health, half of individuals with addiction also experience co-occurring disorders, such as:

  • Anxiety disorders
  • Depression
  • Attention deficit hyperactivity disorder (ADHD)
  • Bipolar disorders
  • Personality disorders
  • Schizophrenia

Common co-occurring disorders with SUD include anxiety, depression, ADHD, bipolar, personality disorders, and schizophrenia.

In adolescents, this rate is higher, with 60 percent of teens in community-based treatment programs for addiction also meeting the diagnostic criteria to another mental illness.

What Are the Risk Factors for Anxiety-Depressive Disorder and Addiction?

The risk factors for SUD and co-occurring disorders are:

Genetics

Having a family member with a mental health disorder and/or addiction increases the risk of their child developing these conditions.

Having a Mental Health Disorder

This increases the risk of self-medication with substances and potentially the development of addiction.

Addiction

A substance use disorder can lead to the development of mental health disorders, such as mixed anxiety-depressive disorder.

A substance use disorder can lead to the development of mental health disorders, such as mixed anxiety-depressive disorder.

Drug Use and Mental Health Disorders

These issues, both in childhood and adolescence, can increase the risk of developing co-occurring conditions in adulthood.

Untreated ADHD

Having this issue in childhood can lead to increased risk of addiction.

Trauma

Childhood trauma is a significant risk factor for developing mental health problems and addiction. Traumas in adults such as sexual assault, enduring combat, pandemics and natural disasters, are also a risk factor for developing co-morbidities.

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How Co-occurring Addiction and Anxiety-Depressive Disorders are Treated

When getting help for co-occurring disorders, your doctor will make individual recommendations based on your specific needs. Typically, it is best to treat both disorders simultaneously to ensure that both conditions are effectively managed. In a general sense, these treatments may include:

  • Behavioral therapies, like Cognitive-Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) which work to tackle symptoms of anxiety and depression.
  • Other behavioral interventions include:
    • Contingency Management: Encourages healthy behaviors and provides a reward for practicing those behaviors, such as staying sober, attending a meeting, improving health outcomes.
    • Therapeutic Communities: A type of long-term residential treatment that promotes healthy behaviors.
    • Assertive Community Treatment: a type of community-based mental health support.
  • Behavioral treatments for children and adolescents include:
    • Brief Strategic Family Therapy: works with the family to help improve familial interactions that may lead to and support drug use and mental health disorders.
    • Multisystemic Therapy: works with youth and family members to decrease the frequency and intensity of high-risk behaviors.
    • Multidimensional Family Therapy: involves working with the whole family and the behaviors associated with mental health problems and addiction.
  • Medication: This may include medication-assisted treatment for addiction and medications to treat anxiety and depression.
  • Addiction treatment: This can occur at a facility that has the expertise of treating co-occurring disorders, like addiction and mixed anxiety-depressive disorder.

Behavioral therapies, medication, and addiction treatment can all help treat co-occurring addiction and anxiety-depressive disorders.

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