Illnesses are considered “comorbid” when an individual experiences two or more simultaneously. This concept has become the rule, not the outlier, in many fields of medicine, certainly including psychiatry. The concept of comorbidity is widely acknowledged, but unfortunately is not well understood nor defined. 

In mental health, depression and anxiety are the two most common comorbidities. A number of estimates show that 3 out of 5 of those with anxiety will also experience symptoms of depression and vice versa at a similar rate. 

While the common co-occurrence between depression and anxiety are uncertain, there are several theories. One theory is that the two conditions have similar biological mechanisms in the brain, and therefore they are likely to happen together. Another theory is that they share many of the same symptoms, so people often meet the criteria for both diagnoses (e.g. major depressive disorder and generalized anxiety disorder). Moreover, these conditions result at the same time when an individual is triggered by external stressors. While it is relatively easy for clinicians to recognize one mental illness, it is much more complex to recognize comorbid disease. They must be meticulous to symptoms that could suggest other disorders like bipolar disorder and consider other factors like substance abuse. The modern-day health care system makes this level of assessment complex, but not impossible. 

Unfortunately, most research today tends to focus on individuals with one illness and then conduct treatment accordingly to the research. Consequently, there are multitudes of thoroughly-researched treatments available for mental illnesses, but that is not the case for comorbid illnesses. There is still a lot to be understood in how to recognize and treat comorbid conditions. 

There are many uncertain areas about comorbid depression and anxiety, but this underscores the need for precise assessment. When depression and anxiety co-occur, it can often be more difficult to treat. The reason is that both symptoms of depression and anxiety are more persistent and intense when happening simultaneously.  

This signifies that people dealing with both depression and anxiety will need more advanced treatment. Professionals and guardians providing treatment may need trial and error, like combining one treatment onto another to make sure that both underlying conditions are responding. For instance, if antidepressants are helping better a person’s mood, but not their anxiety, the next step could be to implement cognitive therapy into the treatment plan. 

More research is required to completely understand why some individuals experience comorbid conditions and others do not. Until then, it is crucial for those suffering with one, two, or several mental illnesses to reach for help early, and find a provider they can work with to reach their well-being. While it could be more difficult to find the best treatment when dealing with comorbidity, successfully healing is possible. 

Article Citation: Salcedo, B. (2018, January 19). The Comorbidity of Anxiety and Depression | NAMI: National Alliance on Mental Illness. Nami.org. https://www.nami.org/Blogs/NAMI-Blog/January-2018/The-Comorbidity-of-Anxiety-and-Depression

Image Citation: Understanding Depression and Anxiety. (2020, September 28). GeneSight. https://genesight.com/blog/patient/understanding-depression-and-anxiety/