Depression With Anxious Distress vs. Depression Without Anxious Distress

Anxious vs. Non-Anxious Depression

Depression is a very treatable condition, but the presence of anxious distress makes symptom relief more challenging. This combination is called anxious depression, a relatively new subtype of major depressive disorder. Anxious distress is more than just occasional feelings of worry or fear—it can cause an individual to feel persistently tormented and tense.

Read on to compare depression with anxious distress vs. depression without anxious distress. Learn the essential features of non-anxious major depression. Then compare with anxious depression to understand the distinctions.

Depression without Anxious Distress

Major Depressive Disorder (MDD) is a mood disorder that negatively impacts an individual’s emotions, thoughts, and physical health.

A persistently low mood or a loss of interest in activities is present for at least two weeks, a change that is disruptive and distressing. An individual must experience at least five symptoms during this period.

An MDD Diagnosis Must Include One or Both of the Following:

• Loss of interest or pleasure in activities.
• Low or depressed mood most of the time.

Other common symptoms include:

• Sad or low mood.
• Loss of interest or enjoyment in most activities.
• Feeling guilty or worthless.
• Negative thinking.
• Rumination.
• Change in appetite.
• Sleep disturbance.
• Observable restlessness.
• Observable slowed movement or speech.
• Lack of concentration and trouble making decisions.
• Thoughts of suicide and death.

Depression with Anxious Distress

Research studies suggest that between 54 and 78% of individuals with major depressive disorder also experience anxious distress, emotional anguish, and suffering due to major depression.

At Least Two of the Following Five Symptoms of Anxious Distress Must Be Present

• Feeling keyed up or tense.
• Feeling unusually restless.
• Difficulty concentrating because of worry.
• Fear that something awful might happen.
• A feeling that one might lose control of themselves.

Impact of Symptom Severity

Individuals with anxious depression cope with more severe symptoms than those with non-anxious depression. The heavy strain these symptoms impose on their life is evident in several ways.

• Individuals with anxious depression display more harm avoidance, a personality trait associated with pessimism, worrying, and becoming easily fatigued.
• These individuals are also more likely to seek help than those with non-anxious depression but less responsive to treatment.
• Depression with anxious distress is associated with more functional impairment with relationships, work, home life, and social situations.
• Anxious depression is associated with more suicidal ideation and more suicide attempts than non-anxious depression.

Neurobiological Features

Several distinct brain structures have been linked with anxious depression, most notably in regard to abnormal volume of gray matter. This may be distinctive to anxious depression, possibly explaining the differences between anxious and non-anxious depressive symptoms. Brain regions associated with emotional regulation and sensory processing seem to be significantly affected by these abnormalities.

Genetic and endocrine factors have been linked to poorer treatment response and vulnerability to anxious depression. Asymmetry between brain hemispheres reflects poorer functioning in the right frontal lobe and is associated with anxiety. This asymmetry may also reflect the dysfunction seen in anxious depression.

Physical Impact

Depression with anxious distress has a significant impact on physical health. An individual often has worse emotional and physical functioning, including more physical illness, higher rates of insomnia, and a higher risk of cardiovascular disease. Also, individuals do not stay well for as long with antidepressant treatments and bear a greater side effect burden.

Demographic Factors

Anxious depression is more likely for individuals within specific characteristics and populations. These differences are associated with life situations that are more disadvantaged and stressful, adding to an individual’s vulnerability to anxious distress and depression.

Anxious Depression is Linked with the Following Demographic Factors:

• Women, specifically African American women.
• Individuals who are married, divorced, or widowed but not single.
• Hispanic ethnicity.
• Lower education level.
• Unemployment.
• Lower socioeconomic status.
• Later onset of depression.
• History of trauma or abuse.
• Parents with multiple mental health disorders, including mania.

Depression with and without Anxious Distress

Comparing depression with anxious distress vs. depression without anxious distress, it is clear that research will be critical moving forward. As diagnostic methods improve and effective treatments are recognized, clinicians will have more tools to help individuals with this unique condition.