Feeling hopeless and helpless. When anxiety symptoms coexist with depressive disorder

Among patients with psychiatric disorders, a significant number have a depressive disorder and coexisting symptoms of anxiety. The overlapping conditions present physicians with a confusing array of symptoms that, in the past, has made diagnosis and therapy difficult. Although the anxiety symptoms may not be sufficient to meet diagnostic criteria for an anxiety disorder, they can have a profound influence on the severity of and prognosis for the depressive illness. To clarify diagnosis when symptoms of both depression and anxiety are present, it is important to consider elements such as predominant mood, sleep patterns, psychomotor signs, and suicidal ideation, which serve to differentiate between the two disorders. Once a diagnosis is established, appropriate use of pharmacotherapy (especially antidepressant agents that have anxiolytic side effects) and psychotherapy can help relieve symptoms and lead to a favorable outcome.