Comorbid Conditions: The Relation Between Depression and Anxiety

In medicine, the term Comorbid Conditions is used to refer to the presence of one or more additional diseases that are either concomitant or concurrent with a primary disease or health disorder. So basically, when an individual has a disease and then acquires an additional disease that then co-exists with the primary disease. Comorbid conditions are usually associated with mental disorders.

Facts About Comorbid Conditions

  • A comorbid condition is a disease that a patient has in addition to a pre-existing condition. It is not part of the first and sometimes major disease.
  • A comorbid condition is not caused by another disease but is a result of another disease or condition
  • In the case of a migraine, migraine Disease does not cause the comorbid condition. Although each condition is present in a single patient, each is separate and not related to the other.
  • Comorbid conditions don’t have to be the cause of the other.  It may mean there is something happening in the patient that makes it more likely for them to suffer each of the comorbid conditions however.
  • That being said, some comorbid conditions can influence or make each other worse or more extreme.
  • Sometimes treatment of one condition may exacerbate or worsen the other disease.
  • In other instances, treatment of one comorbid condition may also help heal or lesson the other condition.

Comorbid Conditions : Depression and Anxiety

One of the more prevalent pairs of comorbid conditions is depression and anxiety. Patients that usually suffer from depression are more likely to suffer from anxiety as well. Approximately 85% of patients with depression also experience significant symptoms of anxiety as well as other disorders like panic disorder, generalized anxiety disorder, and social phobia.

“The National Comorbidity Survey Replication 1 reported that in a 12-month period, the prevalence for an anxiety disorder was about 18%, and for a mood disorder, it was 9.5%. Lifetime prevalences for any anxiety disorder and MDD were approximately 29% and 16.6%, respectively.4 Assuming a (perhaps conservative) 50% comorbidity rate, between 5% and 9% of the adult population has comorbid depression-anxiety in a 12-month period” Psychiatric Times

In the medical field, the issue of anxiety of depression has had some sort of controversy as to how they should be diagnosed. Both conditions have an overlap of symptoms that makes diagnosis, research, and treatment particularly difficult. Research has found that there is genetic and neurobiological similarities in patients that have depressive disorders and those that have anxiety disorders.

For example, people that have anxiety disorders are often clinically depressed and also show symptoms of panic disorder, generalized anxiety disorder, and social phobia. Research has also shown that comorbid depression occurs in up to 90% of patients with anxiety disorders. Infact if  patient has depression, there is a more likely chance that they already have or will develop depression, and vice versa.

Due to the high rates of comorbid depression and anxiety, there has been more focused research on coming up with treatments and medication that tackles both. One importance of identifying comorbid conditions is that the presence of a comorbidity could hinder treatment of the primary disease. Depressed patients with comorbid disorders do not respond well to treatment such as therapy or have less positive treatment outcomes.

One of the best ways to deal with comorbid conditions is an early detection of the condition. With early detection, the right kind of medication can be prescribed to tackle both diseases:

“Antidepressant medications, including the selective serotonin reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors, are highly effective in the management of comorbid depression and anxiety”

Are Comorbid Conditions Chronic?

Chronic diseases are usually disease that a quite serious in nature and often lead to death if not treated. Some examples of chronic disease are  arthritis, cardiovascular disease such as heart attacks and stroke, cancer such as breast and colon cancer, diabetes, epilepsy and seizures, obesity etc. In the medical industry, there is a lot of focus on chronic diseases and how they can be cured as they are some of the leading cause of death among patients.

Forty-five percent of Americans (133 million) have at least one chronic condition. Chronic diseases are responsible for seven out of 10 deaths in the U.S., killing more than 1.7 million Americans each year. More than 75 percent of the $2 trillion spent on public and private healthcare in 2005 went toward chronic diseases. Fighting Chronic Disease

Risk factors and Prognoses of Comorbid Conditions

Though there exists research that explore the risk factors associated with comorbid depression and anxiety, there is not a lot of interest on the topic in the healthcare industry. The crux of the matter is that the high rate of comorbidity indicates that the simple occurrence of one disease state should be considered a predisposing factor for the development of the other. In addition to this, external factors such as social difficulties, psychosocial situations etc all act as risk factors that could trigger a comorbidity. In addition to external triggers, genetics also play a role.

Familial/genetic studies reported different results, partly determined by the anxiety disorder under consideration For example, MDD and GAD appear to be related to the same genetic factors, while MDD and PD are familially independent.

Gender also plays a role in some situations. Women in general are at a higher risk of developing one or both conditions than men. These factors combined, can be used to identify a possible occurrence of a comorbidity and lead to proactive measures being taken for the ultimate goal of providing better care and improving population health.