Current treatment options for anxiety comorbid with depression are similar to those for anxiety disorders and non-anxious major depressive disorder. Deep TMS offers a new non-medication, noninvasive option that addresses some of the limitations of traditional treatment methods.

Deep TMS: Deep Transcranial Magnetic Stimulation is a noninvasive treatment that utilizes magnetic pulses to safely and effectively regulate the neural activity of target brain structures. Deep TMS has many advantages over traditional treatment options – no systemic side effects common to medication, no anesthesia or recovery period, and proven efficacy for treatment-resistant patients.

Psychotherapy: Several forms of talk therapy have been shown to be effective in treating anxious depression. Cognitive-Behavioral Therapy (CBT) shows the patient how to replace negative thoughts with productive patterns of thoughts and actions. Interpersonal Therapy (IPT) addresses issues in current relationships to reduce anxiety and depression symptoms. Problem-Solving Therapy enables patients to better manage stress through identifying barriers, developing creative solutions, and making effective decisions. Psychotherapy requires significant time commitment and may not be sufficient alone when faced with more severe anxious depression.

Psychopharmacology: Several classes of medication have been shown to successfully treat both depression and anxiety symptoms. They include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). Studies have noted, though, that patients with anxious depression often do not experience sustained symptom improvement after initial treatment successes and have a greater risk of side effects such as weight gain or sexual dysfunction.

ECT: Electroconvulsive therapy induces a brief set of seizures that stimulate the brain’s neural activity. ECT has been found to help alleviate severe depression, but it’s impact on anxiety is debated with some studies showing limited improvement and others showing exacerbation of symptoms. ECT requires full sedation under anesthesia and presents potential side effects such as nausea, confusion, and short-term memory loss.

Lifestyle Changes to Protect Against Anxious Depression: Stress-reduction habits such as improved sleep habits, better diet, and frequent exercise may be beneficial in reducing symptoms of anxious depression. In addition, avoidance of alcohol, drugs, and tobacco is valuable as they may worsen symptoms and can negatively impact other treatment with therapy, medication, or Deep TMS. Lastly, social support groups can provide an effective network to mitigate anxiety and depression.