Posted by SLS on March 4, 2006, at 9:20:44
In reply to Question for Racer, posted by cecilia on March 4, 2006, at 2:27:14
> What doctors say that comorbid anxiety and depression are always bipolar? My pdoc said the exact opposite, that depression and anxiety are basically the same thing. I certainly have both, and no signs of being bipolar. Cecilia
Your doctor is more right than those that state that anxiety and unipolar depression are mutually exclusive. The fact is, that many cases of anxiety resolve using the same drugs used to treat depression. There might be some commonalities between the biologies of depression and anxiety. Some people think that they are different expressions of the same disorder.
Sometimes, medical people, like real people :-), are very polar in their thinking - "all or nothing", "either or". It is possible that anxiety as a symptom of a cluster of depressive symptoms is statistically more prevalent in bipolar disorder, but it seems that it does present as a symptom of unipolar depression as well. In addition, anxiety as a symptom of depression is conceptually different from having anxiety be an expression of an anxiety disorder comorbid with a depressive disorder. Besides - even if there is no abnormal biological substrate for the overrepresentation of anxiety, just being asked to perform a task while severely depressed can produce anxiety as a reaction.
To conceptualize psychiatric disorders in a way that yields effective therapeutics often requires multidimensional thinking and problem-solving.