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Cognitive Treatment for Anxious Depression

Updated: Mar 17, 2022

Cognitive Treatment for Anxious Depression


Over the last several years, research has recognized anxious depression as a subtype defined by distinct features and challenges. Individuals with anxious depression may present with more severe symptoms and often struggle to get the same symptom relief as those with non-anxious depression.


Cognitive behavioral therapy for anxiety and depression is an effective research-backed treatment. And because this therapy can improve symptoms from both disorders, it is also helpful for treating anxious depression.


Read on to learn more about the efficacy of cognitive behavioral therapy (CBT). Then continue to understand the differences between non-anxious and anxious depression. And finally, review how CBT can improve outcomes for anxious depression.

The Efficacy of Cognitive Behavioral Therapy


CBT is effective for both anxiety and depression symptoms. This type of therapy addresses unhelpful thought patterns and behaviors while promoting positive coping skills. Anxiety and depression symptoms can arise for various reasons, and both disorders have some common symptoms.


Because CBT can treat more than one disorder, it is considered a transdiagnostic treatment. This makes CBT a logical and effective choice for depression with anxious distress, a distinct subtype of depression that is often less responsive to treatment than other depressive or anxiety disorders. Still, CBT improves many of the same symptoms and risk factors effectively, regardless of the disorder.


Symptoms of Depression and Anxiety Treated with CBT

Rumination is a symptom that can fuel anxiety symptoms and plays a significant role in a person’s vulnerability to depression. Rumination-focused CBT has been shown to reduce anxiety symptoms and improve depression treatment outcomes.

Insomnia is one of many sleep disturbances that can occur with both depression and anxiety disorders. CBT can help address the mental and emotional distress causing these disturbances.

Neuroticism is a common personality trait among people who develop depression and anxiety symptoms. Mindfulness-based cognitive therapy has been shown to reduce the negative impact of neuroticism. Neuroticism is linked with many mental health disorders, making this a promising development.

Adverse childhood experiences and trauma are risk factors for both anxiety and depression disorders, leading to distorted thoughts and upsetting beliefs. CBT is effective for helping people cope with these experiences.


Key Differences Between Non-Anxious Depression and Anxious Depression


Clinical depression, also referred to as major depression, is a complex yet commonly diagnosed mental health condition featuring a low mood, loss of interest in activities, or both. And if anxious distress is not present, it is considered non-anxious depression.

Anxious depression includes all the main features of major depression with the additional presence of anxious distress. These symptoms include feeling keyed up, restlessness, difficulty concentrating due to worry, fearing something awful happening, and fearing loss of control.


Anxious depression tends to have a more debilitating effect on individuals than non-anxious depression. Some personal characteristics, such as high neuroticism, can make an individual more vulnerable to anxious distress. Additionally, individuals in diverse populations have a higher chance of developing anxious depression, illustrating how disadvantaged groups face more disparity with mental health issues.


Improving Anxious Depression Treatment Outcomes with Cognitive Treatment


Anxious depression has a reputation as being less treatable than non-anxious depression. However, this perception may change as research reveals more leverage points for improving symptoms impacted by anxious distress. Here are some ways CBT can improve anxious depression treatment outcomes based on its distinct features.

Discovering the most modifiable differences between anxious depression and non- anxious depression may help clinicians target treatment more effectively.

Using an individual’s preferred therapy positively impacts treatment response for non-anxious depression and may have a similar potential for anxious depression.


Outcomes for anxious depression are slightly poorer than for non-anxious depression, but not by a significant amount. Potentially, a longer treatment period or more therapy sessions may be enough to bridge the gap.

Retargeting CBT toward anxiety symptoms instead of depression symptoms may have a more significant impact on the outcome.

Cognitive Behavioral Therapy for Anxious Depression


Anxious depression is a relatively new subtype, but ongoing research continually adds to the knowledge base. With a customized approach, cognitive behavioral therapy for anxiety and depression makes anxious depression more manageable.


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